The receiver operating characteristic curve indicated a cut-off point of -3 points for LCADLtotal (sensitivity 51%, specificity 82%; P=0.01) and -4 points for LCADL%total (sensitivity 56%, specificity 82%; P=0.04). CONCLUSIONS The present findings suggest -3 points and -4 points as the MIDs for LCADLtotal and LCADL%total, respectively. CLINICAL TRIAL REGISTRATION NUMBER ClinicalTrials.gov NCT03251781. OBJECTIVES To explore the feasibility of delivering and evaluating a web-based walking intervention for people with long term musculoskeletal conditions (LTMCs), to determine its acceptability and the feasibility of conducting a definitive trial. DESIGN Prospective randomised feasibility study, with blind outcome assessment at baseline, 3 and 6 months. SETTING Hospital based physiotherapy service. PARTICIPANTS Forty one adults referred for assessment and advice for any mild/moderate LTMCs. doing less then 120minutes of moderate intensity activity per week. INTERVENTIONS Participants randomised to 1. Usual care one usual physiotherapy advice and assessment session, including setting a physical activity goal and one follow up session (8 weeks). 2. "Walk30×5" session one, usual care plus intervention of walking programme. Participants were shown the website and podcasts and practiced how to use them. One follow up session (8 weeks).  https://www.selleckchem.com/products/l-alpha-phosphatidylcholine.html  OUTCOME MEASURES Primary timed six minute walk test (T6MWT). Secondary step count, self-reported pain, fatigue, mood, self-efficacy, happiness, objective blood pressure, peak expiratory flow rate, and self-report and accelerometer measured physical activity. RESULTS Recruitment target achieved. No adverse events occurred. Adherence was high and the intervention acceptable. Loss to follow up n=3 (7%) at 3 months, n=8 (20%) at 6 months. T6MWT and step count proved suitable outcomes, unlike accelerometry. Estimated sample size for a definitive trial is 216. CONCLUSIONS "Walk30×5" is ready for evaluation in a future, appropriately powered (n=216), phase III trial. If effective, the intervention will provide a cheap, highly accessible intervention to enable people with mild/moderate LTMCs to achieve UK physical activity guidelines. CLINICAL TRIAL REGISTRATION NUMBER ISRCTN78581097. Crown All rights reserved.OBJECTIVES Gait disturbance and impaired balance lead to a greater risk of falls and hip fractures for people with dementia. Physiotherapists play an important role in multidisciplinary dementia care. This study aimed to explore physiotherapists' experiences of dementia care and sought to identify their dementia-specific educational needs. DESIGN Qualitative design, using focus group interviews. SETTING Primary care and secondary care physiotherapy services in the Republic of Ireland. PARTICIPANTS Six focus groups with thirty-two physiotherapists, working in community care and hospital settings. RESULTS Physiotherapists described a significant dementia-related workload. Challenges to care included absence of a formal diagnosis, clinical uncertainty, scarcity of resources, physical working environment and the assessment of rehabilitation potential. Dementia care was enhanced by the involvement of family members and by collaboration with other allied healthcare professionals. Participants expressed a wish to receive further dementia training and clear evidence-based physiotherapy guidelines. Identified areas of educational need included enhanced communication techniques, use and interpretation of cognitive screening tools, sub-typing of dementia, and ethical issues in dementia care. CONCLUSIONS Our findings indicate that physiotherapists remain challenged by complex aspects of dementia care. Tailored dementia training for physiotherapists should be developed, focusing on their educational needs. Delivery of training should incorporate interactive case-based activities and interprofessional education with other allied healthcare professionals. OBJECTIVES The Getting it Right Addressing Shoulder Pain (GRASP) trial is a large-scale, multicentre, 2×2 factorial randomised controlled trial investigating clinical and cost-effectiveness of a progressive exercise programme versus best-practice advice, with or without corticosteroid injection, for treating people with rotator cuff disorders. Here we describe the development, implementation and details of the physiotherapy-led interventions. METHODS Medical Research Council guidance for developing complex interventions were used, taking into account clinical guidelines, expert and patient opinion, research evidence, current practice variation, and deliverability. A stakeholder meeting of 26 experts, clinicians, researchers, and patient representatives was used to design key components of the interventions. Stakeholders prioritised strengthening posterior rotator cuff muscles and using practical, easy-to-do exercises. The interventions were designed to be deliverable across the UK National Health Service. RESOBJECTIVE To evaluate the impact of combining nebulised hyaluronic acid plus hypertonic saline (HA+HS) with oscillatory positive expiratory pressure (oscillatory-PEP) on sputum expectoration and related symptoms in adults with cystic fibrosis (CF). DESIGN Randomised crossover trial. SETTING Seven centres. PARTICIPANTS Twenty-two outpatients with CF. INTERVENTIONS Usual care (HA+HS followed by autogenic drainage) and combined therapy (HA+HS with oscillatory-PEP followed by autogenic drainage]. Each treatment was performed for 5 days. MAIN OUTCOME MEASURES Sputum expectoration was measured during the nebulisation period (primary outcome), during autogenic drainage and for 24hours post intervention. The Cough and Sputum Assessment Questionnaire (CASA-Q) and its domains (cough symptoms, cough impact, sputum symptoms and sputum impact), the Leicester Cough Questionnaire (LCQ) and lung function tests were used. Tolerance and patient preference were registered. RESULTS Twenty-two participants [mean age 25 (standard deviation 8) years, percentage predicted forced expiratory volume in 1second 67 (22)] were recruited. Combined therapy promoted greater sputum expectoration than usual care during the nebulisation period median difference 1.8ml [95% confidence interval (CI) 0.2-6.2]. Both treatments led to similar expectoration during autogenic drainage and for 24hours post intervention. Combined therapy led to a greater improvement in the sputum symptoms domain [6.7 points (95% CI 3.3-13.3] and total CASA-Q score [2.4 points (95% CI 0.1-9.3)] compared with usual care. No differences in LCQ score or lung function were observed. Fewer adverse events were reported using combined therapy, which was selected as the preferred intervention. CONCLUSIONS Combined nebulisation increased immediate sputum expectoration, improved sputum symptoms and reduced adverse events compared with usual care in patients with CF. CLINICAL TRIAL NUMBER NCT02303808.