Physiotherapy最新文献

{"title":"‘A challenge to my professional identity’- resisting the shift from over-management to self-management for back pain within an implementation trial: a qualitative study","authors":"Ron Feldman , Tamar Pincus , Noa Ben Ami","doi":"10.1016/j.physio.2024.101424","DOIUrl":"10.1016/j.physio.2024.101424","url":null,"abstract":"<div><h3>Objective</h3><div>The Enhanced Transtheoretical Model Intervention (ETMI) is based on behavioral models and focuses on guiding Chronic Low Back Pain (CLBP) patients to self-manage symptoms and engage in recreational physical activity. While there is promising evidence that ETMI benefits patients, it is unclear how challenging it might be to implement widely. This investigation focused on the perceptions of physiotherapists trained to deliver ETMI for CLBP.</div></div><div><h3>Design</h3><div>A Qualitative study comprised of semi-structured interviews (July to November 2023). Interviews were audio-recorded, transcribed, coded, and analyzed thematically by two independent researchers.</div></div><div><h3>Setting</h3><div>Data were obtained as part of a large implementation study evaluating the uptake and impact of ETMI amongst physiotherapists in a large public healthcare setting.</div></div><div><h3>Participants</h3><div>22 physiotherapists trained to deliver the ETMI approach and chose to use it with at least one patient.</div></div><div><h3>Results</h3><div>While physiotherapists acknowledged the evidence base behind ETMI and the clarity of the approach, they struggled to adapt it to routine delivery. Exploration of the reasons for this identified an overarching meta-theme, ‘A challenge to my professional identity’, and three main themes consisting of 1) interventions such as ETMI contradicted my training. 2) I am ambivalent/ do not accept evidence that contradicts my habitual practice, and 3) I am under-skilled in psychological and communication skills.</div></div><div><h3>Conclusion</h3><div>This study highlights the reluctance of physiotherapists to implement evidence-based interventions such as ETMI, which fundamentally challenge their traditional practice and therapeutic identity. The shift from over-management by experts seeking cures to supporting self-management was not palatable to physiotherapists. The challenge of embracing a new professional identity must be addressed to enable a successful implementation of the approach.</div></div><div><h3>Contribution of the Paper</h3><div><ul><li><span>•</span><span><div>This study highlights the reluctance of physiotherapists to implement evidence-based interventions such as ETMI, which fundamentally challenge their traditional practice and therapeutic identity.</div></span></li><li><span>•</span><span><div>The shift from overdiagnosis (weak cores, bad postures, unstable back, or disc sliding) and over-management (specific exercises, modalities, or special techniques) by experts seeking cures to support self-management was not palatable to physiotherapists.</div></span></li><li><span>•</span><span><div>The findings could lead to a reevaluation of professional development programs for physiotherapists, with an emphasis on updating skills and knowledge to align with evidence-based practices, ultimately aiming to enhance the quality of care provided to patients.</div></span></li></ul></di","PeriodicalId":54608,"journal":{"name":"Physiotherapy","volume":"125 ","pages":"Article 101424"},"PeriodicalIF":3.1,"publicationDate":"2024-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142199839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effects of a prescribed exercise programme in people with metastatic breast cancer: a systematic review","authors":"Joyce M.C.V. O’ Riordan ,&nbsp;Ruth McCullagh ,&nbsp;Paul J. Murphy ,&nbsp;Grainne Sheill ,&nbsp;Frances Horgan ,&nbsp;Helen P. French","doi":"10.1016/j.physio.2024.101423","DOIUrl":"10.1016/j.physio.2024.101423","url":null,"abstract":"<div><h3>Objective</h3><div>To synthesise available evidence on the effects of a prescribed exercise programme in People with Metastatic Breast Cancer (PwMBC).</div></div><div><h3>Data sources</h3><div>Medline, Embase, CINAHL, Web of Science and Scopus were searched up to January 2024.</div></div><div><h3>Study selection</h3><div>Randomised controlled trials (RCTs) recruiting PwMBC to an exercise intervention were included. The primary outcome was Quality of Life (QOL). Secondary outcomes included physical performance, muscle health, cancer-related fatigue (CRF) and physical activity (PA).</div></div><div><h3>Study appraisal and synthesis methods</h3><div>Meta-analysis was not possible due to the low number of included studies. We calculated the effect size (ES), with 95% confidence intervals (95% CIs) of individual studies, adjusting for small sample size. Cohen’s criteria for small (0.2 to 0.5), moderate (0.5 to 0.8) and large (&gt;0.8) describe the size of the effect. Risk of bias (ROB) was assessed using the Cochrane (ROB) version 1 tool.</div></div><div><h3>Results</h3><div>Three RCTs (<em>n</em> = 149 PwMBC) were included. Results showed no significant between-group effects in the primary outcome, QOL. Whilst effects in favour of prescribed exercise were observed in CRF (ES 1.3, 95% CI 0.06 to 2.35) and PA (ES 0.83, 95% CI 0.14 to 1.42) in two separate studies, as the lower bound of the 95% CI did not reach Cohen’s threshold, there is considerable uncertainty regarding the treatment effect.</div></div><div><h3>Conclusions</h3><div>There is currently insufficient evidence to support the use of prescribed exercise to improve QOL, physical performance, muscle health, CRF and PA in PwMBC. Further high-quality trials are required to investigate the effectiveness of exercise interventions in PwMBC.</div></div><div><h3>Systematic Review Registration Number</h3><div>PROSPERO CRD42022304528.</div></div><div><h3>Contribution of the Paper</h3><div><ul><li><span>•</span><span><div>Despite guidelines and recommendations on the positive role of exercise, the evidence for prescribed exercise programmes for PwMBC is limited.</div></span></li><li><span>•</span><span><div>This systematic review of three trials found insufficient evidence to support the use of prescribed exercise to improve QOL, physical performance, muscle health, CRF and PA in PwMBC.</div></span></li><li><span>•</span><span><div>Further high-quality, adequately powered trials are required to investigate the effectiveness of exercise interventions on QOL, CRF, PA, physical performance and muscle health in PwMBC.</div></span></li></ul></div></div>","PeriodicalId":54608,"journal":{"name":"Physiotherapy","volume":"125 ","pages":"Article 101423"},"PeriodicalIF":3.1,"publicationDate":"2024-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142199811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Content analysis of current role/job descriptors for Band 5/junior physiotherapists and mapping of these to Physiotherapy Professional standards of practice","authors":"Catherine J. Minns Lowe, Ben Clements, Nicola Heneghan, Karen Atkinson, Reena Patel, Karen Beeton","doi":"10.1016/j.physio.2024.101421","DOIUrl":"https://doi.org/10.1016/j.physio.2024.101421","url":null,"abstract":"","PeriodicalId":54608,"journal":{"name":"Physiotherapy","volume":"2 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142199807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Translating a Clinical Practice Guideline to a Portuguese, Spanish and English Practice Brief to promote exercise therapy for paediatric Charcot-Marie-Tooth disease","authors":"Caroline Soares de Paula ,&nbsp;Gabrielle Donlevy ,&nbsp;Juliana Cardoso ,&nbsp;Kayla M.D. Cornett ,&nbsp;Rachel Kennedy ,&nbsp;Eppie M. Yiu ,&nbsp;Ana Claudia Mattiello-Sverzut ,&nbsp;Joshua Burns","doi":"10.1016/j.physio.2024.101419","DOIUrl":"10.1016/j.physio.2024.101419","url":null,"abstract":"<div><h3>Background</h3><div>Implementing scientific knowledge in clinical practice is a challenge. In this context, the effective dissemination of scientific findings is of utmost importance.</div></div><div><h3>Objective</h3><div>The aim of this study was to develop a Practice Brief in Portuguese, Spanish and English based on a previously published Clinical Practice Guideline to promote safe and effective exercise for children and young people with Charcot-Marie-Tooth disease and related neuropathies (CMT).</div></div><div><h3>Methods</h3><div>The Practice Brief was developed by eight health professionals from Brazil and Australia with English, Portuguese, and Spanish translations. The target audience chosen were the medical and allied health professionals involved in the rehabilitation of paediatric CMT. The content was based on the world first “Clinical Practice Guideline for the management of paediatric Charcot-Marie-Tooth disease” <span><span>[1]</span></span>. The layout of the Practice Brief was designed according to the criteria for the development of educational materials. The disclosure plan for the Practice Brief involves its publication on University and Hospital websites, <span><span>www.ClinicalOutcomeMeasures.org</span><svg><path></path></svg></span> and through social media platforms such as ResearchGate, Instagram, Facebook and Twitter, as well as in print format for CMT patient care centres.</div></div><div><h3>Results</h3><div>The English, Portuguese and Spanish versions of the Practice Brief is organised into six sections about assessment, exercise and physical rehabilitation, of which one is focused on progressive resistance exercises for the foot dorsiflexor muscles.</div></div><div><h3>Conclusion</h3><div>We developed a Practice Brief in three languages (English, Portuguese and Spanish), synthesising the main recommendations for exercise and related rehabilitative therapies for paediatric CMT from a published clinical guideline.</div></div>","PeriodicalId":54608,"journal":{"name":"Physiotherapy","volume":"125 ","pages":"Article 101419"},"PeriodicalIF":3.1,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142417608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do individuals with ankle instability show altered lower extremity kinematics and kinetics during walking? A systematic review and meta-analysis","authors":"Lijiang Luan ,&nbsp;Dominic Orth ,&nbsp;Phillip Newman ,&nbsp;Roger Adams ,&nbsp;Doa El-Ansary ,&nbsp;Jia Han","doi":"10.1016/j.physio.2024.101420","DOIUrl":"10.1016/j.physio.2024.101420","url":null,"abstract":"<div><h3>Objective</h3><div>To determine if individuals with chronic ankle instability (CAI) demonstrate altered lower extremity kinematics and kinetics during walking.</div></div><div><h3>Data sources</h3><div>Relevant studies were sourced from PubMed, Embase, Cochrane Library, Web of Science, EBSCO and PEDro.</div></div><div><h3>Study selection</h3><div>Kinematic and kinetic studies involving joint angle and/or joint moment measured in individuals with CAI were included.</div></div><div><h3>Study appraisal and synthesis methods</h3><div>The Risk of Bias in Non-randomised Studies - of Interventions (ROBINS-I) tool was used to assess literature quality. Weighted mean differences (WMDs) in joint angles and moments between CAI and controls were analyzed as continuous variables.</div></div><div><h3>Results</h3><div>1261 articles were screened, with a final selection of 13 studies involving 729 participants. Compared to non-CAI controls, CAI participants showed significantly greater ankle inversion angle (degree) (WMD: 3.71, 95% CI: 3.15 to 4.27, <em>p</em> &lt; 0.001), hip adduction angle (degree) (WMD: 1.60, 95% CI: 0.09 to 3.11, <em>p</em> = 0.04), and knee valgus moment (N m/kg) (WMD: 0.07, 95% CI: 0.01 to 0.13, <em>p</em> = 0.02) during walking. Additionally, there were no consistent findings or specific altered patterns in other lower extremity joint angles, or moment changes, regardless of the motion plane (sagittal, coronal, horizontal), for CAI compared with controls.</div></div><div><h3>Conclusions</h3><div>This review provides further evidence of altered lower limb kinematics and kinetics in the frontal plane in CAI participants during certain walking phases, which may partially explain the high level of recurrent ankle sprains observed in the CAI population, and support hip abduction and ankle eversion motor control exercises for CAI rehabilitation.</div></div><div><h3>Systematic Review Registration Number</h3><div>Systematic Review Registration Number PROSPERO CRD42023420418.</div></div><div><h3>Contribution of the Paper</h3><div><ul><li><span>•</span><span><div>Individuals with CAI exhibit greater ankle inversion and hip adduction angles during certain phases of walking compared to non-CAI controls.</div></span></li><li><span>•</span><span><div>There may be an increase in the knee valgus moment of individuals with CAI.</div></span></li><li><span>•</span><span><div>Altered lower extremity kinematics and kinetics may be associated with the occurrence of recurrent ankle sprains in CAI.</div></span></li></ul></div></div>","PeriodicalId":54608,"journal":{"name":"Physiotherapy","volume":"125 ","pages":"Article 101420"},"PeriodicalIF":3.1,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141929859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimal days of application of kinesiotaping for the treatment of lumbo-pelvic pain during pregnancy. A systematic review and dose-response meta-analysis","authors":"Joaquín Salazar-Méndez ,&nbsp;Rodrigo Núñez-Cortés ,&nbsp;Iván Cuyul-Vásquez ,&nbsp;Sergio Sazo-Rodriguez ,&nbsp;Joaquín Calatayud ,&nbsp;Eduardo Guzmán-Muñoz ,&nbsp;Anyela Aguayo ,&nbsp;Benjamín Carrasco ,&nbsp;Areli González ,&nbsp;Luis Suso-Martí","doi":"10.1016/j.physio.2024.101418","DOIUrl":"10.1016/j.physio.2024.101418","url":null,"abstract":"<div><h3>Objective</h3><div>To determine the optimal dose and short-term effectiveness of kinesiotaping (KT) on pain intensity and disability in pregnant women with lumbo-pelvic pain.</div></div><div><h3>Data sources</h3><div>MEDLINE (via PubMed Central), CINAHL, Epistemonikos, Scopus, and Web of Science from inception to 21st March 2023.</div></div><div><h3>Study selection</h3><div>We included randomized controlled trials (RCT) conducted on pregnant women with lumbo-pelvic pain treated with KT.</div></div><div><h3>Data extraction</h3><div>The outcomes included pain intensity and disability. ROB-2 and GRADE were used to assess the risk of bias and the certainty of the evidence, respectively. A random effects meta-analysis was performed using the standardized mean difference (SMD) and the corresponding 95% confidence interval (CI). The dose-response association was evaluated using a restricted cubic spline model.</div></div><div><h3>Data synthesis</h3><div>Seven RCTs involving 527 patients were included. Meta-analysis revealed a statistically significant effect in favor of KT on pain intensity (SMD = −1.71; 95% CI = −2.51 to −0.90; <em>P</em> = &lt;0.001) and on disability (SMD = −1.15; 95% CI = −2.29 to −0.02; <em>P</em> = &lt;0.001). The total duration of KT use ranged from 5 to 35 days. It was estimated that a dose of 5–10 days exceeded the minimal clinically important difference (MCID) for pain intensity (mean difference at 10 days = −2.63; 95% CI = −3.05 to −2.22). Low certainty of evidence was identified for both outcomes.</div></div><div><h3>Conclusions</h3><div>In pregnant women with lumbo-pelvic pain, the use of KT for 5 to 10 days produces a short-term reduction in pain intensity that exceeds the MCID, with a low certainty of evidence.</div></div><div><h3>Systematic Review Registration Number</h3><div>Systematic Review Registration Number PROSPERO CRD42023388174.</div></div><div><h3>Contribution of Paper</h3><div><ul><li><span>•</span><span><div>The meta-analysis showed that KT reduces pain intensity and improves disability in women with lumbo-pelvic pain.</div></span></li><li><span>•</span><span><div>A duration of 5 to 10 days of KT is sufficient to exceed the minimal clinically important difference (MCID) for pain intensity.</div></span></li><li><span>•</span><span><div>Studies of high methodological quality with longer follow-up are needed.</div></span></li></ul></div></div>","PeriodicalId":54608,"journal":{"name":"Physiotherapy","volume":"125 ","pages":"Article 101418"},"PeriodicalIF":3.1,"publicationDate":"2024-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141929856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive factors and dose–response effect of rehabilitation for upper limb induced recovery after stroke: systematic review with proportional meta-analyses","authors":"Silvia Salvalaggio ,&nbsp;Silvia Gianola ,&nbsp;Martina Andò ,&nbsp;Luisa Cacciante ,&nbsp;Greta Castellini ,&nbsp;Alex Lando ,&nbsp;Gianluca Ossola ,&nbsp;Giorgia Pregnolato ,&nbsp;Sebastian Rutkowski ,&nbsp;Anna Vedovato ,&nbsp;Chiara Zandonà ,&nbsp;Andrea Turolla","doi":"10.1016/j.physio.2024.101417","DOIUrl":"10.1016/j.physio.2024.101417","url":null,"abstract":"<div><h3>Background and purpose</h3><div>To date, factors with predictive value for upper limb (UL) recovery after stroke are acknowledged, but little is known on clinical features predicting outcome in response to rehabilitation. The purpose of this review is to investigate whether any factor allows identification of Responders to rehabilitation, and whether clinically important recovery of motor function relies on modalities and dose of intervention received, at different times after stroke.</div></div><div><h3>Methods</h3><div>A systematic review with proportional meta-analysis was conducted. Longitudinal single-cohort studies on patients undergoing rehabilitation after stroke were included. Predictive features investigated in the included studies were reported. The primary outcome was the Fugl-Meyer Assessment for Upper Extremity, and effect sizes (ES) of different rehabilitation doses were calculated.</div></div><div><h3>Results</h3><div>Only 6% of the included studies (<em>n</em> = 141) investigated predictive factors. Studies providing more than 30 hours of therapy induced small to large clinical effect (ES from 0.38 to 0.88). Task-oriented approach led to the largest effect, both in the subacute (ES = 0.88) and chronic (ES = 0.71) phases. Augmenting interventions provided higher effect in the chronic rather than subacute phase. Integrity of the corticospinal tract, preservation of arm motor function and specific genetic biomarkers were found to be associated with motor recovery</div></div><div><h3>Discussion and conclusions</h3><div>Trials on motor recovery after stroke should incorporate analysis of factors associated with rehabilitation outcomes. Task-oriented interventions should be delivered more than 30 hours (high dose) to induce the greatest improvement.</div></div><div><h3>Systematic Review Registration Number</h3><div>Systematic Review Registration Number PROSPERO CRD42021258188.</div></div><div><h3>Contribution of the Paper</h3><div><ul><li><span>•</span><span><div>Demographic characteristics of patients are not associated with rehabilitation-induced upper limb motor outcomes after stroke.</div></span></li><li><span>•</span><span><div>Brain lesion characteristics and residual motor function were found to be the main potential predictive factors of rehabilitation-induced upper limb recovery after stroke.</div></span></li><li><span>•</span><span><div>Task-oriented interventions had the most significant clinical effect, both in the subacute and chronic phases after stroke.</div></span></li><li><span>•</span><span><div>Augmenting interventions are useful in the chronic phase after stroke, if delivered for a minimum of 10 hours.</div></span></li><li><span>•</span><span><div>Priming interventions are more useful in the chronic phase after stroke when 10 to 30 hours of treatment are delivered.</div></span></li></ul></div></div>","PeriodicalId":54608,"journal":{"name":"Physiotherapy","volume":"125 ","pages":"Article 101417"},"PeriodicalIF":3.1,"publicationDate":"2024-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141929864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comments on: “Efficacy of aquatic vs land-based therapy for pain management in women with fibromyalgia: a randomised controlled trial”","authors":"Fatima Abdul Rashid, Ram Prasad M","doi":"10.1016/j.physio.2024.101414","DOIUrl":"https://doi.org/10.1016/j.physio.2024.101414","url":null,"abstract":"","PeriodicalId":54608,"journal":{"name":"Physiotherapy","volume":"76 1","pages":""},"PeriodicalIF":3.3,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141929858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editors","authors":"","doi":"10.1016/S0031-9406(24)00417-6","DOIUrl":"10.1016/S0031-9406(24)00417-6","url":null,"abstract":"","PeriodicalId":54608,"journal":{"name":"Physiotherapy","volume":"124 ","pages":"Page i"},"PeriodicalIF":3.1,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0031940624004176/pdfft?md5=543818b87123e59e2da6a1aeef94d28c&pid=1-s2.0-S0031940624004176-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141949568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers, facilitators and referral patterns of general practitioners, physiotherapists, and people with osteoarthritis to exercise","authors":"Avantika Bhardwaj ,&nbsp;Peter Hayes ,&nbsp;Jacqui Browne ,&nbsp;Stacey Grealis ,&nbsp;Darragh Maguire ,&nbsp;John O’Hora ,&nbsp;Ian Dowling ,&nbsp;Norelee Kennedy ,&nbsp;Clodagh M. Toomey","doi":"10.1016/j.physio.2024.101416","DOIUrl":"10.1016/j.physio.2024.101416","url":null,"abstract":"<div><h3>Background</h3><div>Barriers and facilitators of general practitioners (GPs), physiotherapists (PTs), and people with hip and knee osteoarthritis (PwOA) may influence uptake of and referral to guideline-based exercise treatments for OA.</div></div><div><h3>Objective</h3><div>To identify barriers and facilitators of GPs, PTs and PwOA to uptake of and referral to exercise treatments for OA.</div></div><div><h3>Methods</h3><div>An online survey was circulated to GPs, PTs, and PwOA in Ireland from March to September 2021. Data were collected on demographics, barriers and facilitators, and referral patterns to exercise treatments for OA. Frequency distributions were used to illustrate demographics, barriers and facilitators, and referral patterns to exercise treatments for OA.</div></div><div><h3>Results</h3><div>388 stakeholders responded (GPs = 148; PTs = 154; PwOA = 86). Barriers and facilitators were related to (1) stakeholder (e.g., patient tiredness and fatigue), (2) healthcare setting (e.g., appropriate referrals from GP or other sources), and (3) treatment (e.g., low-cost community-based exercise programmes) factors. While 91% of GPs would refer PwOA to physiotherapy if no barriers existed, only 60% would in their current practice. Only 33% of PwOA reported receiving a GP referral to physiotherapy.</div></div><div><h3>Conclusion</h3><div>Stakeholder, healthcare setting and treatment barriers and facilitators of GPs, PTs, and PwOA influence uptake of and referral to exercise treatments for OA. Future strategies Future strategies addressing these factors may improve implementation of guideline-based management for OA.</div></div><div><h3>Contribution of the Paper</h3><div><ul><li><span>•</span><span><div>Despite an established evidence-based consensus, uptake of and referral to exercise as a first-line treatment for OA is suboptimal, partly influenced by the barriers and facilitators of stakeholders (e.g., GPs, PTs, and PwOA).</div></span></li><li><span>•</span><span><div>Barriers and facilitators that influence uptake of and referral to exercise treatments for OA are related to stakeholder, healthcare setting, and treatment factors.</div></span></li><li><span>•</span><span><div>Majority of PwOA are not receiving GP referrals to physiotherapy, and a mismatch between GPs intentions to and actual referrals to physiotherapy exists, primarily due to long waitlists to access services.</div></span></li><li><span>•</span><span><div>These findings may be adapted to inform strategies for the successful implementation of exercise treatments that are effective in encouraging guideline-based management of OA.</div></span></li></ul></div></div>","PeriodicalId":54608,"journal":{"name":"Physiotherapy","volume":"125 ","pages":"Article 101416"},"PeriodicalIF":3.1,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141851782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}