Lumbar: Surveys of Physical Therapy practice

 

Bernhardsson S, Oberg B, Johansson K, Nilsen P, Larsson M, Clinical practice in line with evidence? A survey among primary care physiotherapists in western Sweden., Journal of Evaluation in Clinical Practice, doi: 10.1111/jep.12380, 2015

271 Swedish physios completed a survey on preferred treatment interventions on 3 msk disorders. Their responsers were compared to the current support of the evidence. Most interventions, including the use of MDT were supported by the evidence. However interventions with unclear or no evidence were also used to a high degree.

Byrne K, Doody C, Hurley DA., Exercise therapy for low back pain: a small-scale exploratory survey of current physiotherapy practice in the Republic of Ireland acute hospital setting., Man Ther, Nov;11(4):272-8, 2006

73% response rate to survey of 24 physiotherapy departments: stabilisation exercises were most popular with acute (39%) and chronic (51%) back pain, followed by McKenzie approach (36% and 17% respectively).

Davies C, Nitz AJ, Mattacola CG, Kitzman P, Howell D, Viele K, Baxter D, Brockopp D., Practice patterns when treating patients with low back pain: a survey of physical therapists., Physio Theory Pract, 30:399-408, 2014

250 physical therapists in Kentucky, USA were mailed the survey about the use of classification systems and outcome measures when treating patients with low back pain, and 120 (48%) responded. 73% reported using a classification system and 85% using outcome measures. The commonest classification systems were: McKenzie (61%), treatment-based approach (58%), movement impairment approach (21%), and other approached (16%). 86% reported that they learned the classification system as a post-graduate. The most common outcome measures were Oswestry, Numeric Pain Rating Scale, and Roland-Morris disability questionnaire.

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Foster NE, Thompson KA, Baxter GD, Allen JM, Management of nonspecific low back pain by physiotherapists in Britain and Ireland. A descriptive questionnaire of current clinical practice., Spine, Jul 1;24(13):1332-42, 1998

The McKenzie method was said to be the second most common treatment approach used by therapists. The Maitland approach was used by 59%, McKenzie method by 47%,, multiple other approaches were used as well with less frequency combined approaches were common.

Gracey JH, McDonough SM, Baxter GD., Physiotherapy management of low back pain: a survey of current practice in Northern Ireland., Spine, Feb 15;27(4):406-11, 2001

Details of management of over 1,000 patients by 157 therapists over 12-month period. McKenzie was used in over 70% of patients, usually in combination, and was one of the most commonly used approaches. McKenzie course attendees ranged from 76% for A to 16% for D.

Hamm L, Mikkelsen B, Kuhr J, Stovring H, Munck A, Kragstrup J, Danish physiotherapists management of low back pain., Advances in Physio, 5:109-113, 2003

An audit of 242 Danish PTs (14% of total) during a 4 week period to see if they used recommended treatments. McKenzie was used in 40% of consultations; there was a lot of combination of treatments; 22% of consultations involved non-recommended treatments, such as ultrasound and short-wave. McKenzie was most commonly used in acute back pain with radiation (64%), acute back pain (44%), chronic back pain with radiation (40%), and least in chronic back pain (27%).

Miller-Spoto M, Gombatta SP., Diagnostic labels assigned to patients with orthopaedic conditions and the influences of the label on selection of interventions: a qualitative study of orthopaedic clinical specialists (OCS), Phys Ther, 94:776-791, 2014

Case reports of 2 patients with back and shoulder pain were developed and sent to 877 board-certified OCS with 107 (12%) responding with sufficient data. The most common labels used were respectively: combination (49%) and pathology (33%); and pathology (57%) and combination (35%). The most common classification systems used for back pain case study were McKenzie (47%), pathoanatomic (18%), and treatment-based classification system (9%). The most common classification system used for shoulder case study was pathoanatomic (58%), with only 3% using the McKenzie classification. The classification systems used did not impact on the interventions used, which were most commonly some form of strengthening or stretching, or mobilisation of joints or soft tissues.

Poitras S, Blais R, Swaine B, Rossignol M, Management of work-related low back pain: a population-based survey of physical therapists., Phys Ther, Nov;85:1168-1181, 2005

Survey of 328 physical therapists treating workers compensation patients with back pain in Quebec to find their treatment objectives and chosen interventions. Wide range of exercise, mobilisation, modality and other interventions were used. McKenzie approach was used by 37% of physical therapists for patients with back pain only and 63% of therapists for patients with back and radiating pain.

 

Sheeran L, Coales P, Sparkes V, "Clinical challenges of classification based targeted therapies, Manual Therapy, 20,456-462, 2015

This qualitative study guaged the views, experiences and perceptions of barriers and enablers for using classification systems of physiotherapists and managers. Although the usefulness of classification systems was acknowledged and advantages seen, barriers were identified that may inhibit adoption.

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Spoto MM, Collins J, Physiotherapy diagnosis in clinical practice: a survey of orthopaedic certified specialists., Physio Res Int, 13.31-41, 2008

A survey of 850 physical therapists in USA of who 253 (30%) responded - 38% utilised a pathoanatomical classification system, 32% the McKenzie classification system, 9% the treatment-based classification system, and 7% movement impairment classification.

Takasaki H, Saiki T, Iwasada Y, McKenzie Therapists Adhere More to Evidence-Based Guidelines and Have a More Biopsychosocial Perspective on the Management of Patients with Low Back Pain than General Physical Therapists in Japan, Open Journal of Therapy and Rehabilitation, 2:173-181, 2014

Survey of 56 Cred MDT therapists and 53 general therapist in Japan. Looking at adherence to LBP guidelines and how biopsychosocial orientated they were. Regression analysis was performed. Cred MDT therapists were more guideline consistent and had a more biopsychosocial orientation than general therapists.