Do the physiotherapists’ practice follow an evidence-based approach? A survey 1,2
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F. Maiorano , PT, MSc, G. Gallone MD, L. Piano
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PT, OMPT, M. Bobbio MD, S. Vernero MD
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Department of Rehabilitation and Functional Recovery, Mondovì Hospital, ASL CN1, Mondovì, Italy 2 Studio di Fisioterapia – Cuneo, Italy 3 Occupational Health Service - ASO “San Luigi Gonzaga”, Turin, Italy 4 Casa di Cura “La Residenza” – Rodello (CN), Italy 5 Studio di Fisioterapia – Alba (CN), Italy 6 Research Office - Associazione Italiana Fisioterapisti (A.I.Fi.) Piemonte e Valle d’Aosta, Turin, Italy 7 Slow Medicine Italia - Turin, Italy
1. BACKGROUND Evidence-based practice (EBP) is a well-known approach to the clinical practice for all health professionals. However many rehabilitation practices seem not to be coherent with the more relevant scientific output.
2. AIM to verify the adherence to evidence-based recommendations in a sample of physiotherapists (PTs) selected from the national health services (i.e. from a more organized and complex context) and from the private health services (i.e. from a more autonomous working place)
3. MATERIALS AND METHODS 87 volunteers PTs completed a 10 items questionnaire regarding the rehabilitative management of some clinical condition: - 8 questions about musculoskeletal disorders (low back pain, subacromial impingement syndrome, lateral elbow epicondylitis) - 1 question about rheumatologic disorders (e.g. rheumatoid arthritis) - 1 question about cardiovascular diseases (e.g. chronic obstructive pulmonary disease) For each question the highest score (i.e. best adherence with literature) was 5 50 PTs (33 self-employed; 17 employed) were younger than 40 years old. 37 PTs were older than 40 years old (10 self-employed; 27 employed).
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4. RESULTS All the subjects enrolled in the study completed the survey. 389 answers (45%) scored best agreement (coherent with literature). 169 answers(19%) scored “uncertain agreement” 312 responses (36%) were inappropriate (not coherent with literature). The younger PTs (4); the older PTs (>40 years old) gave a 40% of “correct” responses.
5. CONCLUSIONS Few PTs know guidelines and adopt an evidence-based approach The more is the age the less is the knowledge and coherent practice according to best available evidences. Further studies are requested to obtain more representative findings about EBP.
REFERENCES van Tulder et al. European guidelines for the management of acute nonspecific low back pain in primary care. Eur Spine J 2006 Ries AL. Pulmonary Rehabilitation: Summary of an Evidence-Based Guideline. Respir Care 2008 Diercks et al. Guideline for diagnosis and treatment of subacromial pain syndrome A multidisciplinary review by the Dutch Orthopaedic Association Acta Orthopaedica 2014 Hurkmans et al. Physiotherapy in rheumatoid arthritis: development of a practice guideline Acta Reumatologia Port 2011 Motor Accidents Authority: Guidelines for the management of acute whiplash-associated disorders – for health professionals. Sydney: third edition 2014 Airaksinen et al. European guidelines for the Management of chronic non-specific low back pain Eur Spine J 2006
Corresponding author - Francesco Maiorano email:
[email protected]
