Tatiana Orozco, D. Feldman, B. Mazer, G. Chilingaryan, M. Hunt, B. Williams-Jones, M. Laliberté
Purpose: The aim of this study was to describe the current patterns of service delivery of Canadian physiotherapy (PT) professionals working in adult musculoskeletal (MSK) outpatient practice. Methods: A total of 846 Canadian PT professionals working with an adult MSK outpatient clientele participated in an online survey about how they would treat a patient with low back pain (LBP). After reading an online clinical vignette about a fictional patient with varying insurance status, participants answered questions about how they would treat the patient (e.g., wait time, frequency and duration of treatment, time allotted for initial evaluation and treatment), about their actual practice (e.g., number of patients seen per day), and about their work setting. Results: The vignette patients with LBP would typically be seen within 2 weeks, especially in private practice, and most would receive care 2-3 times per week for 1-3 months. Initial evaluations and subsequent treatments would take 31-60 minutes. Two-thirds of participants reported treating 6-15 patients a day in their current practice setting. Differences were found between provinces and territories (with the longest wait time in Quebec), practice settings (with a longer wait time in the public sector), and insurance status (patients covered by workers' compensation are seen more frequently). Conclusion: This study adds to our knowledge of the accessibility of outpatient MSK PT services for patients with LBP in Canada, and it points to potential areas for improvement.
{"title":"Low Back Pain: Current Patterns of Canadian Physiotherapy Service Delivery.","authors":"Tatiana Orozco, D. Feldman, B. Mazer, G. Chilingaryan, M. Hunt, B. Williams-Jones, M. Laliberté","doi":"10.3138/ptc.2015-72","DOIUrl":"https://doi.org/10.3138/ptc.2015-72","url":null,"abstract":"Purpose: The aim of this study was to describe the current patterns of service delivery of Canadian physiotherapy (PT) professionals working in adult musculoskeletal (MSK) outpatient practice. Methods: A total of 846 Canadian PT professionals working with an adult MSK outpatient clientele participated in an online survey about how they would treat a patient with low back pain (LBP). After reading an online clinical vignette about a fictional patient with varying insurance status, participants answered questions about how they would treat the patient (e.g., wait time, frequency and duration of treatment, time allotted for initial evaluation and treatment), about their actual practice (e.g., number of patients seen per day), and about their work setting. Results: The vignette patients with LBP would typically be seen within 2 weeks, especially in private practice, and most would receive care 2-3 times per week for 1-3 months. Initial evaluations and subsequent treatments would take 31-60 minutes. Two-thirds of participants reported treating 6-15 patients a day in their current practice setting. Differences were found between provinces and territories (with the longest wait time in Quebec), practice settings (with a longer wait time in the public sector), and insurance status (patients covered by workers' compensation are seen more frequently). Conclusion: This study adds to our knowledge of the accessibility of outpatient MSK PT services for patients with LBP in Canada, and it points to potential areas for improvement.","PeriodicalId":390485,"journal":{"name":"Physiotherapy Canada. Physiotherapie Canada","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122388885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
B. D. da Costa, E. Vieira, I. Gadotti, Conner Colosi, James Rylak, Travis Wylie, S. Armijo-Olivo
Purpose: It is unclear how physical therapists in Florida currently treat people with knee osteoarthritis and whether current best evidence is used in clinical decision making. Methods: We conducted a survey of physical therapists in Florida. We assessed the perceived effectiveness and actual use of physical therapy (PT) interventions and quantified the association between the actual use of interventions and different characteristics of physical therapists. Results: A total of 413 physical therapists completed the survey. Most respondents perceived therapeutic exercise (94%) and education (93%) as being effective or very effective. Interventions least perceived as effective or very effective were electrotherapy (28%), wedged insole (20%), and ultrasound (19%). Physical therapists who followed the principles of evidence-based practice were more likely to use therapeutic exercise (OR 3.89; 95% CI: 1.21, 12.54) and education (OR 3.63; 95% CI: 1.40, 9.43) and less likely to use ultrasound (OR 0.32; 95% CI: 0.16, 0.63) and electrotherapy (OR 0.32; 95% CI: 0.17, 0.58). Results also indicated that older physical therapists were more likely to use ultrasound (OR 3.57; 95% CI: 1.60, 7.96), electrotherapy (OR 2.53; 95% CI: 1.17, 5.47), kinesiology tape (OR 3.82; 95% CI: 1.59, 9.18), and ice (OR 1.95; 95% CI: 1.02, 3.73). Conclusions: In line with clinical guidelines, most physical therapists use therapeutic exercise and education to treat people with knee osteoarthritis. However, interventions that lack scientific support, such as electrotherapy and ultrasound, are still used. A modifiable therapist characteristic, adherence to evidence-based practice, is positively associated with the use of interventions supported by scientific evidence.
{"title":"How Do Physical Therapists Treat People with Knee Osteoarthritis, and What Drives Their Clinical Decisions? A Population-Based Cross-Sectional Survey.","authors":"B. D. da Costa, E. Vieira, I. Gadotti, Conner Colosi, James Rylak, Travis Wylie, S. Armijo-Olivo","doi":"10.3138/ptc.2015-83","DOIUrl":"https://doi.org/10.3138/ptc.2015-83","url":null,"abstract":"Purpose: It is unclear how physical therapists in Florida currently treat people with knee osteoarthritis and whether current best evidence is used in clinical decision making. Methods: We conducted a survey of physical therapists in Florida. We assessed the perceived effectiveness and actual use of physical therapy (PT) interventions and quantified the association between the actual use of interventions and different characteristics of physical therapists. Results: A total of 413 physical therapists completed the survey. Most respondents perceived therapeutic exercise (94%) and education (93%) as being effective or very effective. Interventions least perceived as effective or very effective were electrotherapy (28%), wedged insole (20%), and ultrasound (19%). Physical therapists who followed the principles of evidence-based practice were more likely to use therapeutic exercise (OR 3.89; 95% CI: 1.21, 12.54) and education (OR 3.63; 95% CI: 1.40, 9.43) and less likely to use ultrasound (OR 0.32; 95% CI: 0.16, 0.63) and electrotherapy (OR 0.32; 95% CI: 0.17, 0.58). Results also indicated that older physical therapists were more likely to use ultrasound (OR 3.57; 95% CI: 1.60, 7.96), electrotherapy (OR 2.53; 95% CI: 1.17, 5.47), kinesiology tape (OR 3.82; 95% CI: 1.59, 9.18), and ice (OR 1.95; 95% CI: 1.02, 3.73). Conclusions: In line with clinical guidelines, most physical therapists use therapeutic exercise and education to treat people with knee osteoarthritis. However, interventions that lack scientific support, such as electrotherapy and ultrasound, are still used. A modifiable therapist characteristic, adherence to evidence-based practice, is positively associated with the use of interventions supported by scientific evidence.","PeriodicalId":390485,"journal":{"name":"Physiotherapy Canada. Physiotherapie Canada","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130337395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Clinician's Commentary on Vazir et al.","authors":"Steven Mach","doi":"10.3138/ptc-2018-39-cc","DOIUrl":"https://doi.org/10.3138/ptc-2018-39-cc","url":null,"abstract":"","PeriodicalId":390485,"journal":{"name":"Physiotherapy Canada. Physiotherapie Canada","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117333598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cara M Coghlan, Hilary Mallinger, A. McFadden, J. Richard, Arlee Stern, K. Norman
Purpose: The authors analyzed the demographics of potential future physiotherapists to determine whether they were representative of the Canadian population. The specific objectives were to examine selected demographic variables from all applicants to and students in Ontario English-language Master of Physical Therapy programmes in admission cycles 2004-2014, inclusive, and to analyze the results as compared with Canadian population data. Method: Anonymized applicant records (n=14,135) were obtained for admission cycles 2004-2014, inclusive. Variables examined for applicants and students included their gender, geographical location from Canadian and international regions, Aboriginal identity, and immigrant status. A descriptive analysis of counts and proportions was conducted for all variables. Results: The majority of applicants were women (70%), from southern Ontario (73%), and Canadian born (82%). Aboriginal and rural applicants made up small proportions of the applicant pool (1% and 12%, respectively). The number of applicants from British Columbia was proportionally high relative to those from other Canadian provinces. Conclusion: Although Ontario's physiotherapy education programmes remain female dominated, the demographics of applicants and students are otherwise mostly representative of the diverse Canadian population, although very low in the number of Aboriginal peoples. Further research is needed to understand the diversity and composition of the Canadian physiotherapy workforce.
{"title":"Demographic Characteristics of Applicants to, and Students of, Ontario Physiotherapy Education Programs, 2004-2014: Trends in Gender, Geographical Location, Aboriginal Identity, and Immigrant Status.","authors":"Cara M Coghlan, Hilary Mallinger, A. McFadden, J. Richard, Arlee Stern, K. Norman","doi":"10.3138/ptc.2016-23E","DOIUrl":"https://doi.org/10.3138/ptc.2016-23E","url":null,"abstract":"Purpose: The authors analyzed the demographics of potential future physiotherapists to determine whether they were representative of the Canadian population. The specific objectives were to examine selected demographic variables from all applicants to and students in Ontario English-language Master of Physical Therapy programmes in admission cycles 2004-2014, inclusive, and to analyze the results as compared with Canadian population data. Method: Anonymized applicant records (n=14,135) were obtained for admission cycles 2004-2014, inclusive. Variables examined for applicants and students included their gender, geographical location from Canadian and international regions, Aboriginal identity, and immigrant status. A descriptive analysis of counts and proportions was conducted for all variables. Results: The majority of applicants were women (70%), from southern Ontario (73%), and Canadian born (82%). Aboriginal and rural applicants made up small proportions of the applicant pool (1% and 12%, respectively). The number of applicants from British Columbia was proportionally high relative to those from other Canadian provinces. Conclusion: Although Ontario's physiotherapy education programmes remain female dominated, the demographics of applicants and students are otherwise mostly representative of the diverse Canadian population, although very low in the number of Aboriginal peoples. Further research is needed to understand the diversity and composition of the Canadian physiotherapy workforce.","PeriodicalId":390485,"journal":{"name":"Physiotherapy Canada. Physiotherapie Canada","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127130378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Purpose: The purpose of this case study was to evaluate the delivery of an inter-professional (IP) spinal triage management approach to chronic back disorders using remote presence robotic technology as an innovative form of telerehabilitation in a northern Saskatchewan community. Methods: The IP team, consisting of a local nurse practitioner (NP) and a physical therapist in an urban centre, completed a comprehensive neuromusculoskeletal assessment of, and one follow-up visit with, a post-surgical spinal patient. Treatment included detailed education regarding self-management after spinal surgery, provision and progression of home exercises, and reassurance. The patient was then referred to regional, in-person physical therapy care to complete her treatment. Results: A semi-structured interview with the NP revealed a high level of satisfaction; qualitative themes included the value of IP practice and the benefit to the patient of telerehabilitation achieved through patient-centred care. In a post-treatment survey, the patient expressed a high level of satisfaction with and appreciation for the patient-centred approach and the IP team. Objective clinical improvements in spinal and straight-leg raise movements were noted at the final telerehabilitation session. Conclusion: This report demonstrates the feasibility of delivering IP spinal triage management using telerehabilitation, specifically remote presence robotics, in a remote setting. Further research should include larger scale studies that investigate health, system, and economic outcomes as well as comparative studies for other forms of telehealth technology.
{"title":"Case Report: Using a Remote Presence Robot to Improve Access to Physical Therapy for People with Chronic Back Disorders in an Underserved Community.","authors":"S. Lovo Grona, B. Bath, L. Bustamante, I. Mendez","doi":"10.3138/ptc.2015-77","DOIUrl":"https://doi.org/10.3138/ptc.2015-77","url":null,"abstract":"Purpose: The purpose of this case study was to evaluate the delivery of an inter-professional (IP) spinal triage management approach to chronic back disorders using remote presence robotic technology as an innovative form of telerehabilitation in a northern Saskatchewan community. Methods: The IP team, consisting of a local nurse practitioner (NP) and a physical therapist in an urban centre, completed a comprehensive neuromusculoskeletal assessment of, and one follow-up visit with, a post-surgical spinal patient. Treatment included detailed education regarding self-management after spinal surgery, provision and progression of home exercises, and reassurance. The patient was then referred to regional, in-person physical therapy care to complete her treatment. Results: A semi-structured interview with the NP revealed a high level of satisfaction; qualitative themes included the value of IP practice and the benefit to the patient of telerehabilitation achieved through patient-centred care. In a post-treatment survey, the patient expressed a high level of satisfaction with and appreciation for the patient-centred approach and the IP team. Objective clinical improvements in spinal and straight-leg raise movements were noted at the final telerehabilitation session. Conclusion: This report demonstrates the feasibility of delivering IP spinal triage management using telerehabilitation, specifically remote presence robotics, in a remote setting. Further research should include larger scale studies that investigate health, system, and economic outcomes as well as comparative studies for other forms of telehealth technology.","PeriodicalId":390485,"journal":{"name":"Physiotherapy Canada. Physiotherapie Canada","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128423464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Stanley H Hung, Anne Rankin, N. Virji-Babul, S. Pritchard, C. Fryer, K. Campbell
Purpose: This cross-sectional, observational study investigated whether physical activity (PA) levels are associated with motor performance and physical function in children after treatment for acute lymphoblastic leukemia (ALL). Method: Participants aged 8-13 years who had completed treatment for ALL (3-36 months post-treatment) were tested at their oncology long-term follow-up appointment at the British Columbia Children's Hospital. PA level was measured using the Physical Activity Questionnaire for Older Children (PAQ-C). Motor performance was measured using the Bruininks-Oseretsky Test of Motor Proficiency, Second Edition, Short Form (BOT-2 SF), and physical function was measured using the 6-minute walk test (6MWT). Results: Thirteen children completed testing. PAQ-C scores were not associated with BOT-2 SF or 6MWT performance. Eleven children (85%) performed below the norm for the 6MWT. Children with elevated body mass index had poorer 6MWT but similar PAQ-C scores. Conclusion: PA was not found to be associated with motor performance and physical function. Participants who were overweight or obese had poorer 6MWT performance, which may indicate the need for closer monitoring of post-treatment weight status and physical function in the oncology follow-up setting.
{"title":"Associating Physical Activity Levels with Motor Performance and Physical Function in Childhood Survivors of Acute Lymphoblastic Leukemia.","authors":"Stanley H Hung, Anne Rankin, N. Virji-Babul, S. Pritchard, C. Fryer, K. Campbell","doi":"10.3138/ptc.2015-67LHC","DOIUrl":"https://doi.org/10.3138/ptc.2015-67LHC","url":null,"abstract":"Purpose: This cross-sectional, observational study investigated whether physical activity (PA) levels are associated with motor performance and physical function in children after treatment for acute lymphoblastic leukemia (ALL). Method: Participants aged 8-13 years who had completed treatment for ALL (3-36 months post-treatment) were tested at their oncology long-term follow-up appointment at the British Columbia Children's Hospital. PA level was measured using the Physical Activity Questionnaire for Older Children (PAQ-C). Motor performance was measured using the Bruininks-Oseretsky Test of Motor Proficiency, Second Edition, Short Form (BOT-2 SF), and physical function was measured using the 6-minute walk test (6MWT). Results: Thirteen children completed testing. PAQ-C scores were not associated with BOT-2 SF or 6MWT performance. Eleven children (85%) performed below the norm for the 6MWT. Children with elevated body mass index had poorer 6MWT but similar PAQ-C scores. Conclusion: PA was not found to be associated with motor performance and physical function. Participants who were overweight or obese had poorer 6MWT performance, which may indicate the need for closer monitoring of post-treatment weight status and physical function in the oncology follow-up setting.","PeriodicalId":390485,"journal":{"name":"Physiotherapy Canada. Physiotherapie Canada","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114593809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.3138/ptc.69.1.cochrane
McBain H, Mulligan K, Haddad M, et al. Self management interventions for type 2 diabetes in adult people with severe mental illness. Cochrane Database Syst Rev. 2016;(4):CD011361. http://dx.doi.org/10.1002/14651858.CD011361.pub2. Medline:27120555 Pal K, Eastwood SV, Michie S, et al. Computer-based diabetes self-management interventions for adults with type 2 diabetes mellitus. Cochrane Database Syst Rev. 2013;(3):CD008776. http://dx.doi.org/10.1002/14651858.CD008776.pub2. Medline:23543567
McBain H, Mulligan K, Haddad M，等。患有严重精神疾病的成人2型糖尿病患者的自我管理干预Cochrane Database system Rev. 2016;(4):CD011361。http://dx.doi.org/10.1002/14651858.CD011361.pub2。Pal K, Eastwood SV, Michie S，等。基于计算机的成人2型糖尿病自我管理干预Cochrane Database system Rev. 2013;(3):CD008776。http://dx.doi.org/10.1002/14651858.CD008776.pub2。Medline: 23543567
{"title":"What Does the Cochrane Collaboration Say About Self-Management in Rehabilitation?","authors":"","doi":"10.3138/ptc.69.1.cochrane","DOIUrl":"https://doi.org/10.3138/ptc.69.1.cochrane","url":null,"abstract":"McBain H, Mulligan K, Haddad M, et al. Self management interventions for type 2 diabetes in adult people with severe mental illness. Cochrane Database Syst Rev. 2016;(4):CD011361. http://dx.doi.org/10.1002/14651858.CD011361.pub2. Medline:27120555 Pal K, Eastwood SV, Michie S, et al. Computer-based diabetes self-management interventions for adults with type 2 diabetes mellitus. Cochrane Database Syst Rev. 2013;(3):CD008776. http://dx.doi.org/10.1002/14651858.CD008776.pub2. Medline:23543567","PeriodicalId":390485,"journal":{"name":"Physiotherapy Canada. Physiotherapie Canada","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125439594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Commentary on Shah et al.","authors":"M. Hunt, S. Cleaver, A. Hudon","doi":"10.3138/PTC.2018-23-CC","DOIUrl":"https://doi.org/10.3138/PTC.2018-23-CC","url":null,"abstract":"","PeriodicalId":390485,"journal":{"name":"Physiotherapy Canada. Physiotherapie Canada","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128840191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"L'Association canadienne de physiothérapie joue-t-elle son rôle dans la promotion de la recherche?","authors":"C. L. Richards","doi":"10.3138/ptc-71-4-gef","DOIUrl":"https://doi.org/10.3138/ptc-71-4-gef","url":null,"abstract":"","PeriodicalId":390485,"journal":{"name":"Physiotherapy Canada. Physiotherapie Canada","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"113978543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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