Musculoskeletal patients' preferences for care from physiotherapists or support workers: a discrete choice experiment.

BACKGROUND: Delegation of clinical tasks from physiotherapists to physiotherapy support workers is common yet varies considerably in musculoskeletal outpatient physiotherapy services, leading to variation in patient care. This study aimed to explore patients' preferences and estimate specific trade-offs patients are willing to make in treatment choices when treated in musculoskeletal outpatient physiotherapy services. METHODS: A discrete choice experiment was conducted using an efficient design with 16 choice scenarios, divided into two blocks. Adult patients with musculoskeletal conditions recruited from a physiotherapy service completed a cross-sectional, online questionnaire. Choice data analyses were conducted using a multinomial logit model. The marginal rate of substitution for waiting time to first follow-up physiotherapy appointment and distance from the physiotherapy clinic was calculated and a probability model was built to estimate the probability of choosing between two distinct physiotherapy service options under different scenarios. RESULTS: 382 patient questionnaires were completed; 302 participants were treated by physiotherapists and 80 by physiotherapists and support workers. There was a significant preference to be seen by a physiotherapist, have more follow-up treatments, to wait less time for the first follow-up appointment, to be seen one-to-one, to see the same clinician, to travel a shorter distance to get to the clinic and to go to clinics with ample parking. Participants treated by support workers did not have a significant preference to be seen by a physiotherapist and it was more likely that they would choose to be seen by a support worker for clinic scenarios where the characteristics of the physiotherapy service were as good or better. CONCLUSIONS: Findings highlight that patients treated by support workers are likely to choose to be treated by support workers again if the other service characteristics are as good or better compared to a service where treatment is provided only by physiotherapists. Findings have implications for the design of physiotherapy services to enhance patient experience when patients are treated by support workers. The findings will contribute to the development of "best practice" recommendations to guide physiotherapists in delegating clinical work to physiotherapy support workers for patients with musculoskeletal conditions.

Australian healthcare professionals' beliefs and practice behaviours in management of chronic pelvic pain: a cross-sectional survey.

Background Chronic pelvic pain (CPP) is a common and debilitating condition, and sufferers present to healthcare professionals with variable complex symptoms and co-morbidities. This study aimed to investigate the current beliefs and practice behaviours of healthcare professionals towards the management of CPP in Australian females. Methods We distributed an online survey to Australian healthcare professionals. Participants were questioned regarding their beliefs, the importance of various contributing factors and assessment variables, and their management preferences for two CPP vignettes. Demographic information and responses were analysed with descriptive statistics. Results Complete data were obtained and analysed from 446 respondents including gynaecologists (n =75), general practitioners (GPs) (n =184) and physiotherapists (n =187). Most of the respondents were female (88.1%), with male (11.7%) and other (0.2%) making up a smaller representation. Physiotherapists rated themselves higher in understanding mechanisms of CPP (64.7% very good to excellent) compared to gynaecologists (41.3%) and GPs (22.8%). Physiotherapists also reported higher levels of confidence in managing patients with CPP (57.8% quite or extremely confident) compared to 41.3% of gynaecologists and 22.3% of GPs who reported being quite or extremely confident. All three professions rated patient's beliefs (89.8%), nervous system sensitisation (85.7%), stress/anxiety/depression (91.9%), fear avoidance (83.3%), history of sexual/emotional/physical abuse (94.1%) and pelvic floor muscle function (85.0%) as very/extremely important factors in the development of chronic pelvic pain. Most gynaecologists (71.0%) and GPs (70.2%) always referred for pelvic ultrasound during assessment. Physiotherapists assessed goal setting (88.8%) and screened for patients' beliefs (80.9%) more often than gynaecologists (30.4% and 39.1% respectively) and GPs (46.5% and 29.0% respectively). Conclusions All three groups of healthcare professionals demonstrated a good understanding of pain mechanisms and incorporated a biopsychosocial and multidisciplinary approach to management of females with chronic pelvic pain. However, both gynaecologists and GPs were less confident in their understanding of and management of CPP, and less likely to consider patient beliefs and goals. The findings of this online survey may assist in the provision of more targeted education to further improve management of this condition.

Work-related injuries of rehabilitation therapists and measures for prevention.

Background: Rehabilitation therapists often perform physically demanding treatments that may result in work-related injuries, yet related studies are scarce. This study aimed to investigate the work-related injuries of rehabilitation therapists and provide feasible preventive measures. Methods: A cross-sectional study was carried out in 34 regions across China using an online questionnaire. The survey gathered responses primarily from 1,198 rehabilitative therapists working in 120 health institutes. Following data collection, descriptive analysis, chi-square tests, logistic regression, and receiver operating characteristic (ROC) curves were employed to analyze the data. Results: In this study, the incidence of work-related injuries was reported to be 87% (n = 1,041). The top three musculoskeletal issues reported were low back pain (12%), neck pain (10%), and shoulder pain (9%). Logistic regression and ROC curve analysis identified that working as a physiotherapist and years of work experience (OR [95% CI]: 1.03 [0.99-1.07]) were significant contributors to the incidence of work-related injuries. Specifically, neuro-physiotherapists (OR [95% CI]: 3.04 [1.56-5.92]), musculoskeletal physiotherapists (OR [95% CI]: 2.46 [1.16-5.18]), and intensive care physiotherapists (OR [95% CI]: 4.70 [1.24-17.88]) were at higher risk. Furthermore, five factors were proven to be associated with injury prevention as reported by therapists: patient engagement (OR [95% CI]: 0.38 [0.23-0.62]), improving techniques (OR [95% CI]: 0.59 [0.39-0.90]), maintaining exercise habits (OR [95% CI]: 0.59 [0.40-0.86]), utilizing instruments (OR [95% CI]: 0.80 [0.53-1.19]), and strengthening education (OR [95% CI]: 0.43 [0.21-0.90]). Conclusion: The present study investigated the factors contributing to work-related injuries among rehabilitation therapists, with a focus on identifying both risk and preventive measures. These findings offer new perspectives on decreasing injury risk.

Utilisation of standardised outcomes measures by clinical Physiotherapists working in Namibia: a nationwide cross-sectional study.

Introduction: The utilisation of standardised outcome measures (SOMs) is crucial for evaluating patients' health status. Physiotherapists are highly recommended to use SOMs routinely. Despite the well-documented benefits of using SOMs, the utilisation of SOMs in clinical practice is still problematic particularly in Africa. In Namibia, there is dearth of information about SOMs utilisation by physiotherapists and the associated factors. This study was aimed at determining the extent of routine utilisation of SOMs and the associated demographic and work-related factors among physiotherapists. Methods: A cross-sectional, nationwide, online survey was conducted and all registered qualified physiotherapists and intern physiotherapists working in public or private hospitals/clinics were invited to participate. Data was analysed using Statistical Package for the Social Sciences (SPSS) version 29.0. The Chi-square (χ2) and Fishers exact test investigated the relationship between the associated factors and routine SOMs utilisation. The alpha level was set at 0.05. Results: Of 230 participants who received the invitational link, 99 (43.0%) responded timeously to the call to participate. Although 97.9% (n=94) of the participants indicated having used at least one type of SOMs in the last six months, the frequency of utilisation varied. Routine utilisation, defined as 70%-100% of the time, was reported in only 49.0% of the participants. The Chi-square test only showed significant findings for gender (p=0.01) and clinical specialty (p=0.004). The odds of utilising SOMs were 4.13 greater among physiotherapists with a clinical specialty and 3.88 times greater for females than males. Conclusion: The rates for routine utilisation of SOMs by Namibian physiotherapists are unfavourable. Female gender and clinical specialty influenced the utilisation of SOMs in daily clinical practice. Cognisant of the study limitations, these results call for the need to improve the routine utilisation of the SOMs in Namibia.

Shoulder osteoarthritis: A survey of current (2024) UK physiotherapy practice.

BACKGROUND: Shoulder osteoarthritis can cause significant pain and disability. It is thought that the wider principles of osteoarthritis management can be applied in the management of people with shoulder osteoarthritis, but most prior research has been conducted with people experiencing osteoarthritis of the hip and knee. There is a paucity of evidence to guide the non-surgical management of shoulder osteoarthritis and limited understanding of current physiotherapy practice. OBJECTIVE: We aimed to investigate the current treatment recommendations by physiotherapists in the UK for people with shoulder OA. METHODS: An online survey using a clinical vignette was designed and distributed to UK registered physiotherapists with experience of managing people with shoulder osteoarthritis, via social media and professional networks. Descriptive statistics were used to analyse demographic and multiple-choice questions, and free text responses were summarised narratively. RESULTS: 114 respondents accessed the survey with 110 valid responses; 105 (95%) respondents would offer face-to-face consultations, with 89 (81%) respondents expecting to offer 2-4 appointments. 108 (98%) respondents would offer advice/education; 79 (72%) would offer weight management; 82 (75%) prescribed exercises to improve movement; and 101 (92%) offered exercises to increase strength. If a person lived with obesity or had a treatment preference, the majority of respondents would change their recommendations. CONCLUSION: This is the first survey of NHS physiotherapy practice for people with shoulder osteoarthritis. The responses largely align with NICE guidelines; despite this alignment, it is not known whether such guideline-based care is acceptable to people with shoulder osteoarthritis or clinically effective.

How did COVID-19 pandemic impact on healthy behaviours among Polish professionally active physiotherapists aged 20-50?

BACKGROUND: Due to the introduction of a number of changes to the health care system and the work nature of medical staff, theCOVID-19 pandemic still pose a public health challenge. The objective of the study was to characterize the health behaviours of Polish professionally active physiotherapists during the COVID-19 pandemic. METHODS: The study included 104 Polish licensed and professionally active physiotherapists in whom health behaviours were assessed using an original questionnaire contained, among others, questions from the Global Physical Activity Questionnaire (GPAQ), the Pittsburgh Sleep Quality Index (PSQI) and the Perceived Stress Scale (PSS), available via social media platforms. RESULTS: Among the physiotherapists, 34% worked directly with COVID-19 patients and 49% with those who had survived COVID-19. There were no statistically significant differences in most of the rates of physical activity undertaken by the physiotherapists surveyed (P > 0.05). Men were more likely to report taking up movement-related physical activity than women (P > 0.05). However, they spent more time sitting or lying down on a typical day (P > 0.05). The average time spent on the above-mentioned physical activities was also higher among the male participants than in the group of women (P > 0.05). There was an increase in the proportion of physiotherapists working over 40 h per week, from 29% before the pandemic to 38% during the pandemic. Statistically significant differences were observed for the products constituting the basison which of the diet of the examined physiotherapists was based (P < 0.05). The majority of the respondents reported no problems with falling asleep (p > 0.05). Stress related to the risk of contracting COVID-19, as well as concerns about the health of loved ones were more common and severe in the group of female subjects (P < 0.05). CONCLUSIONS: During the COVID-19 pandemic, the health behaviours in some physiotherapists changed. Further studies are required to assess whether physiotherapists' health behaviours returned to baseline levels or slightly improved compared to the initial results. Also, it is necessary to introduce health-promoting initiatives that would focus on physiotherapists, support their positive health behaviours and provide special recommendations helping them to maintain health during a pandemic.

Does Insurance Provide Adequate Coverage for Physical Therapy Visits for Common Orthopedic Diagnoses? A Survey Study.

OBJECTIVES: This study aimed to analyze the association between physical therapists' recommended number of visits for a full recovery from common orthopedic injuries/surgeries and the extent of insurance coverage for these visits. METHODS: A prospective observational study was conducted with board-certified physical therapists. A qualitative questionnaire was used to gather physical therapists' demographics and the recommended number of physical therapy visits to achieve a full recovery after 11 common orthopedic diagnoses. Physical therapists also were asked to report whether they believe that insurance provides an adequate number of visits overall. In addition to the qualitative survey, insurance coverage details of major Alabama companies were obtained for comparison. Descriptive statistics of the participating therapists were analyzed for sex, age, degree/training, and years of experience. Kruskal-Wallis statistics were used to analyze variance between the aforementioned groupings when compared with the reported average number of sessions. RESULTS: The survey (N = 251) collected data on the average number of physical therapy sessions that are necessary for a complete recovery as recommended by physical therapists for 11 common orthopedic diagnoses. From this survey, the average number of necessary visits ranged from 11.3 visits (ankle sprains) to 37.3 visits (anterior cruciate ligament reconstruction), with the overall average number of visits being 23.8. Only 24% of physical therapists believed that insurance companies provided enough coverage. Insurance coverage varied but often required additional procedures to allocate the adequate number of visits for the studied orthopedic pathologies. CONCLUSIONS: The majority of practicing physical therapists in Alabama perceive insufficient insurance coverage for physical therapy visits for most orthopedic diagnoses. This study has implications for healthcare decision making and patient-centered rehabilitation goals. Physicians and physical therapists can use this information to optimize treatment decisions and rehabilitation goals. Patients will benefit from improved physical and economic well-being. This study has the potential to drive further research and influence national insurance policies to better serve patients' needs.

A survey exploring the needs, preferences, and challenges of the key stakeholders for participating in and developing pulmonary rehabilitation in Pune, India.

Considering a huge burden of chronic respiratory diseases (CRDs) in India, there is a need for locally relevant Pulmonary rehabilitation (PR) services. This cross-sectional survey was aimed to explore the interest, needs and challenges among various stakeholders for PR in Pune city, India. At the outpatient respiratory medicine department of a multi-speciality hospital in Pune, India, 403 eligible people with CRDs were invited to participate in the survey, of which 370 (92%) responded and agreed to participate. (220 males, mean ± SD age 56 ± 15 years). Out of the 370, 323 (87%) people with CRDs were keen to attend PR. In a multiple selection question, there was inclination towards paper-based manuals home-based (70%) and web-based (84%) programs. 207 healthcare providers (HCPs), including physicians, pulmonologists and physiotherapists involved in the care of people living with CRDs across Pune city were invited to participate in the survey. Out of the 207, (80%) of the HCPs believed that PR was an effective management strategy and highlighted the lack of information on PR and need for better understanding of PR (48%) and its referral process. The surveyed stakeholders are ready to take up PR, identifying specific needs around further knowledge of PR, modes of delivery, and referral processes, that could potentially feed the development of relevant PR programs in the Indian healthcare settings.

Informing low back pain care from the ground up: Survey of national musculoskeletal triage physiotherapists in Ireland.

BACKGROUND: Healthcare is changing to meet the challenge of a rising musculoskeletal burden associated with the expanding, aging population. Clinicians, important stakeholders in healthcare provision, have crucial insights into service improvement, but clinician consultation is a shortcoming in healthcare development. In Ireland, specialist physiotherapist-led musculoskeletal (MSK) triage services operate at the primary-secondary care interface to expedite patient care. OBJECTIVES: To inform future development of low back pain (LBP) care in Ireland through profiling the operationalisation of the national MSK triage service for LBP, including access, referral management, clinical investigations, onward referral options, access to multidisciplinary team (MDT) services and integration with primary healthcare services. DESIGN: Cross-sectional observational study using a bespoke, anonymous electronic survey. PARTICIPANTS: Thirty-eight clinical specialist physiotherapists working in national programme Irish MSK triage services. RESULTS: Thirty-eight MSK Triage physiotherapists submitted responses (response rate 72%). There was considerable site-dependent variation in LBP service provision, with discrepancies in access to triage services, wait times, referral processing and prioritisation, access to clinical investigations and onward referral options. Most respondents (81%) reported wait times exceeding the three-month target; 75% reported that the level of clinical autonomy associated with their role limited service efficiency; 75% were dissatisfied with primary-secondary care service integration. Respondents identified insufficient availability of primary care multidisciplinary services. CONCLUSION: Lack of standardisation of LBP services exists in Ireland. Services would benefit from improved standardisation, reduced wait times, national accreditation and a defined scope of advanced physiotherapy practice and the development of nationwide community multidisciplinary infrastructure with enhanced interservice communication.

Hand hygiene compliance of respiratory physiotherapists: An analysis of trends over eight years including the COVID-19 pandemic period.

BACKGROUND: Respiratory physiotherapists (RPs) are an integral part of healthcare workers delivering care to intubated patients. Our study aimed to evaluate the effect of awareness campaigns on hand hygiene (HH) compliance among RPs. METHOD: An observational single-center study was conducted between 2015 and 2022 in different ICU types in both adult and paediatric settings. The hand hygiene compliance rates were monitored prospectively and the quality improvement interventions included various hand hygiene campaigns and awareness sessions with RPs. Compliance was calculated as a percentage of events over total opportunities observed. RESULTS: There was a significant increase in compliance rates for all five moments of HH (p-value: <0.05). Overall, mean compliance rate in ICUs was significantly higher than wards for Moment 1 (p-value: 0.0045), Moment 4 (p-value: 0.0372) and Moment 5 (p-value: 0.0036) by 24.2%, 22.7% and 21.5% respectively. Also, paediatric ICUs had higher HH compliance than adult ICUs for Moment 1 (87.5% vs 61.1%; p-value: 0.0459) and Moment 4 (93.7% vs 79.3%; p-value: 0.0255). A significant increase in HH compliance was observed in post-COVID-19 period compared to pre-COVID-19 period with respect to Moment 1, 2 and 5. CONCLUSION: This study adds to the almost non-existent literature on this important category of healthcare workers working in respiratory ICUs. Our results project an increase compliance after the HH awareness programmes over the years among RP which is critical to prevent spread infection by multidrug resistant organisms among the hospitals.

Non-surgical management of posterior tibial tendon dysfunction- a UK survey.

BACKGROUND: Posterior Tibial Tendon Dysfunction (PTTD) is commonly seen within musculoskeletal care. The condition's prevalence and management is poorly understood. This study aims to demonstrate current practice by multi-professional clinicians across the United Kingdom within the National Health Service. METHODS: A national (UK) cross-sectional online survey was conducted among multi-professionals who treat PTTD within their NHS practice. The survey covered assessment, management and evaluation. This was shared via social media and professional groups. RESULTS: Two hundred thirteen surveys were completed, with 153 matching the eligibility criteria. The main respondents were Physiotherapists (48%) and Podiatrists (38%). Ultrasound scanning was used most frequently when considering initial imaging (67%). Many different treatment modalities were used, but a core set of education/advice, foot orthoses, and foot specific as well as general exercise were most commonly chosen. Outcome measures routinely used were pain scale (96/269) and single leg heel raise (84/269), but patient reported outcome measures were not routinely used. The most frequent reason to escalate care was failure to manage symptoms with conservative management (106/123; 86.2%), followed by fixed deformity (10/123; 8.2%). CONCLUSIONS: This survey provides evidence on current non-surgical management for PTTD from UK NHS practice. It provides a valuable marker for clinicians to use to compare their own practice and can be used in further research as a comparator.

Satisfactory adherence to the Dutch physical therapy guideline for patients with a total knee arthroplasty. A survey study involving 103 specialised physical therapists.

OBJECTIVE: To explore and gain more insight into the usual preoperative and postoperative physical therapy (PT) treatment of patients with a total knee arthroplasty (TKA) among Dutch physical therapists experienced with TKA rehabilitation. Secondly, to evaluate physical therapists' adherence to guideline recommendations for postoperative rehabilitation. METHODS: In this cross-sectional study, physical therapists working in primary care within a designated Dutch hospital's catchment area were surveyed online. The survey queried PT treatment approaches before surgery, during hospitalisation, and after surgery. All data were analysed descriptively. When both education and all recommended exercise modalities were used postoperatively, therapists were considered fully adherent with the Dutch clinical practice guideline. RESULTS: One hundred and three therapists participated, representing a response rate of 58%. Postoperative PT treatment was applied by all therapists, of which 65 (63.1%) were fully adherent to the guideline. Partial adherence was mainly due to not using the aerobic exercise modality. Furthermore, beyond the modalities recommended in the guideline, a range of PT interventions were used. Preoperative treatment was applied by 73 therapists (70.9%). These 73 indicated that only a median of 20% (IQR 10%-40%) of their patients received preoperative PT. CONCLUSIONS: This study revealed satisfactory adherence to guideline recommendations on postoperative management of patients with a TKA among experienced physical therapists. Aerobic exercises were utilised less often or with inappropriate intensity. Correct adherence to guideline recommendations on aerobic exercise training can result in more physically active individuals and important general health benefits.

The supply and demand for rehabilitation health workforce in Saudi Arabia.

Background: Adequate supply of rehabilitation health workforce is a prerequisite for enhancing access to rehabilitation care. However, there is a lack of comprehensive data regarding the supply of rehabilitation health workers in Saudi Arabia. Aims: To determine the need for, and supply of, rehabilitation workforce, and investigate the relationship between rehabilitation workforce supply and rehabilitation needs in Saudi Arabia. Methodology: This cross-sectional study measured the ratio of physiotherapists and occupational therapists per 10 000 population. Data were obtained from the Ministry of Health, family health survey and census data of the General Authority for Statistics and published literature. To assess the need for rehabilitation services, we computed a composite disability index based on 3 variables: count of individuals with physical disabilities, those with chronic diseases, and those aged > 65 years. Determinants of the supply potential were population size, rural population percentage, and physician supply. Data were analysed using descriptive statistics and simple linear regression. Results: The ratios of physiotherapists and occupational therapists working at the Ministry of Health facilities were 0.69 and 0.03 per 10 000 population, respectively. Overall rehabilitation health workforce ratio was 0.73 per 10 000. Supply varied across regions, from 0.4 for Riyadh to 2.5 for Al Jouf. Nine regions exceeded the overall ratio. Rehabilitation need index ranged from 0.144 in Najran to 0.212 in Aseer. No significant associations were found between rehabilitation workforce supply on one hand, and need and other potential determinants on the other hand. Conclusion: The rehabilitation workforce supply in Saudi Arabia surpassed the regional and global averages, but was lower than the average for high-income countries. Workforce distribution varied by region across the country and was not related to need. It is important to consider the need for rehabilitation services and context-specific factors when determining the optimal size and distribution of the rehabilitation health workforce in Saudi Arabia.

Use of cervical traction for managing neck pain: A cross-sectional survey of physiotherapists in India.

BACKGROUND: Neck pain remains the fourth leading cause of disability and work loss, and a multimodal treatment approach is effective in reducing neck pain and disability. PURPOSE: The purpose of this study is to examine the use of cervical traction for managing neck pain by Physiotherapists in India, including how and when the traction is used, the modes and parameters of traction, any additional interventions given with traction, and the influence of professional demographic characteristics in decision making in traction usage. STUDY DESIGN: A cross-sectional survey. METHODOLOGY: A random sample of approximately 2500 musculoskeletal physiotherapists was surveyed, and the data was presented in a descriptive form. Chi-square analyses were used to identify the association between responders' qualifications and traction usage. RESULTS: From the total physiotherapist approached 18.52% (n = 463) responses were obtained, and 62% (n = 287) respondents reported that they would use traction in their clinical practice. Out of 92.3% of responders indicated using traction for radiculopathy, 78.7% of respondents used traction for patients with neck pain without radiculopathy. It is used as a combination therapy by 58.8% for radiculopathy and 52.2% for stiffness. There was no association between the responder's qualification and traction usage (χ2 = 0.707, p = 0.40). Traction is used in combination with other physiotherapeutic techniques. CONCLUSION: Traction use was consistent with the proposed criteria identifying patients likely to benefit. However, disregarding current guidelines, physiotherapists also use traction for non-radicular neck pain. Various traction delivery modes and parameters were used within a comprehensive plan of care incorporating multiple interventions.

Work-related musculoskeletal pain among physical therapists: a cross-sectional study in Kyoto and Shiga prefectures, Japan.

OBJECTIVES: This study aimed to determine the actual working conditions and prevalence of musculoskeletal pain among physical therapists in Japan, and the risk factors associated with low back pain (LBP) and upper limb pain (ULP). METHODS: A cross-sectional study of physical therapists in the Kyoto and Shiga prefectures was conducted using a self-administered questionnaire. The survey contents included questions regarding personal, work-related, and musculoskeletal pain factors. Logistic regression models were used to analyze factors associated with LBP and ULP. RESULTS: Responses from 1479 participants were included in the analyses. The prevalence of LBP at the time of the survey and in the past year was 40.1% and 74.3% in females, and 37.8% and 69.9% in males, respectively. The prevalence of ULP was 34.8% and 64.2% in females, and 27.2% and 53.3% in males. The numbers of patients who performed manual therapy per day, worked using a fixed-height bed, performed manual therapy, had job dissatisfaction and stress, were over 40 years old, and slept less than 6 hours were associated with LBP and ULP. Assistance task was a risk factor only for LBP, and female sex a risk factor only for ULP. CONCLUSIONS: The prevalence of LBP and ULP among physical therapists in Japan was as high as that in nurses and care workers. Work-related factors associated with LBP and ULP were identified among physical therapists. Thus, to prevent work-related musculoskeletal disorders, measures to reduce the physical burden from the perspective of occupational health are required.

A systematic review of work related musculoskeletal disorders among physical therapists and physiotherapists.

Physical therapists and physiotherapists (PPTs) perform and repeat physical tasks that can lead to work-related musculoskeletal disorders (WMSD). The aim was to study the main research concerning this problem, i.e. the risk factors, activities that exacerbate WMSD symptoms, alterations in work habits and the proposed responses, and to estimate mean value (±standard deviation, STD) for the most studied parameters. This review was conducted according to the PRISMA guideline. Five databases (Pubmed, ScienceDirect, Google Scholar, Medeley and Science.gov) were scanned to identify works investigating the different aspects of WMSD among PPTs. Two reviewers independently selected relevant studies using inclusion/exclusion criteria, critically appraised, and extracted data. To homogenize the data, prevalence were reported to the total sample studied when necessary. Among the 9846 articles identified, 19 articles were included. The WMSD prevalence was over 50 %. The areas most affected were the lower back, neck and thumb. An exhaustive list of parameters were constructed for job risk factors (n = 19), activities that exacerbating symptoms (n = 13), altered work habits (n = 15), responses and treatments (n = 26). The mean prevalence (±STD) was calculated for the major parameters. Nine main job risk factors were extracted with an average prevalence of about 30 % and a relatively high variability. Seven activities exacerbating WMSD symptoms and five altered work habits were identified with a homogeneous rate (5-20 %). Three main responses and treatments were found with heterogeneous prevalence. This review provides useful results for the development of future protocols to prevent the occurrence of WMSD among PPTs and meta-analyses.

Prevalence and associated factors of sexual, psychological, and physical violence among physical therapists in their clinical role in Spain: a national web-based cross-sectional survey.

OBJECTIVES: To determine the extent of career-long and 12-month exposure to sexual, physical, and psychological/verbal violence committed by patients or their companions among physical therapists in Spain. Additionally, to identify the factors associated with such exposure. METHODS: This study employed an observational cross-sectional approach. Initially, a questionnaire was developed and validated using a convenience sample. Subsequently, it was distributed via email to all physical therapists registered in Spain in the first quarter of 2022. Individual risk models were created for each type of violence experienced within the past 12 months. RESULTS: The prevalence of violence encountered by physical therapists throughout their careers was 47.9% for sexual violence, 42.7% for psychological/verbal abuse, and 17.6% for physical abuse. Lower values were observed within the last 12 months (13.4%, 15.8%, and 5.2%, respectively). Statistical risk modeling for each type of violence experienced in the past 12 months indicated that the common precipitating factor for all forms of violence was working with patients with cognitive impairment. Working part-time appeared to be a protective factor. Other factors, such as the practitioners' gender, practice setting, or clinic location showed variations among the diverse types of violence. CONCLUSIONS: The exposure to type II workplace violence within the last 12 months among physical therapists in Spain (Europe) is not so high as in some other world regions. Various individual, clinical, and professional/organizational risk factors have been identified in connection with type II workplace violence. Further research is warranted to compare the violence experienced once the COVID pandemic has subsided.

Work-related interventions are not commonly included in physiotherapy management of lower limb osteoarthritis: A cross-sectional survey of Australian Physiotherapists.

BACKGROUND: Lower limb osteoarthritis (OA) is a leading cause of disability and can affect an individual's ability to work. OBJECTIVES: To explore Australian physiotherapists' use of work-related interventions in managing patients with lower limb OA, and identify current management practices. METHODS: Physiotherapists with at least two years of experience treating patients with lower limb OA were invited to complete an online survey to understand how physiotherapists manage patients with lower limb OA, specifically regarding interventions related to work. RESULTS: A total of 132 physiotherapists completed the survey. In free text responses, only 1.5% and 2.3% of physiotherapists nominated work-related items in their key components of treatment or educational topics discussed with patients with lower limb OA, respectively. From a range of work-related activities presented, over half of physiotherapists indicated they regularly/always provided education about the benefits of remaining in work (63.5%) and advice on managing symptoms at work (57.4%). Less than 10% of physiotherapists regularly/always used a validated scale to identify barriers for work (9.6%), discussed absences from work (9.6%), conducted a workplace assessment (4.4%), and discussed submitting workers' compensation claims (2.6%). Exercise and patient education were the most frequently nominated physiotherapy treatments in free text (96.2% and 86.3%, respectively) and fixed response (99.2% and 93.9%, respectively) questions. CONCLUSION: Many physiotherapists do not address work-related activities in their management of patients with lower limb OA. In light of work-related challenges commonly experienced by individuals with lower limb OA, this is an important aspect of management of this condition.

Nível de atividade física de fisioterapeutas de um hospital público / Level of physical activity of physical therapists at a public hospital

Objetivo: avaliar o nível de atividade física dos fisioterapeutas e identificar o perfil socioeconômico desses profissionais de um hospital público de grande porte em Goiânia. Métodos: Trata-se de um estudo observacional, transversal e quantitativo realizado de abril a agosto de 2020. Foram incluídos fisioterapeutas de ambos os sexos, contratados há no mínimo seis meses, e que assinaram o termo de consentimento livre e esclarecido. Excluídos da pesquisa aqueles em férias ou licença médica no período da coleta de dados. Para avaliar o nível de atividade física utilizou-se o Questionário Internacional de Atividade Física (IPAQ), e um questionário para conhecer o perfil socioeconômico desses profissionais. As variáveis contínuas foram apresentadas como média e desvio padrão, enquanto as categóricas, em frequência absoluta e relativa. Resultados: Grande parte dos indivíduos é do sexo feminino (73,5%) com maior prevalência de inativos (76%), sendo que (49,9%) cumprem carga horária maior que 30 horas semanais. Do total da amostra (61,8%) tem pelo menos especialização na sua formação profissional. Conclusão: Os fisioterapeutas do serviço público apresentam o nível de atividade física reduzido, com maior proporção classificados como inativos, segundo a OMS.

Purpose: evaluate the level of physical activity of physical therapists and identify the socioeconomic profile of these professionals in a large public hospital in Goiânia. Methods: This is an observational, cross-sectional and quantitative study carried out from April to August 2020. Physical therapists of both sexes, hired for at least six months, and who signed a free and informed consent form, were included. The research excluded those on vacation or sick leave during the data collection period. In order to assess the level of physical activity, the International Physical Activity Questionnaire (IPAQ) was used, as well as a questionnaire to learn about the socioeconomic profile of these professionals. Continuous variables were presented as mean and standard deviation, while categorical variables were in absolute and relative frequency. Results: Most of the individuals are female (73.5%) with a higher prevalence of inactive people (76%), and (49.9%) working more than 30 hours per week. From the total sample, 61.8% were at least specialists in their areas. Conclusion: Public service physical therapists have a reduced level of physical activity, with a greater proportion being classified as inactive, according to WHO.

Description of physical rehabilitation in intensive care units in Argentina: usual practice and during the COVID-19 pandemic. Online survey. / Descripción de la rehabilitación física en terapias intensivas de Argentina, práctica habitual y durante la pandemia COVID-19. Encuesta tipo online.

OBJECTIVE: To describe the usual practice of mobility therapy in the adult intensive care unit for patients with and without COVID-19. METHODS: Online survey in which physical therapists working in an adult intensive care unit in Argentina participated. Sixteen multiple-choice or single-response questions grouped into three sections were asked. The first section addressed personal, professional and work environment data. The second section presented questions regarding usual care, and the third focused on practices under COVID-19 pandemic conditions. RESULTS: Of 351 physical therapists, 76.1% answer that they were exclusively responsible for patient mobility. The highest motor-based goal varied according to four patient scenarios: Mechanically ventilated patients, patients weaned from mechanical ventilation, patients who had never required mechanical ventilation, and patients with COVID-19 under mechanical ventilation. In the first and last scenarios, the highest goal was to optimize muscle strength, while for the other two, it was to perform activities of daily living. Finally, the greatest limitation in working with patients with COVID-19 was respiratory and/or contact isolation. CONCLUSION: Physical therapists in Argentina reported being responsible for the mobility of patients in the intensive care unit. The highest motor-based therapeutic goals for four classic scenarios in the closed area were limited by the need for mechanical ventilation. The greatest limitation when mobilizing patients with COVID-19 was respiratory and contact isolation.

OBJETIVO: Describir la práctica habitual de asistencia kinésica motora en la unidad de cuidados intensivos de adultos, tanto en pacientes con y sin COVID-19. MÉTODOS: Estudio observacional transversal de tipo encuesta online. Se incluyeron kinesiólogos que trabajan en unidades de cuidados intensivos de adultos en Argentina. Se realizaron 16 preguntas de respuesta múltiple o simple agrupadas en 3 apartados. El primero caracterizado por datos personales, profesionales o del ámbito laboral. El segundo, destinado a conocer el accionar habitual y un tercero enfocado en las prácticas bajo la pandemia COVID-19. RESULTADOS: Sobre 351 kinesiólogos, el 76.1% reportó que la movilización de los pacientes estaba a cargo exclusivamente de ellos. El objetivo máximo a alcanzar desde el aspecto motor fue variable según cuatro escenarios: Pacientes en ventilación mecánica, desvinculados de la ventilación mecánica, los que nunca estuvieron asociados a la ventilación mecánica y con COVID-19 en ventilación mecánica. En el primer y último escenario el objetivo máximo fue optimizar valores de fuerza muscular. En los restantes fue realizar actividades de la vida diaria. Por último, la mayor limitante en el abordaje de pacientes con COVID-19 fue el aislamiento respiratorio y/o de contacto. CONCLUSIÓN: Los kinesiólogos en Argentina reportaron encargarse de la movilización de los pacientes en la unidad de cuidados intensivos. Los objetivos máximos desde el aspecto motor para cuatro escenarios clásicos en el área cerrada podrían estar determinado por la asociación con la ventilación mecánica. La mayor limitación a la hora de movilizar a pacientes con COVID-19 fue el aislamiento respiratorio y de contacto.