ObjectiveTo evaluate the effectiveness of physiotherapy intervention following lumbar
spinal fusion.DesignSystematic review and meta-analysis. 2 independent reviewers searched information
sources, assessed studies for inclusion and evaluated risk of bias. Quantitative
synthesis using standardised mean differences was conducted on comparable outcomes
across trials with similar interventions.Information sourcesPredefined terms were employed to search electronic databases. Additional studies
were identified from key journals, reference lists, authors and experts.Eligibility criteria for included studiesRandomised control trials published in English prior to 30 September 2011
investigating physiotherapy outpatient management of patients
(>16 years), following lumbar spinal fusion, with measurements
reported on one or more outcome of disability, function and health were
included.Results2 Randomised control trials (188 participants) from two countries were included.
Both trials included a behavioural and an exercise intervention. 1 trial was
evaluated as high risk of bias and one as unclear. 159 participants were
incorporated in the meta-analysis. Although evidence from both trials suggested
that intervention might reduce back pain short term (6 months) and long
term (12 months and 2 years), and a behavioural intervention might
be more beneficial than an exercise intervention, the pooled effects (0.72, 95% CI
−0.25 to 1.69 at 6 months; 0.52, 95% CI −0.45 to 1.49 at
12 months and 0.75, 95% CI −0.46 to 1.96 at 2 years) did not
demonstrate statistically significant effects. There was no evidence that
intervention changes pain in the short (6 months) or long term
(12 months and 2 years). The wide CI for pooled effects indicated
that intervention could be potentially beneficial or harmful. Considerable
heterogeneity was evident.ConclusionsInconclusive, very low-quality evidence exists for the effectiveness of
physiotherapy management following lumbar spinal fusion. Best practice remains
unclear. Limited comparability of outcomes and retrieval of only two trials
reflect a lack of research in this area that requires urgent consideration.
This study explores some of the perceived concepts of physiotherapy student supervision in clinical placements through investigation and analysis of the views of clinical educators and physiotherapy managers. The author found evidence to suggest that supervising is advantageous in many aspects of professional practice.
This study aimed to explore possible links between clinical experience in cardiorespiratory physiotherapy and the potential for career choice within that specialty. The perceptions of a purposive sample of physiotherapy students were explored using a self-administered questionnaire, which was constructed to produce in-depth data. Analysis showed that students' perceptions of cardiorespiratory physiotherapy correlated significantly to the degree of experience gained. However, experience was gained both within and outside specialty-specific areas and students were using cardiorespiratory skills in a number of clinical areas and settings. Students with the greatest level of experience within cardiorespiratory patient management were more likely to consider future employment within this specialty. Among the influencing factors was the attitude of clinical educators to the specialty. These findings may have implications for future practice and the recruitment of physiotherapists in to this specialty.
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