Clinical reasoning in physiotherapy management of acute lumbar radiculopathy

Smythe, Andrew

doi:10.15761/mcrr.1000148

Cited by 2 publications

(2 citation statements)

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“…Also, we approached the patients from the perspective of the biopsychosocial model. It must always be taken into account that the painful status, complex and multifactorial [67], affects the capacity to carry out everyday tasks and can cause damage to the somatosensory system, leading to long-lasting incapacity, which can have significant economic and social repercussions. [3].…”

Section: Discussionmentioning

confidence: 99%

Quality of Life in Patients with Lumbosacral Radicular Syndrome and Complete Rehabilitation Program (PRISUM PHSD/1/2022)

2024

J Family Med Prim Care Open Acc

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Worldwide, Lumbosacral Radicular Syndrome (L.R.S.) represents one of the most common lumbar spine problems, inducing disability, reduced quality of life, and working capability. We performed a prospective, double-blind, randomized study in the Departments of Physical Medicine and Rehabilitation, Filantropia Hospital, Craiova, and Techirghiol Balneal and Rehabilitation Sanatorium from June to October 2022. We analyzed the effects of ProHumano+ SpineDinamic (PHSD) on the severity reduction of radicular pain and improvement of quality of life in patients with L.R.S. over three months. A total of 247 patients were randomly divided into two groups: Group 1 (151 patients) received 10 sessions of the rehabilitation program and PHSD (daily, three months), and Group 2 (96 patients) received ten sessions of the rehabilitation program and placebo (daily, three months). Conventional physical therapy (transcutaneous nerve stimulation, ultra-sound, and low-intensity laser treatment) and kinetic program represented the components of a rehabilitation program. Statistical analysis was performed using Microsoft Excel (Microsoft Corp., Redmond, WA, U.S.A.), together with the XLSTAT add-on (Addinsoft SARL, Paris, France). All patients had a favorable evolution, but the difference was significantly statistic for G1 patients. These results concluded that daily PHSD for three months naturally affected clinical and functional status in L.R.S.

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Section: Discussionmentioning

confidence: 99%

Quality of Life in Patients with Lumbosacral Radicular Syndrome and Complete Rehabilitation Program (PRISUM PHSD/1/2022)

2024

J Family Med Prim Care Open Acc

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“…But the lack of consensus on exercise treatment in RCRSP might also be due to heterogeneity of clinical patterns of pain and dysfunction, which demands individualisation of exercise management. This is where clinical reasoning is important, allowing physiotherapists to best adapt treatment to the patient's individual needs improving outcomes (39,40) Many respondents didn't provide reasoning with their dosage responses which may re ect a lack of individualisation of management in practice, though this lack of response partly may also be due to survey fatigue (40).…”

Section: Exercisementioning

confidence: 99%

Physiotherapy management of rotator cuff-related shoulder pain in Germany is broadly consistent with recommended practice: An observational study

Alwins,

Smythe,

Balzer

2024

Preprint

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Background: Rotator cuff-related shoulder pain (RCRSP) is a disabling cause of shoulder pain commonly encountered by physiotherapists internationally. Current clinical practice guidelines recommend conservative management (education, exercise, activity modification, analgesia) prior to consideration of imaging and interventional care (injections/surgery). Previous research from the United Kingdom, Belgium, and the Netherlands, Italy, Australia, and France show that current physiotherapy practice is broadly consistent with guideline recommendations, with some key differences in practice between nations. In contrast to these countries, primary qualification of physiotherapists in Germany is not academically based, but a three-year program of vocational training. It is unknown to what extent German physiotherapists are consistent with providing recommended management for RCRSP, and if this differs from practice shown in other countries. The aim of this study was to investigate the adherence to recommended management for RCRSP in German physiotherapists and compare the findings to practice in other countries. Methods: An English case vignette-based questionnaire, which had been applied in other studies, was translated, and adapted into German context. An online cross-sectional survey was conducted from January 2022 to March 2022. Relationships between different data were analysed using a Chi-square test or Fisher's exact test. A qualitative content analysis was conducted for the open-ended questions. Results: One hundred and ninety-two German physiotherapists responded to the survey. Results showed that most physiotherapists would use exercise therapy (99,0%;190/192) and education (99,0%;190/192) as part of management of RCRSP, consistent with guideline recommendations. Non-academically trained physiotherapists were more likely to use interventions with insufficient evidence (i.e., electrotherapy, taping) (73.0%;111/152), (Pearson-Chi-square = 6.88, p = 0.011). Views on the design of specific parameters of exercise therapy (i.e., type of exercise, dosage etc.) varied widely within the cohort, but were comparable with findings from the other nations. Conclusions: German physiotherapy management for RCRSP is broadly consistent with recommendations of current evidence, but heterogeneity exists in the specific recommendations when considering exercise type and dosage. Compared to similar international studies, German physiotherapists provided less research based clinical reasoning to their management choices and non-academically trained German physiotherapists were significantly more likely to recommend interventions with unclear or missing evidence. Trial Registration: German Clinical Trials Register (DRKS00030955). Retrospectively registered 05 January 2023.

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Clinical reasoning in physiotherapy management of acute lumbar radiculopathy

Cited by 2 publications

References 0 publications

Quality of Life in Patients with Lumbosacral Radicular Syndrome and Complete Rehabilitation Program (PRISUM PHSD/1/2022)

Quality of Life in Patients with Lumbosacral Radicular Syndrome and Complete Rehabilitation Program (PRISUM PHSD/1/2022)

Physiotherapy management of rotator cuff-related shoulder pain in Germany is broadly consistent with recommended practice: An observational study

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