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J Eval Clin Pract. 2015 Dec;21(6):1169-77. doi: 10.1111/jep.12380. Epub 2015 May 19.

Clinical practice in line with evidence? A survey among primary care physiotherapists in western Sweden.

Author information

1
Närhälsan Rehabilitation, Region Västra Götaland, Hönö, Sweden.
2
Department of Medical and Health Sciences, Division of Physiotherapy, Linköping University, Linköping, Sweden.
3
Department of Medical and Health Sciences, Division of Social Medicine, Linköping University, Linköping, Sweden.
4
Närhälsan Research and Development Primary Health Care, Region Västra Götaland, Gothenburg, Sweden.
5
Institute of Neuroscience and Physiology, Department of Health and Rehabilitation, Unit of Physiotherapy, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.

Abstract

RATIONALE, AIMS AND OBJECTIVES:

Evidence-based practice is becoming increasingly important in primary care physiotherapy. Clinical practice needs to reflect current best evidence and be concordant with evidence-based clinical guidelines. There is limited knowledge about therapeutic interventions used in primary care physiotherapy in Sweden. The objectives were to examine preferred treatment interventions reported by publicly employed physiotherapists in primary care for three common musculoskeletal disorders (low back pain, neck pain and subacromial pain), the extent to which these interventions were supported by evidence, and associations with demographic variables.

METHODS:

419 physiotherapists in primary care in western Sweden were surveyed using a validated web-based questionnaire.

RESULTS:

The survey was completed by 271 respondents (65%). Median number of interventions reported was 7 (range 1-16). The most common treatment interventions across the three conditions were advice on posture (reported by 82-94%), advice to stay active (86-92%), and different types of exercise (65-92%). Most of these interventions were supported by evidence. However, interventions with insufficient evidence, such as advice on posture, TENS and aquatic exercise, were also used by 29-96%. Modalities such as laser therapy and ultrasound were sparingly used (<5%), which is in line with evidence. For neck pain, use of evidence-based interventions was associated with gender and for subacromial pain, with work experience.

CONCLUSIONS:

Advice and exercise therapy were the interventions most frequently reported across the three diagnoses, illustrating an active treatment strategy. While most reported interventions are supported by evidence, interventions with unclear or no evidence of effect were also used to a high extent.

KEYWORDS:

clinical practice; evidence; evidence-based practice; interventions; physical therapy; treatment

PMID:
25988993
DOI:
10.1111/jep.12380
[Indexed for MEDLINE]
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