Knowledge and Care Quality of Physiotherapy Technologists in the Management of Common Shoulder Disorders: Results from a Survey in the Province of Quebec, Canada

Abstract

Purpose: In Québec, physiotherapy technologist (Phys.T.) scope of practice allows them to complete the evaluation and treat various musculoskeletal disorders, including shoulder disorders, after an initial assessment by a referring provider. They may need to re-evaluate and refer back to the providers if a patient does not progress in a satisfactory manner. Our purpose is to evaluate knowledge and care of practicing Phys.T. in identifying and managing overall care for common shoulder disorders. Method: A survey presented four clinical vignettes featuring common shoulder disorders. Survey participants provided information regarding diagnosis, imaging recommendations, specialist referrals, medical and rehabilitation care, and their confidence in managing these clinical cases. Responses were compared to recommendations from selected clinical practice guidelines (CPGs). Results: 43 Phys.T. completed the survey, with the majority accurately identifying common shoulder disorders across all vignettes (74%–94%). Compliance with CPGs was observed for rotator cuff tendinopathy (60%) and adhesive capsulitis (61%), with most Phys.T. refraining from initial imaging tests. However, a significant proportion recommended imaging for acute full-thickness rotator cuff tear (52%) and recurrent traumatic glenohumeral instability (80%), in line with CPGs. Education and exercises were prioritized in all vignettes as per CPGs, although a proportion favored passive physical modalities not endorsed by CPGs (13%–72%). Conclusion: Most Phys.T. demonstrated adequate identification and management of shoulder disorders, reflecting their collaborative role in patient care. However, discrepancies existed in adherence to evidence-based recommendations, suggesting the need for additional training to optimize care pathways and inter-professional collaborations for shoulder and musculoskeletal disorders.