Use Of Physical Therapy Services Research Articles

Effectiveness of joint mobilisation after cast immobilisation for ankle fracture: a protocol for a randomised controlled trial [ACTRN012605000143628

BackgroundPassive joint mobilisation is a technique frequently used by physiotherapists to reduce pain, improve joint movement and facilitate a return to activities after injury, but its use after ankle fracture is currently based on limited evidence. The primary aim of this trial is to determine if adding joint mobilisation to a standard exercise programme is effective and cost-effective after cast immobilisation for ankle fracture in adults.Methods/DesignNinety participants will be recruited from the physiotherapy departments of three teaching hospitals and randomly allocated to treatment or control groups using a concealed procedure. All participants will perform an exercise programme. Participants in the treatment group will also receive joint mobilisation twice a week for four weeks. Blinded follow-up assessments will be conducted four, 12 and 24 weeks after randomisation. The primary outcome measures will be the Lower Extremity Functional Scale and the Assessment of Quality of Life. Secondary outcomes will include measures of impairments, activity limitation and participation. Data on the use of physiotherapy services and participants' out-of-pocket costs will be collected for the cost-effective and cost-utility analyses. To test the effects of treatment, between-group differences will be examined with analysis of covariance using a regression approach. The primary conclusions will be based on the four-week follow-up data.DiscussionThis trial incorporates features known to minimise bias. It uses a pragmatic design to reflect clinical practice and maximise generalisability. Results from this trial will contribute to an evidence-based approach for rehabilitation after ankle fracture.

Management of Back and Neck Pain: Who Seeks Care From Physical Therapists?

Little information is available on factors associated with physical therapist use by people with back or neck pain. Identifying the characteristics of people who seek care from physical therapists is a useful first step in determining whether there is appropriate use of physical therapy services. The purpose of this study was to identify factors associated with physical therapist use by people with back or neck pain. The subjects were 29,049 people who had back pain or neck pain, or both, and who were seen for an initial evaluation at 1 of 21 US spine care centers. Each subject and evaluating physician completed a written survey at the time of the initial evaluation. Multiple logistic regression analyses were conducted to identify factors associated with physical therapist use. Several measures of health and illness severity were associated with physical therapist use. Age and being male were negatively associated with physical therapist use. Education level, having workers' compensation coverage, and being in litigation were positively associated with physical therapist use. Physical therapist use also varied by previous physician use and census region. The results suggest that variations in physical therapist use are associated with factors other than health and illness severity. The results also suggest that people who would benefit from physical therapy may not be receiving it or that people who would not benefit from physical therapy are receiving it, or both.

Use of physiotherapy and alternatives by children with cerebral palsy: a population study.

To describe the use of physiotherapy services and alternative therapies by a population of children with moderate to severe cerebral palsy (CP). Descriptive cross-sectional survey. A total of 212 parents of children aged 4-14 years with moderate to severe CP were identified from the Northern Ireland Cerebral Palsy Register (NICPR) and a random subsample of their paediatric physiotherapists. A standardized description of motor impairment or assessment form; a postal questionnaire to parents and paediatric physiotherapists (to validate parents' reports of service use). RESPONSE RATES: In total, 85% of parent questionnaires were returned and 100% of paediatric physiotherapists responded. Service use among families was high; on average the families had contact with approximately seven services in a 6-month time interval. The overwhelming majority of children (96%) received physiotherapy during the school term and most (59%) received treatment at least twice a week for 30 min; 43% of children had their physiotherapy discontinued over the summer holidays. Over one-quarter (28%) of families had opted out of the NHS and bought alternatives like conductive education (21%) or private forms of conventional physiotherapy (16%). Children with more severe forms of CP, in special education, particularly at schools for physical disability, were high-intensity users of the physiotherapy service. Despite this, 74% of parents wanted more physiotherapy for their child. The demand for physiotherapy services is likely to continue given the relatively stable prevalence rate of CP, the proportion of children with disabling CP and the level of parent interest in the service. A number of quality aspects and gaps in the service have been identified.

Factors that Impact Functional Levels of Hispanic Elders

The purpose of this manuscript is to raise awareness about the prevalence of low functional health among the Hispanic elderly population in America. This paper provides a brief review of the literature relating to the functional health of this population and explores the inter-relationships between poor functional status, health needs, socioeconomic status, health services utilization,living arrangements, family structure, and culture. Many older Hispanics would undoubtedly benefit from physical therapy services but are being underserved by our profession. This paper discusses the cultural and institutional factors which influence the use of physical therapy services. Specific implications for physical therapists' initiatives regarding minority recruitment, public awareness, physician awareness, and health care reform are evaluated.

Use of physiotherapy services by elderly patients at a central hospital in Zimbabwe

The health status of the elderly in a community may he reflected in their use of the available health services. The records of elderly patients who utilized physiotherapy services at a central hospital in Zimbabwe over a five-year period (1989-1993) were reviewed to determine the range of medical problems for which the patients had been treated through physiotherapy. It is argued that physiotherapy has a role to play in improving the quality of life of older Zimbabweans with physical disabilities. Further, a case is made out for physiotherapists to become involved in health-education programmes to prevent the occurrence of factors which contribute to the onset of physical disability in older persons.

National Health Insurance. Physical therapists' attitudes.

APTA members living in New England were surveyed by a mail questionnaire to assess their attitudes toward National Health Insurance. Respondents' strata included educators, private practitioners, and clinicians. Generally, respondents believed that National Health Insurance was inevitable, would not cause unnecessary use of physical therapy services, and would not affect the individual therapist's professional freedom. The majority of the respondents judged themselves not well informed about the health plan. Respondents' perceptions of their peers' views of National Health Insurance were inaccurate. Options favored by the respondents under a hypothetical health plan are reported. Results indicate that the physical therapists surveyed generally favored National Health Insurance and thought the APTA should represent them in planning such a program. No significant differences in attitude toward National Health Insurance could be attributed to respondent strata or any of the personal data collected.