TY - JOUR
T1 - Orthopedic surgeons and physical therapists differ regarding rehabilitative needs after lower extremity fracture repair
AU - McLaughlin, Kevin H.
AU - Archer, Kristin R.
AU - Shafiq, Babar
AU - Wegener, Stephen T.
AU - Reider, Lisa
N1 - Publisher Copyright:
© 2022 Taylor & Francis Group, LLC.
PY - 2023
Y1 - 2023
N2 - Background: Little evidence is available to guide physical therapy (PT) following lower extremity fracture repair distal to the hip. As such, variability has been reported in the way PT is utilized post-operatively. Examination of current practice by orthopedic surgeons (OS) and physical therapists is needed to inform clinical practice guidelines in this area. Objective: To describe current PT referral practices among OS, identify patient and clinical factors that affect PT referral, and examine differences between OS and physical therapists with regard to visit frequency, duration, and use of specific PT interventions. Methods: Provider surveys. Results: Surveys were completed by 100 OS and 347 physical therapists. Over half (54%) of OS reported referring “most patients” to PT and identified joint stiffness and strength limitations as top reasons for PT referral. Over 80% of OS and physical therapists indicated that joint stiffness, strength limitations, and patients’ functional goals affected their recommendations for PT visit frequency. More physical therapists than OS reported that pain severity (55% vs 25%, p < .001), maladaptive pain behaviors (64% vs. 33%, p < .001), and patient self-efficacy (70% vs. 49%, p = .003) affected their visit frequency recommendations. While OS recommended more frequent PT for patients with peri-articular fractures, fracture type had minimal impact on the visit frequencies recommended by physical therapists. Conclusion: OS and physical therapists consider similar physical impairments when determining the need for PT and visit frequencies, however, physical therapists consider pain and psychosocial factors more often, with OS focusing more on injury type.
AB - Background: Little evidence is available to guide physical therapy (PT) following lower extremity fracture repair distal to the hip. As such, variability has been reported in the way PT is utilized post-operatively. Examination of current practice by orthopedic surgeons (OS) and physical therapists is needed to inform clinical practice guidelines in this area. Objective: To describe current PT referral practices among OS, identify patient and clinical factors that affect PT referral, and examine differences between OS and physical therapists with regard to visit frequency, duration, and use of specific PT interventions. Methods: Provider surveys. Results: Surveys were completed by 100 OS and 347 physical therapists. Over half (54%) of OS reported referring “most patients” to PT and identified joint stiffness and strength limitations as top reasons for PT referral. Over 80% of OS and physical therapists indicated that joint stiffness, strength limitations, and patients’ functional goals affected their recommendations for PT visit frequency. More physical therapists than OS reported that pain severity (55% vs 25%, p < .001), maladaptive pain behaviors (64% vs. 33%, p < .001), and patient self-efficacy (70% vs. 49%, p = .003) affected their visit frequency recommendations. While OS recommended more frequent PT for patients with peri-articular fractures, fracture type had minimal impact on the visit frequencies recommended by physical therapists. Conclusion: OS and physical therapists consider similar physical impairments when determining the need for PT and visit frequencies, however, physical therapists consider pain and psychosocial factors more often, with OS focusing more on injury type.
KW - Trauma
KW - health services
KW - pain
KW - practice analysis
KW - survey
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U2 - 10.1080/09593985.2022.2078753
DO - 10.1080/09593985.2022.2078753
M3 - Article
C2 - 35594136
AN - SCOPUS:85130433219
SN - 0959-3985
VL - 39
SP - 2446
EP - 2453
JO - Physiotherapy Theory and Practice
JF - Physiotherapy Theory and Practice
IS - 11
ER -