Reported practices related to, and capability to provide, first-line knee osteoarthritis treatments: a survey of 1064 Australian physical therapists

Christian J Barton; Marcella F Pazzinatto; Kay M Crossley; Karen Dundules; Natasha A Lannin; Matt Francis; Jason Wallis; Joanne L Kemp

doi:10.1016/j.bjpt.2021.08.001

Reported practices related to, and capability to provide, first-line knee osteoarthritis treatments: a survey of 1064 Australian physical therapists

Braz J Phys Ther. 2021 Nov-Dec;25(6):854-863. doi: 10.1016/j.bjpt.2021.08.001. Epub 2021 Sep 9.

Authors

Christian J Barton¹, Marcella F Pazzinatto², Kay M Crossley³, Karen Dundules², Natasha A Lannin⁴, Matt Francis², Jason Wallis⁵, Joanne L Kemp²

Affiliations

¹ La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia; Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Australia; Department of Surgery, St Vincent's Hospital, University of Melbourne, Melbourne, Australia. Electronic address: c.barton@latrobe.edu.au.
² La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia; Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Australia.
³ La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia.
⁴ Department of Physiotherapy, Podiatry and Prosthetics and Orthotics, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia; Alfred Health, Melbourne, Australia.
⁵ Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Clayton, Australia; Monash-Cabrini Department of Musculoskeletal Health and Clinical Epidemiology, Cabrini Health, Clayton, Australia.

Abstract

Background: Physical therapists play a key role in providing first-line knee osteoarthritis treatments, including patient education and exercise therapy.

Objectives: Describe Australian physical therapists' awareness of guidelines; reported practices; and beliefs about capability, opportunity, motivation, and evidence.

Methods: An online cross-sectional survey was completed by physical therapists prior to attending the Good Living with osteoArthritis from Denmark (GLA:D®) Australia training courses (March 2017 to December 2019). The survey instrument was developed by an expert panel and was informed by the Theoretical Domains Framework.

Results: 1064 physical therapists from all Australian states and territories participated. 11% (n = 121) could name an accepted guideline, 98% agreed it was their job to deliver patient education and exercise therapy, and 92% agreed this would optimise outcomes. Most reported providing strength exercise (99%), written exercise instructions (95%), treatment goal discussion (88%), and physical activity advice (83%) all or most of the time. Fewer provided aerobic exercise (66%), neuromuscular exercise (54%), and weight management discussion (56%) all or most of the time. Approximately one quarter (23-24%) believed they did not have the skills, knowledge, or confidence to provide education and exercise therapy recommended by guidelines, and just 48% agreed they had been trained to do so.

Conclusion: Australian physical therapists treating knee osteoarthritis typically provide strength-based home exercise with written instructions, alongside goal setting and physical activity advice. Just one in nine could name a guideline. Education and training activities are needed to support physical therapists to access, read and implement guidelines, especially for aerobic and neuromuscular exercise, and weight management.

Keywords: Education; Evidence; Exercise; Osteoarthritis; Physical therapy.

MeSH terms

Australia
Cross-Sectional Studies
Exercise Therapy
Humans
Osteoarthritis, Knee* / therapy
Physical Therapists*
Surveys and Questionnaires