Physical Therapists' Choices, Views and Agreements Regarding Non-Pharmacological and Non-Surgical Interventions for Knee Osteoarthritis Patients: A Mixed-Methods Study

Ricardo M Ferreira; Pedro N Martins; Nuno Pimenta; Rui S Gonçalves

doi:10.31138/mjr.34.2.188

Physical Therapists' Choices, Views and Agreements Regarding Non-Pharmacological and Non-Surgical Interventions for Knee Osteoarthritis Patients: A Mixed-Methods Study

Mediterr J Rheumatol. 2023 Jun 30;34(2):188-219. doi: 10.31138/mjr.34.2.188. eCollection 2023 Jun.

Authors

Ricardo M Ferreira^{1

2}, Pedro N Martins^{1

3}, Nuno Pimenta¹, Rui S Gonçalves²

Affiliations

¹ Physical Exercise and Sports Department, Polytechnic Institute of Maia, N2i, Maia, Portugal.
² Physical Therapy Department, Coimbra Health School, Polytechnic Institute of Coimbra, São Martinho do Bispo, Coimbra, Portugal.
³ Physical Exercise and Sports Department, Polytechnic Institute of Bragança, Bragança, Portugal.

Abstract

Objective/aims: The aims of this study are to collect the most common non-pharmacological and non-surgical interventions used by the Portuguese physical therapists in their knee osteoarthritis patients, and to deeper understand the factors associated to their intervention choices.

Methods: This study incorporated a mixed-methods design. For the quantitative data it was choose an e-survey (with 25 close-end questions, plus general information of the study and a clinical vignette), retrieving sociodemographic and self-reported practice on knee osteoarthritis information. It was analysed response frequencies and associations between variables with logistic regression analyses. For the qualitative data, it was chosen to perform semi-structured interviews in purposefully selected physical therapists to include different sociodemographic factors and survey responses regarding the physical therapists' interventions chosen. After the interviews, the audios were collected, anonymised, transcribed verbatim, and the texts explored by the thematic approach.

Results: From the 277 PTs that shown interest in participating in the study, 120 fully completed the questionnaire and, from those, 10 participated in the interviews. The most chosen interventions included Resistance Exercise, Manual Therapy, Nutrition/Weight Loss, Self-care/Education, Stretching and Aquatic Exercise. Furthermore, it seems that PTs' individual characteristics (age, experience, and clinical reasoning), patient's characteristics (clinical findings and preferences), and work-related factors (facility type, work environment and available resources) are the main actors responsible for an intervention chosen.

Conclusions: In the Portuguese PTs context the most important interventions are Exercise, Manual Therapy, Nutrition/Weight Loss, and Self-care/Education; these interventions chosen may be influenced by PT, patient and work-related factors.

Keywords: knee osteoarthritis; non-pharmacological interventions; non-surgical interventions; physical therapy.