Orthopedic surgeon perspectives on appropriate referral of trauma patients to physical therapy (PT).

Abstract:

OBJECTIVES:To evaluate orthopedic surgeon referral of trauma patients to PT. DESIGN:Cross-sectional survey. SETTING:Alberta, Canada. PARTICIPANTS:Orthopedic surgeons and residents. METHODS:A web-based survey was utilized to poll orthopedic surgeons and residents on referral practices. Statistical analysis using Kruskal-Wallis One-Way Analysis of Variance by Ranks; Post hoc analysis using the minimum significant difference method for multiple comparisons and nonparametric correlations using Spearman's rho. RESULTS:The overall response rate was 48 %. Key indications for referral were range of motion deficits, failure to progress, strength and gait training. Of those surveyed, 72.5 and 26.1 % felt that there was either moderate or significant improvement following PT, respectively. Years in practice had a significant effect on survey responses. Residents and surgeons in practice for >20 years viewed PT as being less important in orthopedic trauma (p < 0.05) and were less likely to refer orthopedic trauma patients to PT (p < 0.05). Residents were less likely to view PT in orthopedic trauma as evidence-based (0.05) and more likely to disagree with the statement that formalized PT results in better outcomes than a prescribed home exercise program (p < 0.05). CONCLUSIONS:There are potential differences in the referral practices of orthopedists of varying levels of experience. Although outcome is viewed as positive following PT, it appears that many orthopedists view a prescribed home exercise program as an acceptable equivalent to formalized PT in the setting of orthopedic trauma. Future research should be directed at determining indicators for formalized PT.

authors

Dusik CJ,Buckley RE,Robertson-More C

doi

10.1007/s00402-013-1706-9

subject

Has Abstract

pub_date

2013-05-01 00:00:00

pages

603-8

issue

5

eissn

0936-8051

issn

1434-3916

journal_volume

133

pub_type

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