Abstract:
OBJECTIVES:Physicians often refer patients with musculoskeletal conditions to physical therapy. However, it is unclear to what extent physical therapists' treatment choices align with the evidence. The aim of this systematic review was to determine what percentage of physical therapy treatment choices for musculoskeletal conditions agree with management recommendations in evidence-based guidelines and systematic reviews. DESIGN:Systematic review. SETTING:We performed searches in Medline, Embase, Cumulative Index to Nursing and Allied Health Literature, Cochrane Central Register of Controlled Trials, Allied and Complementary Medicine, Scopus and Web of Science combining terms synonymous with 'practice patterns' and 'physical therapy' from the earliest record to April 2018. PARTICIPANTS:Studies that quantified physical therapy treatment choices for musculoskeletal conditions through surveys of physical therapists, audits of clinical notes and other methods (eg, audits of billing codes, clinical observation) were eligible for inclusion. PRIMARY AND SECONDARY OUTCOMES:Using medians and IQRs, we summarised the percentage of physical therapists who chose treatments that were recommended, not recommended and had no recommendation, and summarised the percentage of physical therapy treatments provided for various musculoskeletal conditions within the categories of recommended, not recommended and no recommendation. Results were stratified by condition and how treatment choices were assessed (surveys of physical therapists vs audits of clinical notes). RESULTS:We included 94 studies. For musculoskeletal conditions, the median percentage of physical therapists who chose recommended treatments was 54% (n=23 studies; surveys completed by physical therapists) and the median percentage of patients that received recommended physical therapy-delivered treatments was 63% (n=8 studies; audits of clinical notes). For treatments not recommended, these percentages were 43% (n=37; surveys) and 27% (n=20; audits). For treatments with no recommendation, these percentages were 81% (n=37; surveys) and 45% (n=31; audits). CONCLUSIONS:Many physical therapists seem not to follow evidence-based guidelines when managing musculoskeletal conditions. There is considerable scope to increase use of recommended treatments and reduce use of treatments that are not recommended. PROSPERO REGISTRATION NUMBER:CRD42018094979.
journal_name
BMJ Openjournal_title
BMJ openauthors
Zadro J,O'Keeffe M,Maher Cdoi
10.1136/bmjopen-2019-032329subject
Has Abstractpub_date
2019-10-07 00:00:00pages
e032329issue
10issn
2044-6055pii
bmjopen-2019-032329journal_volume
9pub_type
杂志文章相关文献
BMJ Open文献大全abstract:OBJECTIVES:To examine the trends in inhospital mortality for England and Scotland over a 17-year period to determine whether and if so to what extent the time trends differ after controlling for differences in the patients treated. DESIGN:Analysis of retrospective administrative hospital data using descriptive aggrega...
journal_title:BMJ open
pub_type: 杂志文章,多中心研究
doi:10.1136/bmjopen-2017-017195
更新日期:2018-02-21 00:00:00
abstract:INTRODUCTION:At present, physicians have a limited ability to predict major cardiovascular complications after non-cardiac surgery and little is known about the anatomy of coronary arteries associated with perioperative myocardial infarction. We have initiated the Coronary CT Angiography (CTA) VISION Study to (1) estab...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2012-001474
更新日期:2012-07-31 00:00:00
abstract:OBJECTIVE:To estimate the costs and outcomes associated with treating non-asthmatic adults (nor suffering from other lung-disease) presenting to primary care with acute lower respiratory tract infection (ALRTI) with oral corticosteroids compared with placebo. DESIGN:Cost-consequence analysis alongside a randomised con...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2019-033567
更新日期:2020-02-18 00:00:00
abstract:INTRODUCTION:Understanding what enhances the motivation and performance of community health workers (CHWs) in humanitarian emergencies represents a key research gap within the field of human resources for health. This paper presents the research protocol for the Performance ImprovEment of CHWs in Emergency Settings (PI...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2016-011753
更新日期:2016-08-16 00:00:00
abstract:INTRODUCTION:In individuals with early (indexed ≤7 days poststroke) and severe upper limb paresis (shoulder abduction and finger extension score of <5 out of 10), our objectives are to: (1) determine if biomarkers of brain structure and function collected at <1 month poststroke explain who will experience clinically im...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2018-026435
更新日期:2018-11-25 00:00:00
abstract:OBJECTIVES:Undertake a systematic scoping review to determine how a research evidence base, in the form of existing systematic reviews in the field of mobile health (mHealth), constitutes education and training for community health workers (CHWs) who use mobile technologies in everyday work. The review was informed by ...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2017-019827
更新日期:2018-07-30 00:00:00
abstract:OBJECTIVES:This study examines the characteristics of studies that Health Canada uses to grant full marketing authorisation for products given a conditional approval between 1 January 1998 and 30 June 2017. DESIGN:Cohort study. DATA SOURCES:Journal articles listing drugs that fulfilled their conditions and received f...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2017-020377
更新日期:2018-04-28 00:00:00
abstract:OBJECTIVE:To determine the extent of agreement and patterns of disagreement between wound swab and tissue samples in patients with an infected diabetic foot ulcer (DFU). DESIGN:Multicentre, prospective, cross-sectional study. SETTING:Primary and secondary care foot ulcer/diabetic outpatient clinics and hospital wards...
journal_title:BMJ open
pub_type: 杂志文章,多中心研究
doi:10.1136/bmjopen-2017-019437
更新日期:2018-01-31 00:00:00
abstract:INTRODUCTION:Secondary prevention drugs for cardiac disease have been demonstrated by clinical trials to be effective in reducing future cardiovascular and mortality events (WAMACH is the Western Australian Medication Adherence and Costs in Heart disease study). Hence, most countries have adopted health policies and gu...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2014-006258
更新日期:2014-09-18 00:00:00
abstract:OBJECTIVES:Data have indicated low to non-existent increased mortality risk for individuals with prediabetes, but it is unclear if the risk is increased when the patient has elevated iron markers. Our purpose was to examine the mortality risk among adults with prediabetes in the context of coexisting elevated transferr...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2014-006491
更新日期:2014-12-11 00:00:00
abstract:INTRODUCTION:Cancer is a major health problem worldwide and the leading cause of death in many countries. The number of patients with cancer and socioeconomic costs of cancer continues to increase. SH003 is a novel herbal medicine consisting of Astragalus membranaceus, Angelica gigas and Trichosanthes Kirilowii Maximow...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2017-019502
更新日期:2018-08-05 00:00:00
abstract:OBJECTIVE:To examine whether confidence in primary healthcare (PHC) differs among ethnic-linguistic groups and which PHC experiences are associated with confidence. DESIGN:A cross-sectional study where patient surveys were administered using random digit dialling. Regression models identify whether ethnic-linguistic g...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2013-003884
更新日期:2014-02-25 00:00:00
abstract:OBJECTIVE:Public opinion and support can be powerful mandates for smoke-free policy. However, the scarcity of evidence on public opinion among Malaysians necessitates further investigation. Therefore, this study aimed to determine the level of support for smoke-free policy at various public domains and its associated f...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2017-020304
更新日期:2019-02-12 00:00:00
abstract:OBJECTIVES:To examine if the estimated glomerular filtration rate (eGFR) slope over a 5-year period is related to incident cardiovascular (CV) events in the following 5 years. DESIGN:Retrospective cohort study. SETTING:Primary care. PARTICIPANTS:All patients aged ≥50 years with at least four eGFR measurements betwee...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2018-023594
更新日期:2018-11-12 00:00:00
abstract:INTRODUCTION:Sub-Saharan Africa remains the epicentre of the HIV pandemic, yet enormous knowledge gaps still exist to elicit a comprehensive portrait of multimorbidity and HIV linkage. This study aims to conduct a systematic meta-analysis of peer-reviewed literature to investigate the current status of multimorbidity e...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2020-036988
更新日期:2020-12-12 00:00:00
abstract:INTRODUCTION:The appropriateness of using routinely collected laboratory data combined with administrative data for estimating influenza vaccine effectiveness (VE) is still being explored. This paper outlines a protocol to estimate influenza VE using linked laboratory and administrative data which could act as a compan...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2019-029708
更新日期:2019-09-30 00:00:00
abstract:INTRODUCTION:Making change towards child and family-based and coordinated services is critical to improve quality, outcomes and value. The Let's Talk about Children (LTC) approach, which consists of brief psychoeducational discussions with parents of kindergarten-aged and school-aged children, has been launched as a mu...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2017-015985
更新日期:2017-07-13 00:00:00
abstract:OBJECTIVES:Regular physical exercise may preserve β cell function in newly diagnosed adults with type 1 diabetes (T1D). However, clinical trials to test this theory require the recruitment and retention of adults with new-onset T1D, which can be challenging. We sought to determine the overall experiences of newly diagn...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2018-022353
更新日期:2018-07-17 00:00:00
abstract:OBJECTIVES:Injury is an important issue in public health. Spinal curvature disorders are deformities characterised by excessive curves of the spine. The prevalence of spinal curvature disorders is not low, but its relationship with injury has not been studied. The aim of this study is to investigate whether spinal curv...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2018-023604
更新日期:2019-01-17 00:00:00
abstract:OBJECTIVE:To investigate how different lay and professional groups perceive and understand the use of routinely collected general practice patient data for research, public health, service evaluation and commissioning. DESIGN, METHOD, PARTICIPANTS AND SETTING:We conducted a multimethod, qualitative study. This entaile...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2017-019378
更新日期:2018-01-08 00:00:00
abstract:INTRODUCTION:Acute, non-low back-related musculoskeletal pain is common and associated with significant socioeconomic costs. No review has evaluated all interventional studies for acute musculoskeletal pain, which limits attempts to make inferences regarding the relative effectiveness of treatments. METHODS AND ANALYS...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2018-024441
更新日期:2019-04-03 00:00:00
abstract:OBJECTIVES:The aim of this study was to assess the risk of injuries among children exposed to a stressful life exposure (defined as bereavement) before conception or during fetal life. DESIGN:Population-based cohort study. SETTING:Denmark. PARTICIPANTS:All singleton births in Denmark between 1 January 1995 and 31 De...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2012-002357
更新日期:2013-04-22 00:00:00
abstract:INTRODUCTION:Insomnia is a highly prevalent, often debilitating and economically burdensome sleep disorder with limited effective therapies. Few data are available to understand which of the therapeutic alternatives is the most effective for patients with insomnia, especially for Traditional Chinese Medicine (TCM). Chi...
journal_title:BMJ open
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1136/bmjopen-2015-008459
更新日期:2016-02-02 00:00:00
abstract:OBJECTIVE:To summarise the evidence on determinants of health-related quality of life (HRQL) in Asian patients with breast cancer. DESIGN:Systematic review conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations and registered with PROSPERO (CRD42015032468...
journal_title:BMJ open
pub_type: 杂志文章,评审
doi:10.1136/bmjopen-2017-020512
更新日期:2018-04-20 00:00:00
abstract:BACKGROUND:The first- and second-trimester screening for trisomy 21 (T21) are reimbursed for all pregnant women in Belgium. Using a cut-off risk of 1:300 for T21, about 5% of all pregnant women are referred for definitive prenatal diagnosis using an invasive test, at a sensitivity of (only) 72.5%. The sensitivity and s...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2014-005922
更新日期:2014-11-07 00:00:00
abstract:INTRODUCTION:Selective dorsal rhizotomy (SDR) is a neurosurgical intervention intended to permanently reduce spasticity in the lower limbs and improve mobility in selected children with cerebral palsy (CP). Despite SDR having been performed worldwide for the past 30 years, there is moderate quality of evidence that SDR...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2018-025093
更新日期:2019-05-01 00:00:00
abstract:INTRODUCTION:Mobility limitation is common and often results from neurological and musculoskeletal health conditions, ageing and/or physical inactivity. In consultation with consumers, clinicians and policymakers, we have developed two affordable and scalable intervention packages designed to enhance physical activity ...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2019-034696
更新日期:2020-11-03 00:00:00
abstract:OBJECTIVES:The aim of this study was to investigate the associations between surrounding greenness levels and asthma among children, and to explore a possible change of this association by the distance of the residence to a city park. DESIGN:A nested case-control study. SETTING:Children aged 4-6 years residing at the...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2015-010341
更新日期:2016-04-11 00:00:00
abstract:OBJECTIVES:The clinical course and prognosis of follicular lymphoma (FL) are diverse and associated with the patient's immune response. We investigated the lymphocyte-to-monocyte ratio (LMR) and neutrophil-to-lymphocyte ratio (NLR) as prognostic factors in patients with FL, including those receiving radiotherapy. DESI...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2017-017904
更新日期:2017-11-03 00:00:00
abstract:OBJECTIVES:To evaluate the risk of major congenital anomaly associated with first-trimester exposure to insulin analogues compared with human insulin in offspring of women with pregestational diabetes. DESIGN AND SETTING:A population-based cohort of women with pregestational diabetes (n=1661) who delivered between 199...
journal_title:BMJ open
pub_type: 杂志文章,多中心研究
doi:10.1136/bmjopen-2016-014972
更新日期:2018-02-24 00:00:00