Current perspectives of New Zealand physiotherapists on rehabilitation and return to sport following anterior cruciate ligament reconstruction: A survey

Fausett, Wayne A.; Reid, Duncan; Larmer, Peter

doi:10.1016/j.ptsp.2021.10.012

Cited by 11 publications

(14 citation statements)

References 42 publications

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“…Other studies that focussed on clinician opinion of ACL management identified similar findings of variation in care and inconsistent application of the evidence (Fausett et al., 2022; McRae et al., 2011), as well as the importance of joined up physiotherapy‐orthopaedic care and ambiguity around return to sport rehabilitation (von Aesch et al., 2016). This study uniquely explores the extent of variety in care models and how clinical staff identify and work to reconcile the gap between guidelines for ACL rehabilitation and essential resources such as time, equipment and adequately trained staff.…”

Section: Discussionmentioning

confidence: 83%

“…Putting the patient and their goals at the heart of care (Weston, 2005; World Health Organization, ‎2001). Previous surveys of clinical opinion on ACL management also emphasised the importance of biopsychosocial patient‐centred care (Fausett et al., 2022; von Aesch et al., 2016), however this UK‐based study explored the challenges associated with reconciling PCP with limited resources. In some cases, the long term implications of resource management appeared to have created a cultural shift within physiotherapy teams where resource management is prioritised over evidence‐based later‐stage rehabilitation and patient‐centred care.…”

Section: Discussionmentioning

confidence: 99%

“…The evidence‐based approach to ACL care is criteria‐based progression through phases of care that align with biological and functional recovery (Adams et al., 2012; Grindem et al., 2016; Kruse et al., 2012; Myer et al., 2006; van Melick et al., 2016). Other qualitative and survey studies show that variation and inconsistency are common in ACL rehabilitation management and may be contributing to suboptimal outcomes (Fausett et al., 2022; McRae et al., 2011; von Aesch et al., 2016). This study was the first to show that adherence to evidence‐based practice was just a part of what constitutes optimal care.…”

Section: Discussionmentioning

confidence: 99%

“…It has been suggested that variability in practice may contribute to suboptimal outcomes in this population (Fausett et al, 2022;Greenberg et al, 2018;von Aesch et al, 2016). This highlights the need to explore variability in current practice and to identify unwarranted variability as well as what participants consider to be optimal care.…”

mentioning

confidence: 99%

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Beyond guidelines: A qualitative clinical stakeholder study of optimal management of anterior cruciate ligament rehabilitation

Dunphy¹,

Button

Murray³

et al. 2022

Musculoskeletal Care

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Aims: This study gathered expert perspectives in the management of anterior cruciate ligament (ACL) rehabilitation to explore current practice, variations in care and optimal management strategies. Materials and methods:This was a qualitative semi-structured interview study. The participants' experiences were considered in terms of their roles as employees, managers, clinicians and professional gatekeepers. Purposive and snowball sampling were used to recruit physiotherapists and orthopaedic surgeons. Participants were included if they had a proven record in clinical management or research involving ACL patients. Persons were excluded if they could not speak English. Interviews were conducted in person, via skype or over the phone at a time convenient to the participant. Data was analysed using a framework analysis and critical realist approach.Results: Results included 24 interviews that were conducted with 19 physiotherapists and 5 surgeons. Themes of variation in current care and optimal care were explored including subthemes of patient centred practice, evidence based medicine, resources, self-management, multidisciplinary teamwork, training and expertise were explored. Participant's perceptions of current care were that it was a location 'lottery' that significantly varied for patients across the UK. Conclusions:Stakeholders identified that optimal management should be patient centred and incorporate adequate equipment, specific training for physiotherapists and a closely communicating multidisciplinary team. Research is needed to explore cost effective models of optimal rehabilitation that include return to sport strategies.

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Section: Discussionmentioning

confidence: 83%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Beyond guidelines: A qualitative clinical stakeholder study of optimal management of anterior cruciate ligament rehabilitation

Dunphy¹,

Button

Murray³

et al. 2022

Musculoskeletal Care

View full text Add to dashboard Cite

show abstract

“…Although there is no data on the general utilisation of PROMs by NZ physiotherapists, only 52% of NZ physiotherapists report using PROMs when considering a return to sport after ACLR (Fausett et al, 2022). Patient-reported outcome data following ACLR in NZ is collected by an ACL Registry.…”

Section: Discussionmentioning

confidence: 99%

Patient acceptance of knee symptoms and function after anterior cruciate ligament reconstruction improves with physiotherapy treatment

Fausett¹,

Reid²,

Larmer³

et al. 2023

NZJP

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Physiotherapy is considered an important component of rehabilitation following anterior cruciate ligament reconstruction (ACLR). The relationship between physiotherapy treatment and patient-reported outcomes following ACLR in New Zealand (NZ) is not clear. We used repeated measures logistic regression to examine the relationship between patient-reported outcome data from the NZ ACL Registry and physiotherapy treatment data from the Accident Compensation Corporation (ACC). Outcome measures utilised were the patient acceptable symptom state (PASS) on the Knee Injury Osteoarthritis and Outcome Score (KOOS 4 ) and a normative score on the Marx Activity Rating Scale (MARS) within 24 months of ACLR. Data from 5,345 individuals were included in the final analysis, with a mean (SD) of 11.7 (10.5) (range 0-91) physiotherapy treatments received, over an average (SD) of 185 (153) (range 0-725) days, in the two years following ACLR. Physiotherapy treatment post-ACLR increased the likelihood of achieving a KOOS 4 PASS score at 6 and 12 months, but not at 24 months, following surgery. Physiotherapy did not increase the likelihood of achieving a normative MARS score in the 24 months after ACLR. Multiple factors likely contribute to people who have had an ACLR in NZ receiving a low dosage of physiotherapy treatment following surgery. Physiotherapy treatment after ACLR may increase patient acceptance of any post-surgical symptoms and functional limitations, but the effect on post-operative activity levels is less clear.

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Optimising the Early-Stage Rehabilitation Process Post-ACL Reconstruction

Buckthorpe,

Gokeler,

Herrington

et al. 2023

Sports Med

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Current perspectives of New Zealand physiotherapists on rehabilitation and return to sport following anterior cruciate ligament reconstruction: A survey

Cited by 11 publications

References 42 publications

Beyond guidelines: A qualitative clinical stakeholder study of optimal management of anterior cruciate ligament rehabilitation

Beyond guidelines: A qualitative clinical stakeholder study of optimal management of anterior cruciate ligament rehabilitation

Patient acceptance of knee symptoms and function after anterior cruciate ligament reconstruction improves with physiotherapy treatment

Optimising the Early-Stage Rehabilitation Process Post-ACL Reconstruction

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