French physiotherapy management of rotator cuff related shoulder pain: An observational study

Riera, Jerome; Smythe, Andrew; Malliaras, Peter

doi:10.1002/msc.1545

Cited by 2 publications

(13 citation statements)

References 46 publications

(101 reference statements)

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“…Overall, German physiotherapists are broadly consistent with providing guideline recommended care for RCRSP, almost all respondents recommending some form of education and exercise as management., though high levels of uncertainty exist regarding indication for interventionalist care (imaging, injection, surgery) and heterogeneity is apparent in speci c exercise paradigms. Findings are comparable to those found internationally (11)(12)(13)25), though in German physiotherapists there are signi cant differences in the reported management of RCRSP when comparing academically trained versus non-academically trained physiotherapists.…”

Section: Discussionsupporting

confidence: 72%

“…In comparison to other countries German physiotherapists were much less consistent in recommending injection management considering guideline recommendations (42.9%) compared to France and Australia with over 70% (12,13). Referral rate for imaging by German physiotherapists (39.9%, 76/192) is higher than those in Australia (6.4%), the United Kingdom (9.0%), France (12.6%), and Belgium/the Netherlands (31.0%), but slightly lower than in Italy (42.0%) (11-13, 25, 26).…”

Section: Imaging Injection and Surgerymentioning

confidence: 70%

“…Referral rate for imaging by German physiotherapists (39.9%, 76/192) is higher than those in Australia (6.4%), the United Kingdom (9.0%), France (12.6%), and Belgium/the Netherlands (31.0%), but slightly lower than in Italy (42.0%) (11-13, 25, 26). No indication for surgery was stated in 74.0% (142/192) of German respondents compared to Australia (90.0%), France (89.3%), Italy (62.0%), and Belgium and the Netherlands (70.0%) (12,13,25,26).…”

Section: Imaging Injection and Surgerymentioning

confidence: 99%

“…Researchers in the United Kingdom, Australia and France investigated common physiotherapy practice for shoulder pain (11-13). They found most physiotherapists are compliant with current recommendations, but use of adjunctive therapies (dry needling, electrotherapy) with limited supportive evidence is common (11)(12)(13). Discrepancies between research evidence and practice (evidence-practice-gap) could highlight a lack of effective knowledge translation (11).…”

Section: Introductionmentioning

confidence: 99%

“…It is recommended to trial conservative management for at least six weeks before considering imaging and twelve weeks before considering interventionalist care (injection/surgery) (7-10).Researchers in the United Kingdom, Australia and France investigated common physiotherapy practice for shoulder pain (11-13). They found most physiotherapists are compliant with current recommendations, but use of adjunctive therapies (dry needling, electrotherapy) with limited supportive evidence is common (11)(12)(13). Discrepancies between research evidence and practice (evidence-practice-gap) could highlight a lack of effective knowledge translation (11).Under the premise of needs-based health care, bene ts and effectiveness of physiotherapeutic examination and treatment strategies are increasingly being researched in Germany, with research outcomes justifying the cost of care and resource utilisation (14).…”

mentioning

confidence: 99%

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Physiotherapy management of rotator cuff-related shoulder pain in Germany is broadly consistent with recommended practice: An observational study

Alwins,

Smythe,

Balzer

2024

Preprint

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Background: Rotator cuff-related shoulder pain (RCRSP) is a disabling cause of shoulder pain commonly encountered by physiotherapists internationally. Current clinical practice guidelines recommend conservative management (education, exercise, activity modification, analgesia) prior to consideration of imaging and interventional care (injections/surgery). Previous research from the United Kingdom, Belgium, and the Netherlands, Italy, Australia, and France show that current physiotherapy practice is broadly consistent with guideline recommendations, with some key differences in practice between nations. In contrast to these countries, primary qualification of physiotherapists in Germany is not academically based, but a three-year program of vocational training. It is unknown to what extent German physiotherapists are consistent with providing recommended management for RCRSP, and if this differs from practice shown in other countries. The aim of this study was to investigate the adherence to recommended management for RCRSP in German physiotherapists and compare the findings to practice in other countries. Methods: An English case vignette-based questionnaire, which had been applied in other studies, was translated, and adapted into German context. An online cross-sectional survey was conducted from January 2022 to March 2022. Relationships between different data were analysed using a Chi-square test or Fisher's exact test. A qualitative content analysis was conducted for the open-ended questions. Results: One hundred and ninety-two German physiotherapists responded to the survey. Results showed that most physiotherapists would use exercise therapy (99,0%;190/192) and education (99,0%;190/192) as part of management of RCRSP, consistent with guideline recommendations. Non-academically trained physiotherapists were more likely to use interventions with insufficient evidence (i.e., electrotherapy, taping) (73.0%;111/152), (Pearson-Chi-square = 6.88, p = 0.011). Views on the design of specific parameters of exercise therapy (i.e., type of exercise, dosage etc.) varied widely within the cohort, but were comparable with findings from the other nations. Conclusions: German physiotherapy management for RCRSP is broadly consistent with recommendations of current evidence, but heterogeneity exists in the specific recommendations when considering exercise type and dosage. Compared to similar international studies, German physiotherapists provided less research based clinical reasoning to their management choices and non-academically trained German physiotherapists were significantly more likely to recommend interventions with unclear or missing evidence. Trial Registration: German Clinical Trials Register (DRKS00030955). Retrospectively registered 05 January 2023.

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Section: Discussionsupporting

confidence: 72%

Section: Imaging Injection and Surgerymentioning

confidence: 70%