Pattern and Physiotherapy Management of Shoulder Pain  A 5-Year Retrospective Audit of a Nigerian Tertiary Hospital

Ayanniyi, Olusola; Dosumu, Olutade Joseph; Mbada, Chidozie Emmanuel

doi:10.5455/medscience.2015.04.8321

Cited by 3 publications

(4 citation statements)

References 37 publications

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“…Based on the clinical vignette, the majority of physiotherapists (54.2%) provided up to 10 treatment sessions, while others (45.8%) provided more than 10 treatment sessions. This is consistent with previous findings in Nigeria with respect to physiotherapy management of similar musculoskeletal problems, such as neck and shoulder pain [24,25]. Findings from other studies clearly demonstrate that there is no consensus with respect to the number of treatment visits or duration of treatment for knee OA.…”

Section: Discussionsupporting

confidence: 92%

Physiotherapy management of knee osteoarthritis in Nigeria—A survey of self-reported treatment preferences

Ayanniyi

Egwu

Adeniyi

2017

Hong Kong Physiotherapy Journal

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Background: knee osteoarthritis (OA) is a prevalent condition. Little is known about whether treatments provided by physiotherapists to patients with knee OA in Nigeria follow recommended clinical practice guidelines. Objective: The aims of this study were to investigate Nigerian physiotherapists' treatment preferences for knee osteoarthritis (OA) and to evaluate if their preferences were in line with contemporary clinical practice guidelines and recommendations. Methods: A cross-sectional survey of 267 physiotherapists from various health institutions in Nigeria were surveyed, using a structured questionnaire incorporating a clinical vignette on knee OA. Results: Based on the clinical vignette, the majority of the respondents (68.2%) recommended review of x-rays as part of the diagnostic process for knee OA. Thermotherapy was the most utilized modality (86.1%), followed by therapeutic exercise (81.3%). Only 11.1% of the physiotherapists used therapeutic exercise alone. Manual therapy in conjunction with other modalities was the choice for 18% of the physiotherapists. Only 49.1% of the physiotherapists reported including advice on weight control and up to 39% reported bed rest as part of the treatment approach. Conclusion: There was a poor consensus among the physiotherapists in Nigeria on how knee OA is managed compared with contemporary clinical guidelines and recommendations which emphasized application of core modalities, such as therapeutic exercises, patients' education, and weight control over passive modalities. Some areas of practice are in line with contemporary guidelines, while some were in conflict with evidence-based practice.

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Section: Discussionsupporting

confidence: 92%

Physiotherapy management of knee osteoarthritis in Nigeria—A survey of self-reported treatment preferences

Ayanniyi

Egwu

Adeniyi

2017

Hong Kong Physiotherapy Journal

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“…After removing duplicates and screening 8567 titles and abstracts and 254 full-texts reports, 94 studies were included (figure 1). Physical therapy treatment choices were investigated for low back pain (n=48 studies),11–58 knee pain (n=10),32 34 57 59–65 neck pain or whiplash (n=11),15 18 32 34 51 66–71 foot or ankle pain (n=5),72–76 shoulder pain (n=7),15 51 77–81 pre or post knee arthroplasty (n=6)46 82–86 (including one study of hip and knee arthroplasty86) and other musculoskeletal or orthopaedic conditions (where treatment choices were only reported in one study or where one of either recommended or not recommended treatments could not be inferred from guidelines or systematic reviews) (n=18) 87–104. We contacted 15 authors for data (regarding 18 studies): 12 responded and 5 were able to provide the data we requested (regarding six studies) 15 16 22 64 89 100.…”

Section: Resultsmentioning

confidence: 99%

“…Seven studies investigated treatment choices for shoulder pain: four15 78 80 81 focused on subacromial pain syndrome (the most common form of shoulder pain105), two77 79 included patients with various diagnoses (including subacromial pain syndrome) and one51 did not specify a diagnosis (online supplementary table 4). Evidence on the management of subacromial pain syndrome was used to categorise treatment choices for all studies on shoulder pain.…”

Section: Resultsmentioning

confidence: 99%

Do physical therapists follow evidence-based guidelines when managing musculoskeletal conditions? Systematic review

2019

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ObjectivesPhysicians 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.DesignSystematic review.SettingWe 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.ParticipantsStudies 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 outcomesUsing 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).ResultsWe 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).ConclusionsMany 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 numberCRD42018094979.

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“…There was a lack of agreement across respondents in relation to their approaches to diagnosis and treatment. This lack of consensus has been highlighted previously [4], with numerous studies highlighting the varied opinions and practices of HCPs in relation to the management of shoulder pain [12,19,[53][54][55]. The reasons for this variation is likely to be multifactorial, influenced by the impact of inconsistent research findings, a lack of high quality clinical practice guidelines [56], different guidelines and recommendations produced by and targeted to individual HCP discipline groups [3,9], and also the individual role and expertise of the HCP with different levels of training and emphases in professional education.…”

Section: Discussionmentioning

confidence: 99%

Managing shoulder pain: a meta-ethnography exploring healthcare providers’ experiences

Maxwell

Robinson

McCreesh

2021

Disability and Rehabilitation

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To review and synthesize qualitative research studies exploring the experiences of Healthcare Providers (HCPs) of managing shoulder pain.A meta-ethnographic approach was adopted to review and synthesize eligible studies. The findings from each included study were translated into one another using Noblit and Hares' seven-stage process. A systematic search of eleven electronic databases was conducted in March 2020. Methodological quality was assessed using the CASP Appraisal Tool.Nine studies were included in the meta-synthesis, all deemed of high methodological quality. Three themes were identified; (1) Lack of consensus: "we all have different approaches." (2) Challenges to Changing Practice: It's "really hard to change and switch to a different approach," (3) Getting "Buy in" to Treatment: "…so you have to really sell it early".Healthcare providers working with people with shoulder pain struggle to reconcile, often conflicting, research recommendations with their own clinical experience, beliefs and patient expectations. These findings help explain the continued lack of consensus on how best to manage shoulder pain in clinical practice.

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Pattern and Physiotherapy Management of Shoulder Pain A 5-Year Retrospective Audit of a Nigerian Tertiary Hospital

Abstract: Shoulder Pain (SP) is a common musculoskeletal problem and it constitutes a source of referral and

Cited by 3 publications

References 37 publications

Physiotherapy management of knee osteoarthritis in Nigeria—A survey of self-reported treatment preferences

Physiotherapy management of knee osteoarthritis in Nigeria—A survey of self-reported treatment preferences

Do physical therapists follow evidence-based guidelines when managing musculoskeletal conditions? Systematic review

Managing shoulder pain: a meta-ethnography exploring healthcare providers’ experiences

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