Your comments: 15 June 2016

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Song of praise

As CSP members, we are writing to thank you for your support and to ask for your help (again) in our campaign to celebrate the NHS and its amazing workforce.
We are four physios and a therapy assistant at Lewisham and Greenwich NHS Trust, and members of the Trust’s NHS choir.
Thanks to the support of the CSP and NHS colleagues across the country, we gained the Christmas number 1 spot with our single ‘A Bridge Over You’.
Following this, we are pleased to let you know that our choir’s album, ‘Something Inside so Strong’, will be released on 24 June. On the following day, we are very excited to have been invited to perform at the Glastonbury Festival. You can see a ‘sneak preview’ of the album, with a video of the first single at  
All royalties earned by the choir will be paid into Lewisham and Greenwich NHS Trust’s charitable funds, which works to enhance the patient experience and the working lives of staff.
  • Caroline Harbord, Caroline Smith, Joan Mills, Elizabeth Steele and Rachael Reader

Hip and current

Total hip replacement (THR) is one of the most common orthopaedic procedures in the UK. Historically, following THR people have been provided with hip precautions and equipment such as raised toilet seats and furniture rises, to reduce the risks of dislocation.
This has, however, been questioned recently, with some hospitals opting to change practice and relax these restrictions. 
Professor Catherine Sackley, chair in rehabilitation and head of physiotherapy at King’s College London, and I recently published the findings from our national survey of current practices in the provision of these interventions for people following primary THR.
Their results, published in BMC Musculoskeletal Diseases, reported the views of 170 health professionals. It suggests that hip precautions of restricted hip flexion, abduction and rotation are routinely prescribed by 97 per cent of hospital trusts, and most frequently taught in a pre-operative group (52 per cent). 
Similarly equipment was most frequently provided pre-operatively (61 per cent), and most commonly by occupational therapists (74 per cent). There was variability in the advice provided on the duration of hip precautions and equipment from up to six weeks post-operatively to life-time usage. When asked whether therapists would like to change their current practice, 48 per cent reported that they would if they could. These changes were largely (86 per cent) around decision-making on the provision of equipment and movement restriction on an individual basis, rather than providing precautions and equipment to all patients irrespective of individual need (86 per cent).
Based on these results, the authors concluded that current practice on hip precautions and equipment provision is not fully representative of clinicians’ perceptions of best care after THR. 
Future research is warranted to determine whether, and to whom, hip precautions and equipment should be prescribed post-THR as opposed to the current ‘blanket’ provision of equipment and movement restriction provided in UK practice.
The article is titled ‘UK survey of occupational therapist’s and physiotherapist’s experiences and attitudes towards hip replacement precautions and equipment’.  See:
  • Toby Smith, lecturer in physiotherapy, University of East Anglia 

You’ve added...

In response to Carley King’s Advice line column in the last issue of Frontline
Carole Griffith commented;
I’m a physiotherapist in the community having qualified in 1983 and am a specialist in neuro rehab. I’m also a trained yoga teacher gaining a diploma with the British Wheel of Yoga and have done the extra training to deliver the Yoga for healthy lower backs 12-week programme.
‘I understand your concern re individual people’s preferences but I can say the classes have been very effective to enable people to manage this disabling condition.
‘Following the NICE guidance some physios may wish to consider yoga as part of their provision for this speciality and Alison Trewhela is offering training to physiotherapists.’
Check out the website
Frontline and various

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