The Implementation of an advanced practitioner therapist Role within a community independence service.In Central Southampton, demand for Comprehensive Geriatric Assessment (CGA) was higher than capacity so GPs were sent requests such as medications review. Audits showed that 60% of requests were not actioned, impacting on rehabilitation whilst waiting for a GP appointment. This delay on patient care presented an opportunity to train a therapist to complete CGAs and enhance career development opportunities.
How effective is physiotherapy for sciatica? A systematic review and meta-analysis.Sciatica is a broad term describing spinally referred pain of neural origin that radiates into the leg. Sciatica is a significant burden to healthcare and health economies globally. Physiotherapy is often prescribed for the treatment of sciatica, however its effectiveness remains controversial. This systematic review will establish whether physiotherapy is effective for patients with sciatica.
Achieving a definition and mechanism of evaluation for spinal surgical conversion within the National Back and Radicular Pain Pathway.To achieve consensus amongst relevant stakeholders regarding what constitutes spinal surgical conversion (from primary to secondary care) within the National Back and Radicular Pain Pathway (NBPP) and what would be an appropriate mechanism to evaluate this. Data from the Getting It Right First Time (GIRFT) project team highlights wide variation in service delivery across the UK making the evaluation and refinement of NBPP aspects imperative.
Musculoskeletal MRI requesting is an overused resource: Can a multi-disciplinary group reduced inappropriate referrals from primary care to secondary care?An interdepartmental audit of acute MRI imaging in neurologically compromised patients identified a greater than 24hour average delay for this vulnerable group of patients. The reason cited by our radiology department were the number of routine referrals from primary care overloading the capacity available.
A dedicated physiotherapy led clinic for the assessment and management of cough weakness in a complex home ventilation cohort.A service redesign was undertaken to reduce the wait for treatment amongst patients with cough weakness, thus at risk of respiratory tract infection (RTI) (Chatwin et al, 2018), previously reviewed within the general clinics of a large and complex adult home ventilation cohort at the regional centre. The now well-established clinic dedicated to assessing and treating those with cough weakness is led by a rotational band 6 physiotherapist. Patients may also receive this review during planned hospital admissions for assessment of Non Invasive Ventilation (NIV), during unplanned admissions, and
Transforming Musculoskeletal Physiotherapy delivery to provide a combined digitalised serviceThis service evaluation sought to review whether a move from a face to face only physiotherapy pathway to one initiated by a digital first approach improved speed of access to care whilst providing wider patient choice, maintaining patient satisfaction and reducing average number of treatment sessions.
Physiotherapy interventions for pain management in haemophiliaHaemophilia is an inherited bleeding disorder characterised by recurrent and spontaneous bleeding into joints and muscles, and fatal bleeding in the untreated state. People with haemophilia (PWH) experience acute pain from an early age from musculoskeletal bleeding episodes. As a result of such bleeds, many PWH have chronically painful, multi-joint haemophilic arthritis. 35-50% of PWH report living with chronic musculoskeletal pain, with most reporting their pain was poorly managed by their healthcare providers. There are no published guidelines for management of chronic arthritic joint pain
The Relationship Between the Use of Personal Electronic Devices and Musculoskeletal Pain in ChildrenMusculoskeletal disorders (MSDs) in the adult population have increased over the past decade. Evidence suggest that this is due to the rapid development and usage of computer technology and personal electronic devices (PEDs). Research has identified risk factors associated with musculoskeletal (MSK) pain as: duration of use, type of device used, and positions people are using them in. Similarly, children's usage of PEDs has rapidly increased. With this growth comes a need to understand the potential link between PED use and MSK pain in children. There is a dearth of evidence related to risk
Determining the information needs of patients undergoing lumbar fusion.There is emerging evidence to support pre-operative education for patients undergoing elective spinal surgery. However, there is currently limited evidence and agreement regarding the actual content of the information given to patients before lumbar fusion surgery. Anecdotally, patients at Guy´s and St Thomas´ NHS trust have expressed dissatisfaction with a lack of clear and concise preoperative information regarding their surgery, expected prognosis and rehabilitation milestones. In contrast, patients awaiting hip and knee surgery have spoken positively about the experience of attending
Effectiveness of Graded Exercise & Graded Exposure for Chronic Nonspecific Low Back Pain.Previous literature supports that using a graded exposure (GEXP) approach for managing patients with chronic nonspecific lower back pain (CNSLBP) may have more favourable clinical outcomes than graded activity (GA) and general exercise. However, this evidence is limited and of low quality. The aim of this research was to rapidly review the current literature to evaluate whether graded exposure or graded activity is more effective than usual physiotherapy care for managing patients with CNSLBP.