Conradsson David, Leavy Breiffni, Hagströmer Maria, Nilsson Maria H, Franzén Erika
Division of Physiotherapy Departmlent of Neurobiology Care Sciences and Society Karolinska Institutet Stockholm Sweden.
Function Area Occupational Therapy and Physiotherapy Department Allied Health Professionals Function Karolinska University Hospital Stockholm Sweden.
Mov Disord Clin Pract. 2017 Aug 20;4(6):843-851. doi: 10.1002/mdc3.12525. eCollection 2017 Nov-Dec.
Evidence for the positive effects of physiotherapy for persons with Parkinson's disease (PwPD) is rapidly increasing. However, little is known about the provision of physiotherapy for PwPD in everyday practice. The objective of this study was to gain insight into the nature of physiotherapeutic care for PwPD in hospitals, primary care units, and community services in Sweden.
A web-based survey was sent out to 2956 members of the Swedish Association of Physiotherapists, including questions about treatment, measurement tools, multi-professional collaborations, adherence to physiotherapy guidelines, professional expertise, and needs for gaining expertise regarding PwPD.
Of the 1189 physiotherapists who completed the survey, 705 were treating 1 or more PwPD per month in hospitals (21%), in primary care units (37%), and in the community (42%). Physiotherapy frequently targeted a wide range of musculoskeletal and mobility impairments; however, freezing of gait and pain were less frequently treated. Measurement tools recommended for PwPD were infrequently used, and there was a preference for single-item questions/tools compared with multi-item instruments. Collaboration with other health care professionals for the rehabilitation of PwPD was rare and was more evident in hospitals than in primary care units and the community. Adherence to physiotherapy guidelines was poor, and most respondents reported that they treated too few PwPD to retain their expertise and they perceived a need to increase their knowledge and skills about physiotherapy for PwPD.
The current findings emphasize the need to strengthen expertise regarding the assessment and treatment of PwPD among physiotherapists in Sweden and to apply strategies endorsing multi-professional collaboration for PD rehabilitation.
物理治疗对帕金森病患者（PwPD）具有积极作用的证据正在迅速增加。然而，在日常实践中，关于为PwPD提供物理治疗的情况却知之甚少。本研究的目的是深入了解瑞典医院、初级保健单位和社区服务中为PwPD提供的物理治疗护理的性质。
向瑞典物理治疗师协会的2956名成员发送了一项基于网络的调查，包括有关治疗、测量工具、多专业合作、对物理治疗指南的遵守情况、专业知识以及获取PwPD相关专业知识的需求等问题。
在完成调查的1189名物理治疗师中，有705名每月在医院（21%）、初级保健单位（37%）和社区（42%）治疗1名或更多PwPD。物理治疗经常针对广泛的肌肉骨骼和运动障碍；然而，步态冻结和疼痛的治疗频率较低。推荐用于PwPD的测量工具很少使用，与多项目仪器相比，更倾向于单项问题/工具。与其他医疗保健专业人员合作进行PwPD康复的情况很少见，在医院比在初级保健单位和社区更明显。对物理治疗指南的遵守情况较差，大多数受访者报告说他们治疗的PwPD太少，无法保持专业知识，并且他们认为需要增加有关PwPD物理治疗的知识和技能。
目前的研究结果强调需要加强瑞典物理治疗师对PwPD评估和治疗的专业知识，并应用支持多专业合作进行PD康复的策略。
