Centre of Precision Rehabilitation for Spinal Pain, School of Sport, Exercise & Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.
Shropshire Physiotherapy, Newport, Shropshire, TF10 7AB, UK.
Musculoskelet Sci Pract. 2019 Feb;39:58-66. doi: 10.1016/j.msksp.2018.11.006. Epub 2018 Nov 22.
The thoracic spine (TS) is relatively under-researched compared to the neck and low back. As the challenge of managing spinal pain persists, understanding current physiotherapy clinical practice for TS pain and dysfunction is necessary to inform future research in this area.
To investigate physiotherapy practice for managing thoracic spine pain and dysfunction (TSPD) in the UK, with a secondary focus on examining differences across settings and expertise.
A cross sectional e-survey informed by existing evidence was designed. Comprising closed and open questions, the survey is reported in line with Checklist for Reporting Results of Internet E-Surveys. Eligible participants were UK-trained physiotherapists managing patients with TSPD, recruited for 9 weeks up to 8/2/16. Data analysis included descriptive analyses (closed questions) and thematic analysis (open questions).
From the 485 respondents, fulfilling the required sample size, key findings included.
Active motion testing, palpation and postural assessment was 'always' undertaken by >89% of respondents.
Active (exercises) and passive (e.g. mobilisations) techniques were used by >85% of respondents, with ∼50% using manipulation, taping and acupuncture. Practice settings: Although broadly similar passive techniques were used more in private practice and sport. Expertise: Broadly similar patterns were seen for use of exercise across levels of expertise, although differences observed for electrotherapy and manipulation.
Despite limited research exercise is widely used in all areas of practice and across all level of expertise. Further research is required to investigate exercise prescription for TSPD and implementation of evidence-based practice.
与颈部和下背部相比，胸椎（TS）的研究相对较少。随着管理脊柱疼痛的挑战持续存在，了解当前物理治疗胸椎疼痛和功能障碍的临床实践对于该领域的未来研究是必要的。
调查英国治疗胸椎疼痛和功能障碍（TSPD）的物理治疗实践，其次是检查不同设置和专业知识之间的差异。
根据现有证据设计了一项横断面电子调查。该调查由封闭和开放式问题组成，按照互联网电子调查结果报告清单进行报告。合格的参与者是在英国接受过培训的物理治疗师，负责管理 TSPD 患者，招募时间为 9 周，截止日期为 2016 年 8 月 2 日。数据分析包括描述性分析（封闭问题）和主题分析（开放式问题）。
从 485 名符合要求样本量的受访者中，得出了以下关键发现：
检查：>89%的受访者始终进行主动运动测试、触诊和姿势评估。
管理：>85%的受访者使用主动（运动）和被动（例如推拿）技术，约 50%的人使用手法、贴扎和针灸。
实践设置：尽管在私人执业和运动领域广泛使用类似的被动技术，但仍存在差异。
专业知识：在各级专业知识中，使用运动的模式大致相似，但在电疗和手法方面存在差异。
尽管研究有限，但运动在所有实践领域和各级专业知识中都得到广泛应用。需要进一步研究 TSPD 的运动处方和循证实践的实施。
