瑞士物理治疗师治疗前交叉韧带重建患者的临床实践和障碍:重返运动的术前康复调查。

Clinical practice and barriers among Swiss physiotherapists treating patients with anterior cruciate ligament reconstruction: A survey of pre-operative rehabilitation to return to sport.

机构信息

Department of Health Professions, Bern University of Applied Sciences, Bern, Switzerland; School of Health Sciences, University of Applied Sciences and Arts Western Switzerland, HES-SO Valais-Wallis, Sion, Switzerland.

Physiotherapy Tschopp & Hilfiker, Glis, Switzerland.

出版信息

Phys Ther Sport. 2024 Jan;65:38-48. doi: 10.1016/j.ptsp.2023.10.007. Epub 2023 Nov 7.

Abstract

OBJECTIVES

To investigate current clinical practice of Swiss physiotherapists treating patients with anterior cruciate ligament reconstruction (ACLR) from pre-operative rehabilitation until return to sport (RTS). We assessed optimisation strategies in daily practice and the perceived barriers to these optimisations, and evaluated whether there was a relevant difference in clinical practice for physiotherapists with post-graduate certification in sports physiotherapy or deep clinical experience and those without such experience.

DESIGN

Cross-sectional survey.

SETTING

Online survey platform.

PARTICIPANTS

Swiss physiotherapists.

MAIN OUTCOME MEASURES

The survey comprised six sections: participant information, pre-operative rehabilitation, post-operative rehabilitation, RTS, re-injury prevention, and optimisation strategies and barriers.

RESULTS

A minority of physiotherapists treated ACLR patients pre-operatively. Overall, 91% included quadriceps open kinetic chain exercise in their treatment, 37% used patient-reported outcomes measures (PROMs) and 39% considered psychological criteria when making decisions about RTS. Most physiotherapists (67%) felt limited due to the time available, the number of prescriptions and the tariffication system.

CONCLUSION

This study highlights areas within ACLR rehabilitation practice in Switzerland that could be improve. Improvements in understanding of the barriers to implementation of best evidence in practice and a redefinition of the clinical process around ACLR rehabilitation in Switzerland are necessary.

摘要

目的

调查瑞士物理治疗师在 ACLR 患者术前康复直至重返运动(RTS)期间的临床实践现状。我们评估了日常实践中的优化策略以及这些优化措施面临的障碍,并评估了是否有针对具有运动物理治疗研究生证书或深厚临床经验的物理治疗师与无此类经验的物理治疗师之间存在临床实践的相关差异。

设计

横断面调查。

地点

在线调查平台。

参与者

瑞士物理治疗师。

主要观察指标

调查包括六个部分:参与者信息、术前康复、术后康复、RTS、再损伤预防以及优化策略和障碍。

结果

少数物理治疗师对 ACLR 患者进行术前治疗。总体而言,91%的物理治疗师在治疗中采用了股四头肌开链运动,37%的物理治疗师使用了患者报告结局测量(PROMs),39%的物理治疗师在决定 RTS 时考虑了心理标准。大多数物理治疗师(67%)认为由于可用时间、处方数量和收费系统的限制,他们的工作受到限制。

结论

本研究强调了瑞士 ACLR 康复实践中可以改进的领域。有必要深入了解在实践中实施最佳证据的障碍,并重新定义瑞士 ACLR 康复的临床流程。

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