Garner Jill, Lange Belinda, Lennon Sheila, van den Berg Maayken
Physiotherapy, College of Nursing and Health Sciences Flinders University Adelaide Australia.
Southern Adelaide Local Health Network Adelaide Australia.
Health Sci Rep. 2024 Jun 2;7(6):e2117. doi: 10.1002/hsr2.2117. eCollection 2024 Jun.
Currently there are approximately one billion people worldwide affected by a neurological condition. These conditions may result in a variety of impairments that require assessment and management from a physiotherapist. However, there is a lack of consensus in the literature as to what domains physiotherapists working in clinical settings include in their assessment of this population, with only five domains identified in a recent systematic review. This study aimed to explore current physiotherapy assessments in people with neurological conditions, including barriers, enablers, and influencing factors.
A National online survey of Australian physiotherapists who assessed adults with neurological conditions in their clinical practice.
A total of 212 respondents from all states in Australia completed the survey. The mean (SD) age was 35.7 (9.6) years, and the majority were female (85.4%). Respondents worked across various settings assessing stroke most frequently (58.0%). Study results demonstrated variability in assessment practice, with a number of assessment domains being assessed more commonly including balance, muscle strength, gait, falls and safety, function, goal setting, range of movement, pain, co-ordination, activity tolerance, postural alignment and symmetry, and the upper limb. Experienced physiotherapists and those in rural and remote settings included fewer domains in their assessments. On the other hand, physiotherapists in the community setting included certain domains more frequently than those in other settings. Barriers and enablers were related to therapist caseload, knowledge, and intrinsic patient factors.
There is variability in domains assessed by Australian physiotherapists, with an emerging consensus for a number of assessment domains. Study results suggest that clinical experience, geographical location, and clinical setting may play a role in the assessment patterns observed.
There is little evidence to support what physiotherapists assess in practice, in different settings, in different states within Australia. This study indicates that experience, geographical location, and clinical setting affect the number and types of domains included in the assessment. Further research is needed to develop a consensus on best practices.
目前全球约有10亿人受神经疾病影响。这些疾病可能导致各种功能障碍，需要物理治疗师进行评估和管理。然而，关于临床环境中的物理治疗师在评估这一人群时纳入哪些领域，文献中缺乏共识，最近的一项系统评价仅确定了五个领域。本研究旨在探讨当前对神经疾病患者的物理治疗评估，包括障碍、促进因素和影响因素。
对澳大利亚在临床实践中评估成年神经疾病患者的物理治疗师进行全国性在线调查。
来自澳大利亚所有州的212名受访者完成了调查。平均（标准差）年龄为35.7（9.6）岁，大多数为女性（85.4%）。受访者在各种环境中工作，最常评估中风患者（58.0%）。研究结果表明评估实践存在差异，一些评估领域被更普遍地评估，包括平衡、肌肉力量、步态、跌倒与安全、功能、目标设定、活动范围、疼痛、协调、活动耐力、姿势对齐与对称以及上肢。经验丰富的物理治疗师以及农村和偏远地区的物理治疗师在评估中纳入的领域较少。另一方面，社区环境中的物理治疗师比其他环境中的物理治疗师更频繁地纳入某些领域。障碍和促进因素与治疗师的工作量、知识以及患者的内在因素有关。
澳大利亚物理治疗师评估的领域存在差异，一些评估领域已逐渐形成共识。研究结果表明，临床经验、地理位置和临床环境可能在观察到的评估模式中起作用。
在澳大利亚不同州的不同环境中，几乎没有证据支持物理治疗师在实践中评估的内容。本研究表明，经验、地理位置和临床环境会影响评估中纳入的领域数量和类型。需要进一步研究以就最佳实践达成共识。
