Althobaiti Khalid F, Zadro Joshua R, Alzhrani Fahad A, Alzahrani Hosam A
From the Department of Rehabilitation and Physiotherapy (Althobaiti, Alzhrani), King Fisal Medical Complex, Department of Physical Therapy (Alzahrani), College of Applied Medical Sciences, Taif University, Taif, Kingdom of Saudi Arabia, and from Sydney Musculoskeletal Health (Zadro), Institute for Musculoskeletal Health, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney and Sydney Local Health District, Camperdown 2050, Australia.
Neurosciences (Riyadh). 2025 Apr;30(2):101-107. doi: 10.17712/nsj.2025.2.20240035.
To explore the ability of physiotherapists in Saudi Arabia to identify cauda equina syndrome (CES) in a timely manner, and to identify the methods used by physiotherapists to manage patients with suspected CES.
This study utilized a cross-sectional research design and was conducted in the period May-October 2023. It included licensed physiotherapists working in Saudi Arabia. The data was collected using a survey that aimed to assess physiotherapists' ability to identify CES early, using 12 statements. Based on the participants response to these statements, all responders were categorized into the following groups based on their ability to identify and manage CES early: proficient (10-12 points); good ability (7-9); fair ability (5-6); and poor ability (<=4). Consensus to a statement was reached when more than 70% of participants agreed or disagreed with the statement.
This study included 401 physiotherapists (mean age=29.51 (SD 5.54); 53.4% female). Most participants (63.6%) have a proficient-good ability to identify and manage CES early, while 36.4% were categorized as having fair-poor ability Consensus for the CES statements was achieved for 8 statements [1, 2, 3, 4, 5, 8, 9, 12] out of 12. Among these statements, most participants agreed that a patient should be suspected to have CES when they exhibited urinary difficulties of neurogenic origin (88.3%) and/or bilateral radiculopathy (85.5%); and 88.0% of them agreed that an MRI should be requested urgently when managing a patient with CES. Conversely, consensus was not achieved on statements, concerning communication with patients, patient instructions, and management decisions for suspected CES cases.
Most physiotherapists had a proficient-good ability to identify and manage CES early. The study's findings can aid in the creation or improvement of clinical standards and protocols pertaining to physiotherapists' roles in the early identification of CES.
探讨沙特阿拉伯物理治疗师及时识别马尾综合征（CES）的能力，并确定物理治疗师用于管理疑似CES患者的方法。
本研究采用横断面研究设计，于2023年5月至10月期间进行。研究对象包括在沙特阿拉伯工作的持牌物理治疗师。通过一项旨在评估物理治疗师早期识别CES能力的调查收集数据，该调查使用了12条陈述。根据参与者对这些陈述的回答，所有应答者根据其早期识别和管理CES的能力分为以下几组：熟练（10 - 12分）；能力良好（7 - 9分）；能力一般（5 - 6分）；能力较差（<=4分）。当超过70%的参与者同意或不同意某一陈述时，即达成对该陈述的共识。
本研究纳入了401名物理治疗师（平均年龄 = 29.51（标准差5.54）；53.4%为女性）。大多数参与者（63.6%）具有熟练 - 良好的早期识别和管理CES的能力，而36.4%被归类为能力一般 - 较差。12条CES陈述中有8条[1、2、3、4、5、8、9、12]达成了共识。在这些陈述中，大多数参与者同意，当患者出现神经源性排尿困难（88.3%）和/或双侧神经根病（85.5%）时，应怀疑患者患有CES；88.0%的参与者同意，在管理CES患者时应紧急要求进行MRI检查。相反，在关于与患者沟通、患者指导以及疑似CES病例的管理决策等陈述上未达成共识。
大多数物理治疗师具有熟练 - 良好的早期识别和管理CES的能力。该研究结果有助于制定或改进与物理治疗师在早期识别CES中的作用相关的临床标准和方案。
