Physiotherapy for the Management of Polymyalgia Rheumatica: Results From a UK Cross-Sectional Survey.

INTRODUCTION

Polymyalgia rheumatica (PMR) international management guidelines advocate patient education and individualised exercises but lack evidence and physiotherapy practice for PMR is unknown. PMR is typically treated with glucocorticoids, but side effects are frequent and concerning to patients. This study investigated UK physiotherapy practice in PMR.

METHOD

Physiotherapists recruited from UK rheumatology and physiotherapy professional networks and university alumni were invited to complete a postal or online questionnaire. Topics included experiences of managing PMR, perceived role and value of physiotherapy in PMR, assessment and management priorities and physiotherapists' education about PMR. Results were summarised using descriptive statistics.

RESULTS

4288 invitations to participate were sent, and 1072 (25%) responses were received. Physiotherapy referrals for PMR were infrequent; 5.8% of respondents had treated ≥ 10 patients in the previous year. 80% of respondents advocated a physiotherapy role for PMR. 38% reported receiving some pre-registration education about PMR within their qualifying physiotherapy programme. Establishing patients' knowledge and understanding of PMR, pain levels, and ability to undertake activities of daily living were physiotherapists' assessment priorities. 90% of respondents promoted self-management approaches, including pacing and activity modification. Prioritising upper limbs, 89% prescribed individualised graded exercises to improve movement, muscle strength and activities of daily living function.

CONCLUSION

A positive role for physiotherapy was reported for some people with PMR. Exercise, education and advice to improve daily functioning may be useful adjuncts to glucocorticoids. The limited PMR education for UK physiotherapists warrants attention. Further research is needed to evaluate the effectiveness of physiotherapy approaches for PMR.