Do physical therapists follow evidence-based practices for treatment of inflammatory arthritis? Results from an online survey

Physiother Theory Pract. 2024 Mar 3;40(3):637-646. doi: 10.1080/09593985.2022.2135150. Epub 2022 Oct 13.

Abstract

Background: Physical therapists (PTs) should know how to best treat patients with inflammatory arthritis.

Objective: To document interventions chosen by PTs for patients with rheumatoid arthritis (RA) and ankylosing spondylitis (AS) and whether choices follow evidence-based practice.

Methods: Licensed musculoskeletal PTs in Quebec, Canada responded to an online survey. Descriptive statistics illustrated proportions for each treatment choice and inferential statistics explored associations with demographic and practice-related factors.

Results: There were 298 PTs who responded to the survey. For both RA and AS respectively, most common interventions were mobility exercises (91.0%; 98.3%) and patient education (90.1%; 92.8%). For both cases, slightly >60% selected strengthening exercises. Passive forms of therapy were chosen by 36% of PTs for RA and 58% for AS. Aerobic exercise was rarely selected. PTs working in the public sector were less likely to use manual therapy for both RA (Odds Ratio (OR) 0.43, 95% confidence interval (CI) 0.22,0.86) and AS (OR 0.46, 95% CI 0.22,0.97).

Conclusions: Most PTs chose mobility exercises and patient education, representing evidence-based approaches. Despite current recommendations, strengthening and especially aerobic exercises were not used as much. There is a need to increase awareness regarding the benefits of strengthening and aerobic exercise for these patients.

Keywords: Rheumatoid arthritis; ankylosing spondylitis; clinical guidelines; physical therapy.

MeSH terms

  • Arthritis, Rheumatoid* / diagnosis
  • Arthritis, Rheumatoid* / therapy
  • Evidence-Based Practice
  • Humans
  • Physical Therapists*
  • Spondylitis, Ankylosing* / therapy
  • Surveys and Questionnaires