This week: Physiotherapy in Chronic Hip Osteoarthritis and Whiplash
Sara Guilcher and Amol want you to:
1. Recognize that 2 high quality randomized controlled trials showed that a comprehensive physiotherapy intervention did not reduce pain or improve function in chronic hip osteoarthritis or whiplash.
2. Appreciate that although the role of physiotherapy in acute pain is well established, it’s role in chronic pain remains unclear.
Continuing Medical Education
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The papers
Bennel KL, Egerton T, Martin J, et al. Effect of Physical Therapy on Pain and Function in Patients With Hip Osteoarthritis: A Randomized Clinical Trial. JAMA 2014; 311(19):1987-1997. (PubMed).
Michaleff ZA, Maher CG, et al. Comprehensive physiotherapy exercise programme or advice for chronic whiplash (PROMISE): a pragmatic randomised controlled trial. Lancet 2014 Jul 12;384(9938):133-41. (PubMed).
Good Stuff
Sara: Project Big Life
Amol: Three Ideas to Improve Health Care: Dr. Danielle Martin
Relevant Opinion Pieces on Healthy Debate:
Doctor’s Orders: Raise the Minimum Wage. Ritika Goel. Healthy Debate, January 14, 2014.
An Argument Against Increasing the Minimum Wage. Mike Craig. Healthy Debate, January 20, 2014.
Physi-oh my! As an evidence-based profession, it is important for physios to learn from emerging information, particularly when it comes from reputable researchers. The key for physios is to take it to the next level to understand what interventions were used in a study, and which interventions are more or less effective. Based on the information presented on whiplash, this podcast suggests all is not lost. In fact, the moral of the story for me is how important it is to see a physio at the acute stage (when interventions are successful), rather than letting the injury reach the sub-acute or chronic stage.
As for hip OA, there is no magic bullet for chronic pain. However, physios are important for the management of chronic pain, and offer essential and complimentary care to those preparing for surgery, as well as improving functional outcomes post-surgery.