Current Practice, Guideline Adherence, and Barriers to Implementation for Achilles Tendinopathy Rehabilitation: A Survey of Physical Therapists and People with Achilles Tendinopathy
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BMJ
Abstract
Objective To explore clinical practice patterns of physical therapists (PTs) who treat people with Achilles tendinopathy (AT), and identify perceived barriers and facilitators for prescribing and engaging with therapeutic exercise among PTs and people with AT. Methods Two cross-sectional surveys were electronically distributed between November 2021 and May 2022; one survey was designed for PTs while the second was for people with AT. Survey respondents answered questions regarding their physical therapy training and current practice (PTs), injury history and management (people with AT), and perceived barriers and facilitators (PTs and people with AT). Results 341 PTs and 74 people with AT completed the surveys. In alignment with clinical practice guidelines, more than 94% of PTs surveyed (97% of whom had some form of advanced musculoskeletal training) prioritise patient education and therapeutic exercise. Patient compliance, patient knowledge, and the slow nature of recovery were barriers to prescribing therapeutic exercise reported by PTs, while time, physical resources, and a perceived lack of short-term treatment effectiveness were barriers for people with AT. Conclusions Consistent with clinical practice guidelines, PTs with advanced training reported prioritising therapeutic exercise and education for managing AT. However, both PTs and people with AT identified many barriers to prescribing or engaging with therapeutic exercise. By addressing misconceptions about the time burden and ineffectiveness of exercise, and by overcoming access issues to exercise space and equipment, PTs may be able to improve intervention adherence and subsequently outcomes for people with AT.Description
Keywords
32 Biomedical and Clinical Sciences, 4201 Allied Health and Rehabilitation Science, 4203 Health Services and Systems, 3202 Clinical Sciences, 42 Health Sciences, Physical Rehabilitation, Clinical Research, Rehabilitation, Behavioral and Social Science, 7.3 Management and decision making, 7 Management of diseases and conditions, 6.7 Physical, 7.1 Individual care needs, 6 Evaluation of treatments and therapeutic interventions, 4 Quality Education, 1106 Human Movement and Sports Sciences, 3202 Clinical sciences, 4207 Sports science and exercise
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BMJ Open Sport & Exercise Medicine, ISSN: 2055-7647 (Print); 2055-7647 (Online), BMJ, 10(1), e001678-e001678. doi: 10.1136/bmjsem-2023-001678
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