13-3 Results of an on-line survey of methods

Results of an on-line survey of methods used by physical therapists for the management of hand osteoarthritis: pilot study.
Leonid Kalichman PT, PhD, Elisha Vered PT, MEd.


Background: The prevalence of symptomatic hand osteoarthritis (OA) is estimated to be 6-8% in various populations. However, most of the treatment methods used by physical therapists are not supported by research. In addition, there is no information published about commonly accepted practices used for the management of hand OA. This information may be important for defining directions for future research.

Aims: 1. To study the commonly accepted practices used by Israeli physical therapists for the management of symptomatic hand OA using an internetbased survey. 2. To study the therapists’ opinions on the effectiveness of treatment modalities used in hand OA management. 3. To learn if on-line surveys can be used to study practices commonly used by physical therapists.

Methods: An internet-based survey was conducted using the free SurveyMonkey on-line tool. The survey included demographic questions and inquired about treatment modalities that therapists use for management of hand OA. Therapists were also asked to grade the effectiveness of these modalities (as low, medium or high).

Results: Among 93 therapists who completed the survey, 26.9% were male and 73.1% female. Mean years of practice in physical therapy was 12.6±9.1 years. The percent of responders who worked in outpatient clinics of local HMOs was 76.7%; 17.8% worked in private PT clinics, 13.3% in hospitals, and 4.4% in nursing homes. In the management of symptomatic hand OA, 97.8% of therapists used paraffin baths and 96.7% used education about the disease, prognosis and methods of treatment. These modalities were followed in frequency of use by joint mobilizations (94.3%), strengthening exercises (89.9%) and exercises to improve range of motion (88.2%). Less frequently used were ultrasound (75.6%), massage (72.1%) and whirlpool hot baths (62.2%). The least commonly used treatments were TENS (41.5%) and laser (6.8%). Two treatment modalities frequently were graded as highly effective: paraffin baths (40.4%) and education about the disease, prognosis and treatment methods (34.4%). Effectiveness of treatment modalities other than paraffin baths and education was graded by a majority of therapists as medium.

Conclusions: This feasibility study demonstrated that an on-line survey can be a useful tool for gathering information from physical therapists about current practices and can help to identify the most commonly used methods, which can be targeted for research.

Most commonly used, and graded as most effective, modalities were paraffin baths and explanation about the disease, prognosis and treatment methods, followed by joint mobilizations and exercises to improve strength and range of motion. There is an acute need for high quality clinical research to determine the effectiveness of these modalities.


Key words: hand, osteoarthritis, physical therapy, survey.




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