How to describe physiotherapy treatment session?
If visit a physician for a simple back pain you will be prescribed a painkiller. In that doctor could have clearly written about the dosage of the medicine. The dosage information will include the weight of the drug, when it should be consumed, how many times a day, what time of the day, how many days to be taken. This standardized information ensures consistency in treatment regardless of whether you are consulting in chennai, brisbane or Khartoum.
However, in physical therapy (PT) for conditions like low back pain, treatment details are often unclear. Unlike prescribing medication, PT lacks standardized dosing information and treatment descriptions. This is huge problem in research, hence in clinical practice. We dont communicate or describe PT, either it is passive therapies (electro and manual) or active treatment (exercise). We just say i gave exercise and the patient got better or gave US and he got better. We don’t give detail description as given for the drugs. That can stop from other PTs in chennai, brisbane or Khartoum doing the same and getting the same result.
What do i mean by that. Well, there are formal description of how to describe the treatment, i will try to highlight the salient information.
The cochrane review for OA knee says exercise for 4 weeks is good for reducing pain and improving quality of life in patients with moderately affliction. You can’t just say do quadriceps or knee strengthening exercise. These are the additional information for me to replicate in my clinic.
what type of exercise was given - strengthening or endurance exercise.
what was the starting position- was it weight bearing or non weight bearing
was any equipment used for this (is it available in generally), example for cycling was used part of the endurance training or resistance band for strengthening.?
How many repetitions were prescribed for each exercise? What was the duration of each session? Were there designated rest periods during the session? Additionally, how should I respond if a patient experiences pain - should they continue or rest? These are just a few examples of the additional information needed to effectively prescribe and monitor physiotherapy interventions.
Was the treatment protocol adjusted subtly for each patient to accommodate their individual needs and symptoms? If so, what principle guided these adjustments, so that I can apply the same approach in my clinic. (don’t just say we applied tailor made treatment or i give treatment according to each patient.)
how many days was the overall protocol? 4 weeks? ok, how many days per week
In patient education, research, and teaching, it's essential to articulate the rationale behind selecting specific exercises. Clarity regarding the purpose and benefits of each exercise helps to enhance understanding and engagement with the treatment regimen.
more details here
The information necessary to prescribe physical therapy protocols for patients is often missing from textbooks and research papers. As a result, clinicians may struggle to apply effective treatments in their practice. Despite knowing that physical therapy can be beneficial, the specific details of how to implement it remain unclear. When attempting to replicate research findings or teachings from guru, there is a risk of unintentionally deviating from the intended treatment approach. For instance, one might unknowingly opt for free exercises when resistance exercises are needed, or choose walking instead of fast walking as prescribed by the researcher. This lack of clarity can hinder the effectiveness of physiotherapy interventions in clinical settings.
To establish credibility as a scientific discipline, precision is essential. It's imperative to quantify the variables under examination and implement beneficial findings in clinical practice. When prescribing exercises, particularly unsupervised home exercises, it's crucial to clearly define and explain all relevant variables to patients. This ensures they understand how to perform the exercises correctly and independently at home.
I also want to add my book skips the dosage part- the repetitions and cleverly says need to do more, without defining more. Well, the justification for that is- well we don’t know and i also did not know i should explicitly write it.
Lets make PT a better science.