Evidence-Based Physiotherapy
At Fitness Physio Newcastle, we use evidenced-based treatments to treat sports and spinal injuries.
What are evidenced based treatments?
We are a physiotherapy clinic that use evidence-based treatments (EBT). EBT refers to the most effective treatments backed up by the latest research in physiotherapy. That is, clinical studies have been undertaken and extensive research has been documented on a physiotherapy treatment, and it has proven to be an effective intervention.
The objective of EBT is to encourage the use of safe and effective treatments to achieve positive outcomes for patients. This should lessen the use of unproven and potentially unsafe treatments. In doing so, this will reduce the financial and social costs to patients.
The increased emphasis on the importance of EBT has led to insurance companies and the government looking to only funding EBT. For instance, insurance companies are no longer covering some alternative therapies in Australia from next year.
Which alternative therapies are no longer going to be covered by insurance companies?
Considering that the criteria for determining whether a treatment has evidence backing is quite detailed, some health practitioners argue that there are treatments available that may not meet EBT criteria but have proven successful in other ways. Hence, for this reason they will continue to use non EBT's as they believe their treatments are effective through clinical experience, previous results or through clinical reasoning.
The Goals and Benefits of Evidenced Based Physiotherapy
The main goal of evidenced based physiotherapy is to improve the overall quality of physiotherapy care for patients, reduce the cost of treatments, eliminate unnecessary or harmful treatments and make physiotherapists accountable.
There is good evidence for treatments in some areas of physiotherapy. However, unless physiotherapists are actively keeping up with the research, they may not be using EBT's for their patients. Hence they will continue to use treatments that is of "low value" or shown to be of little benefit.
Treatments that are evidenced based should be more effective and result in less time and money needed to recover from injuries.
Physiotherapists need to responsible and accountable to their patients and work towards performing and only charging for treatments they know are effective.
Examples of Evidenced based treatments in Physiotherapy
The growth in research over the last few years has helped physiotherapist to understand and improve treatments for injuries.
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Back
The treatment for low back pain has evolved over the last few years as we begin to understand the spine and what are the factors that effect pain.
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Knee
Some area's of knee injuries have had extensive research to understand what is and what isn't useful treatment.
For example:
- Kinesiotaping is of no more benefit then undergoing a corrective exercise program for patello-femoral pain.
- ACL reconstruction rehab is essential in preventing repeat tears.
- A neuromuscular program called GLAD reduces pain by 30% in people with knee or hip osteoarthritis.
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Hip
Gluteal tendon tears respond better to a graded exercise program with a psychosocial approach compared to cortisone or rest.
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Shoulder
- Bursitis is secondary to an underlying injury to the shoulder, most likely a strain of tendon or capsule.
- Rotator cuff partial thickness tears respond well to a graded exercise program and cortisone injection does not improve this further.
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Ankle
- A neuromuscular retraining program is effective in reducing the likelihood of repeat ankle ligament strains.
- Achilles tendon rehabilitation needs to be progressive with a graded loading program coupled with activity modifications.
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Foot
- Plantar fasciitis can be effectively treated with a rehabilitation program aimed at strengthening the calves and deep toe flexors coupled with an initial period of unloading.