ArticleBrazilian journal of physical therapy
Has physical therapists' management of musculoskeletal conditions improved over time?
Article in Brazilian journal of physical therapy. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
13 citing papers in PubMed, 2 syntheses or guidelines pooled it, 42 citations in OpenAlex.
- Is there 'trustworthy' evidence for using manual therapy to treat patients with shoulder dysfunction?: A systematic review.PloS one · 2024Pooled it
- Manual therapy for non-radicular cervical spine related impairments: establishing a 'Trustworthy' living systematic review and meta-analysis.The Journal of manual & manipulative therapy · 2023Pooled it
- Comparing the impact of interactive versus traditional e-learning on physiotherapists' knowledge, attitudes, and clinical decision-making in low back pain management: a randomized controlled trial.The Journal of manual & manipulative therapy · 2025Trial
- Implementation status and barriers to multimodal management of low back pain among physical therapists: A cross-sectional study.Scientific reports · 2026Article
- Article
- Development of a low back pain care pathway in an academic hospital system: results of a consensus process.Journal of orthopaedic surgery and research · 2024Article
- Adapting a Clinical Practice Guideline for Management of Patients with Knee and Hip Osteoarthritis by Hong Kong Physiotherapists.Healthcare (Basel, Switzerland) · 2023Article
- Guideline adherent screening and referral: do third year Doctor of Physical Therapy students identify red and yellow flags within descriptive patient cases? a United States based survey study.The Journal of manual & manipulative therapy · 2023Article
- Protocol for the development of a 'trustworthy' living systematic review and meta analyses of manual therapy interventions to treat neuromusculoskeletal impairments.The Journal of manual & manipulative therapy · 2023Article
- Physiotherapy for patients with hip and knee osteoarthritis in Germany: a survey of current practice.BMC musculoskeletal disorders · 2023Article
- Management of Low Back Pain: Do Physiotherapists Know the Evidence-Based Guidelines?International journal of environmental research and public health · 2023Article
- Physiotherapists' knowledge of and adherence to evidence-based practice guidelines and recommendations for ankle sprains management: a cross-sectional study.BMC musculoskeletal disorders · 2022Article
- GLA:D® Back Australia: a mixed methods feasibility study for implementation.Chiropractic & manual therapies · 2022Article
Corrections and comments
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Authors and funding
2 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundOur 2019 systematic review found that up to 63% of physical therapists provided recommended care for musculoskeletal conditions, up to 43% provided non-recommended care, and up to 81% provided care of unknown value. We included studies published as early as 1993 and as recent as 2017.
objectiveTo determine whether physical therapists' treatment choices for musculoskeletal conditions have improved over time.
methodsFor the original review, we included studies (until April 2018) that quantified physical therapy treatment choices for musculoskeletal conditions through surveys of physical therapists, audits of clinical notes, and other methods (e.g. clinical observation). Using medians and interquartile ranges, we summarised the percentage of physical therapists who provided treatments that were recommended, not recommended, and of unknown value. For this analysis, we stratified the findings from the above systematic review by decade (1990-1999, 2000-2009, 2010-2018).
resultsThe median percentage of physical therapists who provided recommended treatments (40% from 1990 to 1999, 50% from 2000 to 2009, and 35% from 2010 to 2018) and non-recommended treatments (41%, 28%, and 39% respectively) has not changed over time. However, more physical therapists seem to be providing treatments of unknown value (41% from 1990 to 1999, 55% from 2000 to 2009, and 70% from 2010 to 2018).
conclusionPossible explanations for this trend include the growing need for clinical innovation, challenge of keeping up to date with evidence, increased exposure to treatments of unknown value, belief that evidence is not relevant to practice, and possible limitations of the data. Strategies to help physical therapists replace non-recommended care with recommended care are discussed.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.