ArticlePhysical therapy2025
Exploring the Quality of Physical Therapy in Patients With Hip or Knee Osteoarthritis in Germany: A Cross-Sectional, Vignette-Based Study.
Article in Physical therapy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Consistency of post-acute care discharge recommendations among acute care physical therapists: a national vignette survey study.Physiotherapy theory and practice · 2026Article
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5 authors.
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No grant is acknowledged in the PubMed record.
Abstract
importanceConservative, non-pharmacological interventions are the recommended first-line treatment for hip and knee osteoarthritis (OA). Clinical practice guidelines (CPGs), such as those from the Osteoarthritis Research Society International (OARSI), guide evidence-based care by physical therapists. However, no studies in Germany have examined physical therapists' treatment choices across patient cases and compared them with the latest evidence.
objectiveThe objective of this study was to investigate to what extent physical therapists meet the latest evidence when treating different types of people with hip or knee OA. DESIGN AND
settingA cross-sectional vignette-based online survey was conducted among physical therapists working in outpatient practices.
participantsEligible participants had adequate German language skills, internet access, and recent experience treating patients with hip or knee OA. MEASURES: The survey included 4 case vignettes of hip or knee OA, with and without comorbidities, and a list of treatment modalities from the OARSI guideline. Correct selections matched high-evidence recommendations. Descriptive statistics analyzed demographics and treatment choices; linear regression assessed the influence of professional degree and work experience on meeting the latest evidence.
resultsOf 612 eligible therapists, 335 (54.7%) completed the survey (mean age 35.9+/-11.9 years; 60% female). Only 22% selected all recommended modalities across vignettes. Structured exercise (96%) and arthritis education (95%) were the most frequently chosen. However, many therapists also selected interventions with limited or conflicting evidence, such as massage and taping. Both professional degree and work experience significantly influenced the extent to which the latest evidence was met. Additionally, 49% were aware of at least 1 OA guideline. CONCLUSIONS AND RELEVANCE: While many physical therapists aligned with evidence-based practices, inappropriate modality selection remained common. De-implementation is needed where evidence suggests a lack of benefit or potential safety concerns. Translating and implementing the OARSI guideline into various languages, specifically for physical therapists, is recommended to close knowledge gaps. IMPACT: The study's findings underscore the importance of understanding the treatment modalities used by physical therapists in managing hip or knee OA worldwide. This insight is crucial for addressing the evidence-to-practice gap and ensuring the effective implementation of high-quality physical therapy, a need that is equally relevant in other countries. Additionally, this knowledge is vital for developing targeted strategies, such as the creation and integration of (de-)implementation protocols into the education and ongoing professional development of physical therapists globally.
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