wcpt congress: event of a lifetime - World Confederation for Physical ...

RESEARCH
THE LATEST RESEARCH,
REVIEWS AND REFERENCES
JANET COPELAND
POLICY & RESEARCH ADVISOR
PHYSIOTHERAPY NEW ZEALAND
Osteoarthritis
The Ottawa panel consists
of a group of health professionals
based in Canada.
In 2005 they published
guidelines on physiotherapy
management for osteoarthritis
(OA).
Recently they have published a new
guideline specifically focusing on the
needs of people with OA who are
obese/overweight. The guideline focuses
on the complex issues they often
present with (Ottawa Panel, 2011).
The guideline was based on a literature
review conducted using the Cochrane
Collaboration search techniques. 114
articles were found but only 10 meet
the rigorous inclusion criteria.
An overriding finding was that a
physical activity programme combined
with dietary advice produced greater
benefits for pain relief and improved
functional status than either intervention
alone. This has implications for
physiotherapy practice and supports
the move from physiotherapists working
in isolation to working as part of a
healthcare team.
The study also found the interventions
produced significant improvements in
quality of life. This was thought to be
due to the beneficial effects on mental
health of participating in physical
activity, including for many the
social contact involved. The physical
activity programmes included a combination
of aerobic, strength and
resistance training.
Although this article is not yet open
access the earlier guidelines are:
(Ottawa Panel, 2005) http://ptjournal.
apta.org/content/85/9/907.full.pdf+html
To coincide with our promotion of
the role of physiotherapy in the treatment
of arthritis, towards the end of
August we will put onto our website
resources including articles supporting
the efficacy of our interventions. Also
remember to check out some of the
latest research on arthritis using the
EBSCO database. Access to EBSCO
can be gained from a button on our
website home page.
Lymphoedema
The provision of lymphoedema services
in New Zealand is rather haphazard,
with services being organised through
the Cancer Society in discussion with
individual DHBs. An article in the BMJ
(Girgis, Stacey, Lee, Black, & Kilbreath,
2011) would suggest the same
problems occur in Australia.
Women who were identified as having
lymphoedema were asked to identify
their current unmet needs. The main
needs identified by participants were
improved access to consistent information
on the causes of lymphoedema,
the treatment options and then how
to access treatment. The women
felt there was a need for all health
professionals to take their condition
seriously and to be fully informed so
they could provide the women with
the necessary information.
This article is open access:
http://www.bmj.com/content/342/
bmj.d3442.full.pdf
Prescribing Exercise
An editorial in the BMJ (Khan, Weiler,
& Blair, 2011) discusses the value
of exercise in the prevention and
treatment of many of the chronic
diseases that have become the leading
causes of morbidity and mortality
in the 21st century. The article is
directed to doctors, suggesting that at
each consultation they ask questions
regarding the patient’s activity levels,
and stating that activity levels have
become the 5th vital sign (the other
four are temperature, pulse, blood
pressure and respiratory rate). They
suggest 2 activity screening tools that
can easily be implemented in general
practice: the General Practice Physical
Activity Questionnaire (GPPAQ), and
the Exercise Vital Signs questions (Sallis,
2011). Information on both of these is
easy to Google.
We are well placed to ask our
patients about their activity
levels as part of a routine
assessment and provide them
with advice.
Although doctors were the authors’
prime audience, the article makes
equal sense to physiotherapy. We are
well placed to ask our patients about
their activity levels as part of a routine
assessment and provide them with advice.
For some this may include further
physiotherapy assessment and a structured
exercise programme to get them
started; for others encouragement and
providing information about community
resources and facilities may be
sufficient. Many of these are low cost,
and walking is free. It is useful to have
available in the practice information
on community resources. Whatever
approach is taken, it is important to follow
up with the patient at subsequent
visits. One of the authors (Sallis) based
12 | PHYSIO MATTERS AUGUST 2011