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  • Title: Orthopedic surgeon perspectives on appropriate referral of trauma patients to physical therapy (PT).
    Author: Dusik CJ, Buckley RE, Robertson-More C.
    Journal: Arch Orthop Trauma Surg; 2013 May; 133(5):603-8. PubMed ID: 23443530.
    Abstract:
    OBJECTIVES: To evaluate orthopedic surgeon referral of trauma patients to PT. DESIGN: Cross-sectional survey. SETTING: Alberta, Canada. PARTICIPANTS: Orthopedic surgeons and residents. METHODS: A web-based survey was utilized to poll orthopedic surgeons and residents on referral practices. Statistical analysis using Kruskal-Wallis One-Way Analysis of Variance by Ranks; Post hoc analysis using the minimum significant difference method for multiple comparisons and nonparametric correlations using Spearman's rho. RESULTS: The overall response rate was 48 %. Key indications for referral were range of motion deficits, failure to progress, strength and gait training. Of those surveyed, 72.5 and 26.1 % felt that there was either moderate or significant improvement following PT, respectively. Years in practice had a significant effect on survey responses. Residents and surgeons in practice for >20 years viewed PT as being less important in orthopedic trauma (p < 0.05) and were less likely to refer orthopedic trauma patients to PT (p < 0.05). Residents were less likely to view PT in orthopedic trauma as evidence-based (0.05) and more likely to disagree with the statement that formalized PT results in better outcomes than a prescribed home exercise program (p < 0.05). CONCLUSIONS: There are potential differences in the referral practices of orthopedists of varying levels of experience. Although outcome is viewed as positive following PT, it appears that many orthopedists view a prescribed home exercise program as an acceptable equivalent to formalized PT in the setting of orthopedic trauma. Future research should be directed at determining indicators for formalized PT.
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