A SURVEY OF PHYSICAL THERAPY GOALS AND INTERVENTIONS FOR PATIENTS WITH BACK AND KNEE PAIN

Background and Purpose. The physical therapy management of patients wi th pain often lacks a theoretical or conceptual basis. The purpose of this study was to compare treatments of patients with back and knee pa in with a treatment framework (conceptual model) that we developed. Th is framework emphasizes physiological recovery, or reduction of impair ments (eg, reduction of swelling), followed by emphasis on the reducti on of disabilities. Expectations were derived concerning treatment goa ls and interventions in the course of treatment. Subjects. Patients wi th back pain (n=1,085) and patients with knee trauma (n=416) were trea ted by 83 Dutch physical therapists. Methods. Survey data were gathere d on impairments and disabilities and on treatment goals and intervent ions. Results. For both groups of patients, two out of a maximum of ei ght treatment goals were directed at alleviating impairments in accord ance with the framework. Goals directed toward the alleviation of disa bilities did not show a similar relationship to the framework. For two treatment goals, the course of treatment was in accordance with the f ramework for-both groups of patients. Conclusion and Discussion. The f ramework is only partially reflected in Dutch physical therapist pract ice. The use of such a framework, however, may be a helpful tool in ga ining more insight into physical therapy in daily practice.