I've just recently finished my SDP with a private practice. My project invovled creating exercise sheets for this private practice. I had to come up with the most common conditions seen at the practice and create 4 exercise leaflets as patient education. In order for me to create this, i had to do a literature review to find out which was the most effective/evidence based exercises for lower back pain (as one of the condition).
I had read a good amount of journal articles and had come up with about 6 exercises for lower back pain. I discussed my findings with my supervisor. He agreed with some of the exercises and disagreed with some. He gave me some exercises that the practice uses most and would like them in the leaflet. Interesting enough, the aritcles that i read actually said that the exercises he had asked me to use were found to be less effective. After i noticed the exercises he wanted were found to be less effective, i brought it to his attention. He did acknowledge what i had pointed out but still preferred me to use the exercises he had suggested. He told me that even though the exercises maybe more effective than others, i had to also consider the therapist's experience and preference. Most of the physios that work at the practice had been in the profession for 10years+, so they would have a pretty good grasp of treating LBP and exercises for patients.
A couple of interesting points from this incident.
-Even though some techniques maybe more effective than others, you need to always consider the therapist's skills and experience. But also have a closer look at the journal article, as to the age, gender, race etc..... and the article was actually written in US, so maybe it wasn't as applicable in Australia? So there were lots of other factors to consider
-It also points out the importance of continual education for us as physios. I found out the practice actually doesn't have any type of professional development within the clinic. So unless the physio themselves keeps up-to-date with reading new journals, their treatment techniques maybe outdated or their might be more effective techniques out there that they have not been exposed to.
Next time if i was to do a similar project, i should discuss with all the physios at the clinic and ask what exercises they use and prefer. So know the therapist's preference and incorporate that with the project and my literature review. Find a balance between the two.
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Hey Kenny,
I have also been in this situation many times, not just across different private practices that i've worked for, but actually even within a particualr practice aswell.
I guess the really important things to consider is that if you have a group of private physiotherapists working at the one practice, each of thise individuals have had different training (ie different universities) as well as having a different range of experience (ie practicing for more than 10 years vs a new graaduate etc).
In most cases, their exercises were similar but it is also interesting to note the different exercises that each physio administers for a specific condition ie lower back pain. I guess its a combination of what they were taught, what is said in the lecture, what each physio prefers and what the patient is like.
I think an important thing to learn from this experience is that there is never only one correct group of exercises to give to a patient for a specific condition. This will always change in the near future depending on research, physio preference and patient presentation.
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