PAST, PRESENT AND FUTURE RESEARCH IN PHYSIOTHERAPY

CH.V. DHARMA RAOMPT in Cardio-Pulmonary

RESEARCH- DEFINITION

Acc to The Learner’s Dictionary of current English “a careful investigation or enquiry specially through search for new facts in any branch of knowledge”.

Acc to Clifford and Woody

Research comprises

defining and redefining problems, formulating hypothesis or suggested solutions;

collecting organizing and evaluating data;

making deductions and reaching conclusions;

and at last carefully testing the conclusions to determine whether they fit the formulating hypothesis”.

PAST• The

techniques used in Physical Therapy were used well before the name “Physical Therapy” came into existence. History is filled with moments of milestones and of pride.

PRESENT• The recent

developments are owed mainly to international collaborations especially in research and its dissemination

FUTURE• We need to

perform a thorough reflection and strategic planning in our doctoral programmes, practice autonomy and imparting professionalism among therapists. Impact analysis of such paradigm shift is thus warranted.

PAST Research in PT’ Journals are acknowledged as crucial sources of

evidence-based information relevant to physiotherapy

practice. The first research about physical therapy in the

United States was published in March 1921 in The PT

Review. The first RCT in Physical Therapy evaluated Ultra-

Violet radiation therapy and was published in 1929 by Dora

Colebrook in Medical Research Council Special Report

Series.

Initially the RCTs were published in medical journals

and not until 1967, for the first time an RCT evaluating

physical therapy intervention was published in a physical

therapy journal. This unique credit goes to author- Landen

B whose study evaluated superficial heat vs. cold in LBP

and was published in Physical Therapy journal.

PAST Research in PT’ (Cntd)

The first systematic review was published in 1975 by Kolind-

Sorensen which was on lateral ankle ligament injuries in

a Danish journal Ugeskr Laeger. The first evidence-based clinical

practice guideline was published in the year 1987, a report of

the Quebec task force on spinal disorders which was on activity-

related spinal disorders by Spitzer W in Spine. In the recent

past, systematic review of systematic reviews also came to be

published, on Spinal Manipulation in Chronic LBP.

PRESENT RESEARCH - PT’

• The rapid growth of evidence as witnessed by the presence of

• 1 record in 1929 to 100 records in 1972,

• to 1000 records in 1986,

• 5000 in 1999 and to 10,000 in 2005 is an indicator of a

rapid shift towards research and evidence-based practice.

• Presently as on March 2010, there are 15,920 records in

Physiotherapy Evidence Database which includes 2257

systematic reviews and 13,096 randomized controlled trials

and 567 clinical practice guidelines in physiotherapy alone.

PRESENT RESEARCH IN PT’ (Cntd)

As we observe the growth of evidence when analyzed specialty-wise,

Musculoskeletal holds the highest position with more than 2,000

records followed by Cardiothoracic with less than 1,250 records.

Region-wise, 1,037 studies were on treatment of lumbo-pelvic

disorders and condition-wise, there were 173 records “surprisingly”

for incontinence alone. Regarding dissemination of “this”  evidence,

it is a rare occurrence that only 3% of this number (340 out of

11,494 records as on September 3, 2007) was published in general

medical journals

PRESENT RESEARCH - PT’ (Cntd)

It is not a matter of pride that 97% of physiotherapy evidence is published

in physiotherapy journals like Physical Therapy, Physiotherapy, Journal of

Physiotherapy (formerly Australian Journal of Physiotherapy) and

Physiotherapy Canada. It is indeed a matter of question and uncertainty

why physiotherapy evidence is not published in general medical journals.

The need of the present hour to improve inter disciplinary awareness and

multi disciplinary collaboration in clinical practice is achievable only if

physical therapy scientific community works in liaison with other medical

community towards solving this issue, if we really mean to aim global

professional autonomy in practice.  

FUTURE RESEARCH – PT’

The existing Researcher clinician gap should be minimized in order

that- improved application of best research findings and evidence into

practice; and also for generation of best research evidence from expert

clinical practice shall go hand in hand towards betterment of our

society and our profession.

Research or science in Physical Therapy has changed from positivism

(verifiable by observation) to hermeneutics (based on understanding)

and then finally to pragmatism (based on actions). Physical Therapy

research was based upon two supposedly different philosophies-

positivism and phenomenology.

FUTURE RESEARCH – PT’ (Cntd)

Positivism relied on quantitative research methods and phenomenology

relied on qualitative ones. Combining science (which is objective and is

based on the body) and art (which is subjective and is based on the

mind) using an inextricably blended mixed model of quantitative-

qualitative research is essential.

Professional autonomy is achievable through the following five steps

outlined by Professor Stanley Paris in his keynote address at Biennial

conference of New Zealand Society of Physiotherapy (NZSP) in 2008, as-

definition of scope of practice; research; clinical doctorate programs;

marketing; and, maintenance and advancement of our autonomy.

REFERENCE:JOURNAL OF PHYSIOTHERAPY, 2010 1ST ISSUE. Pg 58-67

Article pre-publication history:

Date of submission: 4th April 2010 Reviewer: Peter A Huijbregts

Sent for 1st revision: 8th April 2010

Date of 1st resubmission: 11th April 2010 Reviewer: Prof

Maureen Simmonds

Sent for 2nd revision: 18th April 2010

Date of 2nd resubmission: 20th April 2010.

Date of acceptance: 24th April 2010.

Date of publication: 27th June 2010.