Resumen de A national survey of the physiotherapy management of patients following first-time patellar dislocation
Toby O. Smith, Rachel Chester, Allan Clark, Simon T. Donell, Richard Stephenson
Objectives The purpose of thisstudy wasto determine how musculoskeletal physiotherapistsin acute National Health Service (NHS) hospitals manage patients following a first time patellar dislocation. Design National survey study. Setting All NHS acute hospitals with an accident and emergency and/or an orthopaedic department were surveyed. Participants 306 institutions were surveyed. Interventions Each institution was sent a 14 question self-administered questionnaire pertaining to the assessment, treatment, evaluation and outcome of patients following a first time patellar dislocation. After 3 weeks, all non-respondents were sent a reminder letter. After a further 3 weeks, those who had not responded by this time were sent a final reminder and copy of the questionnaire. Results The survey response rate was 59%. The respondents indicated that first-time patellar dislocation was not a common musculoskeletal disorder managed by NHS physiotherapists, constituting an average of 2% of caseloads. The resultssuggested that physiotherapists most commonly assess for reduced quadriceps or VMO capacity, gait, patellar tracking and glide, and knee effusion when examining patients following a first-time patellar dislocation. The most common treatments adopted are reassurance, behaviour modification followed by proprioceptive, knee mobility, quadriceps and specific VMO exercises. Conclusions Generic lower limb assessment and treatment strategies are widely used to manage this patient group. Given the previous paucity in this literature, further study is now recommended to assess the efficacy of these interventions to provide UK physiotherapists with an evidence-base to justify their management strategies. © 2011 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved
