Background/Purpose: Physical therapy plays an important role in the global management of rheumatoid arthritis (RA) and ankylosing spondylitis (AS). Therapeutic exercises (mobility, strength and aerobic) and patient education are recommended whereas passive modalities, such as electrotherapy, are more controversial. Our purpose was to document the type of interventions used by physical therapists for patients with RA and AS, to assess whether intervention choices follow current evidence-based practice recommendations, and to explore factors associated with such choices.

Methods: We sent an online survey to physical therapists in the province of Quebec, Canada. Participants were asked about what kind of treatment they would provide for 2 patients showing typical signs and symptoms of RA and AS. Descriptive statistics were used to illustrate the proportions for each treatment chosen by physical therapists. We explored associations between choice of treatments with physical therapists’ demographic and practice related factors, using inferential statistics and regression analyses.

Results: A total of 298 physical therapists responded to the online survey. For both RA and AS respectively, the most common interventions were mobility exercises (91.0%; 98.3%) and patient education (90.1%; 92.8%). For both cases, just over 60% selected strength exercises. Passive manual forms of therapy were chosen by 36% of PTs for RA and 58% for AS, and electrotherapy was chosen by 30% for RA and 40.9% for AS. Aerobic exercise was rarely selected as a mode of treatment (less than 3% of the PTs for both RA and AS). For RA, choosing electrotherapy (p= 0.006) and passive manual forms of therapy (p< 0.001) were highly associated with working in the private sector. For AS, selecting passive manual forms of therapy were highly associated with working in the private sector (p< 0.001) and having taken post-graduate related courses (p< 0.001).

Conclusion: Most physical therapists chose mobility exercises and patient education, which both represent evidence-based treatment approaches for RA and AS. Despite evidence recommending strength and aerobic exercise for these clienteles, physical therapists underutilize these interventions, especially aerobic exercise. There is a need for better knowledge translation to physical therapists regarding the importance of strength and aerobic exercise for patients with RA and AS.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/do-physical-therapists-follow-evidence-based-practice-recommendations-for-treatment-of-inflammatory-arthritides/