Big hitters in the July issue of the Journal


Journal of Physiotherapy Editor Mark Elkins provides a summary of some of the main research articles in the next issue of the Journal.

The first paper in the July issue of Journal of Physiotherapy is an invited topical review about physiotherapy management of female urinary incontinence by Professor Kari Bø from Olso, Norway.

Professor Bø was awarded the 2015 Mildred Elson Award—the most prestigious award from the World Confederation for Physical Therapy—for her contribution to research and education in pelvic floor dysfunction and women’s health.

As in all of the Journal’s invited topical reviews, the prevalence, aetiology and sequelae of the condition of interest are reviewed initially, with the remaining majority of the content focussed on physiotherapy interventions.

Although other interventions are raised, pelvic floor muscle training is the main focus. In particular, the concept of group pelvic floor muscle training is discussed.

While pelvic floor muscle training may often be thought of as being provided on a one-to-one basis, Professor Bø provides robust evidence that—in addition to being a more efficient way to provide therapy—clinical outcomes are improved when a combination of individual and group training is used, as opposed to individual training only. A very practical description of the Norwegian pelvic floor muscle group training concept is presented in the invited topical review, including a detailed structure for the group classes.

Another paper in the July issue of the Journal is a randomised trial examining a self-management and education program to prevent recurrence of low back pain.

The first author, Tarcisio de Campos, counts among his co-authors Professor Chris Maher, who is an NHMRC Principal Research Fellow and 2019 Journal of Physiotherapy Orator, and Professor Mark Hancock, who is an editorial board member of the Cochrane Back Review Group and the Journal of Physiotherapy.

The trial enrolled 262 adults who had recently recovered from an episode of low back pain. Half the participants were randomised to receive McKenzie-based self-management exercises and education. Although the intervention did not reduce the risk of recurrence of low back pain, it may markedly reduce the risk of care-seeking for a recurrence of low back pain.

One explanation for this combination of results is that the experimental intervention does not delay the recurrence of low back pain, but it does effectively teach patients to self-manage well enough that they don’t need to seek care from a healthcare practitioner when the pain recurs.

A third paper from the July issue is from another impressive group of authors including Ianthe Boden, Professor David Story and Professor Linda Denehy.

Their paper tackles the important issue of preoperative physiotherapy for major abdominal surgery.

Before such surgery, a single physiotherapy session involving education and training markedly reduces the incidence of postoperative pulmonary complications. However, uncertainty about the cost-effectiveness of preoperative physiotherapy may be making some hospitals reluctant to institute this intervention.

The health-economic evaluation published in the July issue clearly shows that preoperative physiotherapy aimed at preventing postoperative pulmonary complications is highly likely to be cost-effective from the hospital’s perspective, especially when delivered by experienced physiotherapists.

With this economic analysis, preoperative physiotherapy can now be regarded as a highly efficacious treatment that halves the incidence of serious postoperative complications, and is valued by patients, non-harmful, and highly likely to be cost-effective.

There are many other prestigious contributors to the July issue of Journal of Physiotherapy such as Professor Leo Costa, and of course the members of the Journal’s editorial board who coordinate the diverse range of appraisal items, including critically appraised papers, clinometric summaries, and appraisals of clinical practice guidelines.

Clinical Associate Professor Mark Elkins, APAM, is the scientific editor of Journal of Physiotherapy. Follow him on Twitter @JOP_ Editor and follow Journal of Physiotherapy @JPhysiother.


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