As discussed in the April issue of InMotion, the APA is partnering with academic institutions on research projects that advance knowledge in the field of physiotherapy and contribute to the evidence base underpinning our advocacy efforts.

This month we will look at three more research project partnerships.

Primary care for low back pain

‘Determining the impact of a new primary care model for low back pain: a cluster randomised trial’ will investigate the impact of integrating a musculoskeletal clinician within primary care teams for people with low back pain.

The project is led by Professors Simon French and Mark Hancock from Macquarie University and is funded via a Medical Research Future Fund grant.

This trial aims to determine whether a team-based approach in a primary care clinic that includes a physiotherapist or chiropractor is more effective than usual GP-led care.

It will measure improvements in low-back-specific disability as the primary outcome as well as pain intensity, quality of life, global rating of change, patient satisfaction and adverse events compared to usual GP-led primary care, evaluated over a one-year period.

The project will also look at the implications for both the health system and society in general by determining the impact on a range of health system outcomes and productivity losses.

These include healthcare access, GP workload, emergency department visits, diagnostic imaging, opioid medications used and time off work, evaluated over a one-year period.

Soon to begin, the project will run over the next four years.

Reform within primary care is a topical advocacy issue and this trial will strengthen the evidence on models of care that modernise primary care for low back pain.

The APA is an advocate for the key role of a physiotherapist in the management of back pain and looks forward to the outcomes of this study.

Injury reduction in AFL

‘Prep-to-Play’ is an injury risk reduction program led by Professor Kay Crossley and Dr Christian Barton at La Trobe University and funded via a National Health and Medical Research Council grant.

Alongside the AFL, a ‘train the trainer’ model draws on physiotherapist expertise to teach and support the coaches of 169 women’s and girls’ teams to use ‘Prep-to-Play’.

The project follows a cluster randomised controlled trial methodology to examine the effect of implementing a physiotherapist-supported injury prevention intervention compared to an unsupported intervention.

‘Prep-to-Play’ includes a dynamic warm-up at both training and games as well as football skill and strength training.

Physiotherapists were recruited and taught the skills required to train and support coaches to use ‘Prep-to-Play’.

People in the unsupported control arm still have access to ‘Prep-to-Play’ resources (such as videos, manuals and posters) but do not have the support and feedback of a ‘Prep-to-Play’ physiotherapist.

Study outcomes—including the use of ‘Prep-to-Play’, injuries and associated healthcare costs—will inform future decisions about ‘Prep-to-Play’ implementation.

Patient-reported outcomes will be captured, including coach and player knowledge at baseline and on completion of the study and coach and player satisfaction with ‘Prep-to-Play’.

The project is expected to finish by September 2023.

The APA is excited about this project, which increases the use of physiotherapist knowledge within a sports setting.

A question we commonly address in advocacy is what physiotherapists ‘do’—often with an overfocus on what is ‘done’ in terms of patient-by-patient treatment—and this study acknowledges what physiotherapists know, highlighting physiotherapy leadership within the injury prevention setting and leveraging physiotherapist knowledge to help the operations of trainers and coaches.

Footwear for patellofemoral pain

The SHAPE study, ‘SHoes for Adolescent PatEllofemoral pain’, is a randomised clinical trial aiming to reduce the impact of patellofemoral pain in adolescents.

The project is led by Associate Professor Kade Paterson at the University of Melbourne’s Centre for Health, Exercise and Sports Medicine and funded via a Medical Research Future Fund Chronic Musculoskeletal Conditions in Children and Adolescents Grant.

Patellofemoral pain affects a third of adolescents and the patellofemoral joint is the most common region for musculoskeletal pain in this population.

Symptoms are aggravated by activities that increase patellofemoral joint forces, such as running, jumping and squatting.

Given that specific shoe features can reduce patellofemoral joint forces, footwear may be a promising novel treatment option for adolescents with patellofemoral pain.

The SHAPE trial will compare the effects of force-reducing minimalist shoes and motion control shoes on symptoms in adolescents with patellofemoral pain.

It will provide the first clinical trial evidence attesting to which type of footwear is best for this patient group and will inform footwear recommendations in the future.

This research project is expected to be completed in 2026.

Findings from this study will be translatable to clinical practice and will influence the advice given by physiotherapists to adolescents with patellofemoral pain.

The APA looks forward to helping disseminate the findings of the study to aid physiotherapists’ understanding of footwear prescription and footwear-related patient advice.

To find out more about how the APA can support your research project, click here, download and complete the application form and send it to research@australian.physio.