A major aspect of the APA’s advocacy involves partnering on research projects to support the excellent work through which researchers are contributing to the field of physiotherapy (as discussed in the February 2023 issue of InMotion here).

We are currently supporting seven projects across a variety of research areas and academic institutions.

This month we will present the ‘Better Hip’ study, the ‘MOTION’ trial, the ‘Promotion of evidence-based physical activity for older adults and people with disabilities by health professionals (PROMOTE PA)’ study and the study ‘The right to rehabilitation for people with dementia: tackling stigma and implementing evidence-based interventions’.

Via a telehealth platform, ‘Better Hip’ provides education delivered by physiotherapists and resources encouraging strengthening exercises and physical activity, along with a very-low-calorie diet produced by a dietitian.

The project supports the vital role of physiotherapists in the management of osteoarthritis by improving access to care via telehealth.

This is particularly relevant to people living with hip osteoarthritis in regional or remote locations—geographic barriers reduce access to healthcare and that reduced access to non-operative care means that people are more likely to rely on pharmaco-surgical options.

Non-surgical care for knee OA

The ‘MOTION’ trial looks at reducing inappropriate knee surgery and hospital burden and is led by Dr Christian Barton at La Trobe University.

In partnership with the University of Melbourne, the ‘MOTION’ trial has received funding from the Medical Research Future Fund.

‘MOTION’ aims to address the evidence- to-practice gap driving inappropriate knee surgery for Australians with osteoarthritis.

Estimates of cost per procedure and outcomes indicate that $120 to $300 million per year is spent on direct hospital costs for surgeries that are inappropriate and unlikely to lead to meaningful improvements for how to implement physical activity promotion in health services.

The ‘MOTION’ trial hypothesises that providing appropriate non-surgical care for knee osteoarthritis will substantially reduce the number of Australians waiting for knee replacement surgery or having the surgery performed annually.

The trial involves assessment and triage completed by advanced practice physiotherapists in a community setting, followed by education and exercise-based treatment for three months prior to reassessment.

Patients with sufficient symptom improvement may elect to forgo knee replacement surgery and move on to stage 2 of the trial, which will continue to support them with non-surgical care.

Trial recruitment is expected to be complete by the end of 2023, with a five-year follow-up planned for all participants.

The APA sees this partnership as an opportunity to strengthen non-operative community care pathways for people living with knee osteoarthritis in Australia.

We know that physiotherapists are currently under-utilised prior to or as an alternative to knee replacement surgery.

This means that Australians don’t have access to the best care, waiting many months—or years—for surgery that they might not need if they have access to alternative physiotherapy care.

Physical activity promotion

The ‘PROMOTE PA’ study evaluates the impact of physical activity promotion by health professionals (including physiotherapists) on the physical activity levels of patients while observing and gathering information to better understand how to implement physical activity promotion in health services.

A large collaborative team, led by physiotherapists Professor Cathie Sherrington and Associate Professor Leanne Hassett at the University of Sydney, is undertaking this project.

It is funded via a National Health and Medical Research Council Partnership Project grant and the APA is one of the key partners.

The trial will recruit 30 clinical teams across NSW Health local health districts and community sites and each clinical team will recruit 30 patients.

Half of the teams will be randomly allocated to receive support to better implement physical activity promotion in their daily practice, with the other half as a waitlist control.

At the end of the intervention period, the waitlist group will also be offered the implementation support.

This support will be tailored to the needs and preferences of each site.

It will include access to an online, evidence-based hub with practitioner resources on physical activity assessment, health coaching, motivational interviewing techniques and community physical activity options, along with consumer resources.

Teams will be offered additional support encompassing training, the development of referral protocols and links, access to clinical mentors, local physical activity champions and transition programs. This research project is expected to finish in December 2025.

The APA is excited about the potential impact of the ‘PROMOTE PA’ study, both on the effectiveness of health services and on health outcomes for older adults and people with disabilities.

We know that physiotherapists are in a prime position to promote positive health behaviours in the community and the ‘PROMOTE PA’ study enables them to do so more easily.

Rehab for people with dementia

‘The right to rehabilitation for people with dementia: tackling stigma and implementing evidence-based interventions’ is led by Associate Professor Michele Callisaya at Monash University and is funded via the Medical Research Future Fund’s Dementia, Ageing and Aged Care Mission.

The aim of this project is to support and increase access to rehabilitation treatments for people with dementia living in the community in order to reduce the impact of disability and improve quality of life.

It will address barriers to participation in rehabilitation, including stigma surrounding its value for people living with dementia, low levels of knowledge about the evidence on rehabilitation for dementia and the difficulty that those living with dementia and their carers have in navigating health services.

Targeting these barriers and reducing disability associated with dementia could save the health system approximately $3 billion in direct health and aged care costs.

In stage 1, the project will bring together health professionals and people living with dementia to co-design resources and strengthen local networks to improve access to quality care.

Stage 2 will see implementation and evaluation within GP clinics in the Eastern and South Eastern Melbourne Primary Health Networks. The trial is expected to finish by August 2025.

This project acts as an exemplar of a model of care of which we would like to see more—physiotherapy services integrated with Primary Health Networks.

Access to physiotherapy expertise within primary healthcare is vital to the ongoing reform of the sector and we look forward to seeing the impact of such a model on outcomes for people living with dementia.