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The research behind physiotherapy
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Physiotherapy is an evidence-based profession and it is critical to keep building knowledge and adding to the literature base. The lead investigators of three projects supported by the APA provide a snapshot of their work.
Since March this year, the APA has doubled the number of research projects it endorses.
We now support 15 projects on a variety of topics led by researchers from Victorian, New South Wales and Queensland universities.
Gathering evidence to support physiotherapy professional development and advocacy has never been more important and the growing research base of the profession underpins policy, funding models and education.
Here are some examples of projects the APA currently supports.
The EMBRACE trial
Associate Professor Stephanie Filbay APAM, University of Melbourne
Evaluating non-surgical management of acute anterior cruciate ligament rupture with a novel BRACE protocol versus early surgical reconstruction—a comparative effectiveness randomised controlled trial
The assumption that anterior cruciate ligament (ACL) ruptures cannot heal has led most Australians with this injury to undergo reconstructive surgery.
However, research that I’ve led has shown that 30 per cent of people with an acute ACL rupture who start with
rehabilitation experience some degree of ACL healing.
These patients report better outcomes than those who undergo early ACL reconstruction.
A novel treatment, the Cross Bracing Protocol, has shown promising results.
This protocol involves immobilising the knee at a 90-degree angle for four weeks, then gradually increasing the range of motion over 12 weeks in combination with physiotherapy.
Initial findings in 80 patients indicate a 90 per cent healing rate, leading to excellent clinical outcomes.
To provide more rigorous evidence, the EMBRACE trial (here), conducted across five Australian cities, will compare the Cross Bracing Protocol to early ACL reconstruction.
Participants aged 16–49 with acute ACL ruptures will be randomly assigned to either the Cross Bracing Protocol group or the surgery group, with comprehensive follow-up over 18 months.
Primary outcomes will be measured using the Knee Injury and Osteoarthritis Outcome Score (here), while secondary outcomes include knee function, pain, return to activity and health economics.
This research aims to improve patient outcomes and potentially reduce the need for surgery and associated healthcare costs.
The SHAPE trial
Dr Kade Paterson, University of Melbourne
SHoes for Adolescent PatEllofemoral pain: a randomised clinical trial
Patellofemoral pain affects nearly one- third of adolescents and is aggravated by running, jumping and squatting, which has a negative impact on participation in sports and exercise.
Traditional treatments such as exercise therapy and orthoses have shown limited success and had poor adherence in adolescents.
Consequently, there is an urgent need for innovative treatment approaches.
The SHAPE (SHoes for Adolescent PatEllofemoral pain) randomised clinical trial aims to address this gap by investigating the efficacy of minimalist shoes compared to motion control shoes (ie, shoes with arch support and cushioned soles) in alleviating patellofemoral pain.
Clinicians typically recommend motion control footwear to people with patellofemoral pain because clinical trials have shown benefits from using foot orthoses that support the medial arch in adults.
However, minimalist shoes, with their lightweight design and flexible soles, can reduce patellofemoral joint forces, which are central to developing this pain.
Significant progress has been made since the inception of the SHAPE trial.
To date, 64 out of the required 156 participants have been successfully recruited, putting the study on schedule.
The retention rate stands at an impressive 95 per cent, underscoring strong participant engagement.
Overall, the SHAPE trial is progressing well, having achieved or exceeded all predetermined milestones.
The Better Hip trial
Professor Kim Bennell APAM, University of Melbourne
Effectiveness of a telehealth-delivered clinician-supported exercise and weight loss program for hip osteoarthritis
The protocol paper for the Better Hip randomised controlled trial, which evaluates the effectiveness of a telehealth-delivered, clinician-supported exercise and weight loss program for hip osteoarthritis, was published in BMC Musculoskeletal Disorders in February and is available online here.
Recruitment for the study is going well, with 181 out of 212 participants recruited (85 per cent).
Of these, 91 have been assigned to the intervention group, for whom physiotherapist-delivered education will be combined with strengthening exercise and physical activity.
Within this group, 47 participants have consented to participate in dietitian consultations for a weight loss intervention.
Meanwhile, 90 participants have been assigned to the control group and have received website-delivered educational information.
The response rate for primary outcomes is 90 per cent at six months (from 143 participants) and 93 per cent at 12 months (from 97 participants).
To learn more about how the APA can support your research project, click here and read the APA Research Partnership Framework in the Research partnerships section.
To seek support from the APA for your research project, complete the application form and return it to research@australian.physio along with the research proposal.
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