Physical therapists have a vital role to play in giving patients the ability, knowledge and self-confidence to self-manage chronic musculoskeletal disorders. Their contribution could be increasingly important as musculoskeletal disorders rise in prevalence, a focused symposium heard.
“Patients can be stimulated to be engaged and to be informed about their choices as new challenges arise,” said Nathan Hutting from the Netherlands, chairing the session.
Julie Richardson from the School of Rehabilitation Science at McMaster University, Canada, said that the goal of self-management was to empower the patient. There was currently no consensus on how rehabilitation should be integrated into self-management service delivery. But the main areas where physical therapists were likely to be involved was in chronic pain, pulmonary disease and arthritis.
A Canadian study indicated that when patients were sent tailored physical therapy protocols via electronic health records, and then monitored over 18 months, those with chronic disease experienced an improvement in function. Another study indicated that educating patients in pain science helped bring improvements in function over 18 months, when given alongside individualised PT and cognitive behavioural intervention.
“There is a natural link between physical therapy interventions and self-management approaches,” she said. “PT needs to maximise the use of technology to deliver self-management approaches. We also need to develop the self-monitoring aspect of self-management, as an aid for people with chronic conditions to identify changes in function.”
Venerina Johnston from the University of Queensland, Australia, offered a series of tips for physical therapists promoting self-management for workers wanting to return to work.
“We can help them identify problems, and solutions likely to result in success which they can feel confident about,” she said. “Physical therapists are uniquely placed to help a worker set and achieve their stay at work and return to work goals using principles of self-management.”
Her research had revealed that workers experience stigmatisation, blame, depression, frustration and a sense of powerless on return to work. Physical therapists could help them by promoting self-management. They need to: actively listen and establish rapport; provide the right information at the right time; jointly develop an action plan with goals that are important for the individual.
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