Physiotherapy Assessment of Patients Referred to Orthopaedic Surgeon

NCT02265172 | Completed

• 1 other identifier: EPN GBG 328-09
• Study Type: interventional
• Target: 208
• Locations: 0 countries
• Sites: N/A

Brief Summary

Many patients with musculoskeletal pain in primary healthcare are referred to orthopaedic surgeon, however, a relatively low percentage of these patients are considered suitable for orthopaedic intervention. Physiotherapists are suitable for musculoskeletal assessments and are used as such in many countries i.e. Advanced Practice Physiotherapists or Extended Scope Physiotherapists, however, this is not an existing model of care in Sweden. To be able to consider this model for implementation in Sweden it is necessary to evaluate it from a healthcare as well as from a patient perspective. The study is a randomised controlled trial. Overall aim is to evaluate if a orthopaedic manual therapy assessment (physiotherapy) assessment of patients referred to orthopaedic surgeon bring any changes to referral routines, patient satisfaction and health-related variables when compared to standard practice.

Conditions

Musculoskeletal Pain

Keywords

Physiotherapy; Orthopaedic; Primary care

Outcome Measures

Primary Outcomes (1)

• Number of referrals after consultation as a measure of Management outcome

  12 months

Secondary Outcomes (6)

• Scores on the questionnaire Quality from the Patient Perspective as a measure of Patient satisfaction

  30 days

• Scores on the EuroQol-5D as a measure of Health-related quality of life

  12 months

• Scores on the Pain Disability Index as a measure of Pain-related disability

  12 months

• Number of sick-leave days

  12 months

• Cost per quality adjusted life year (QUALY) gained as a measure of cost-utitily

  12 months

Study Arms (2)

Physiotherapy screening

EXPERIMENTAL

Screening consisted of a 60-min appointment including assessment, diagnosis and management. The patients received advice regarding ergonomics, exercises and/or treatment when needed. Management options were; * Referral for orthopaedic surgeon consultation. * Referral back to the patient's General Practitioner. * Referral for further investigation. * Referral to the physiotherapy or the occupational therapy clinic.

Procedure: Physiotherapy screening

Standard practice (orthopaedic surgeon)

ACTIVE COMPARATOR

Appointment was 15 min, including assessment, diagnosis and management. The patients received advice, prescriptions or injections when needed. Management options were; * Referral for orthopaedic intervention. * Referral back to the patient's General Practitioner. * Referral for further investigation. * Referral to the physiotherapy or the occupational therapy clinic.

Procedure: Standard practice

Interventions

Physiotherapy screening PROCEDURE

Physiotherapy screening.

Physiotherapy screening

Standard practice PROCEDURE

Orthopaedic surgeon assessment

Standard practice (orthopaedic surgeon)

Eligibility Criteria

• Age: 18 Years - 67 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• patients referred for orthopaedic surgeon with sub acute (four weeks to three months) or chronic (\>three months) musculoskeletal pain who had the ability to understand written and spoken Swedish.

You may not qualify if:

• diagnosed hallux valgus, ganglion or trigger finger.

Sponsors & Collaborators

• Vastra Gotaland Region: lead

Related Publications (4)

• Samsson K, Larsson ME. Physiotherapy screening of patients referred for orthopaedic consultation in primary healthcare - a randomised controlled trial. Man Ther. 2014 Oct;19(5):386-91. doi: 10.1016/j.math.2013.10.004. Epub 2013 Oct 29.

  PMID: 24246908 RESULT

• Samsson KS, Larsson ME. Physiotherapy triage assessment of patients referred for orthopaedic consultation - Long-term follow-up of health-related quality of life, pain-related disability and sick leave. Man Ther. 2015 Feb;20(1):38-45. doi: 10.1016/j.math.2014.06.009. Epub 2014 Jul 15.

  PMID: 25088308 RESULT

• Samsson KS, Bernhardsson S, Sandborgh M, Larsson MEH. The association between screened psychological risk for disability and appropriateness of orthopedic surgery in patients with musculoskeletal disorders - data from a Swedish RCT in primary care 2009-2011. Physiother Theory Pract. 2025 Aug;41(8):1579-1586. doi: 10.1080/09593985.2024.2448709. Epub 2025 Jan 5.

  PMID: 39757368 DERIVED

• Samsson KS, Bernhardsson S, Larsson ME. Perceived quality of physiotherapist-led orthopaedic triage compared with standard practice in primary care: a randomised controlled trial. BMC Musculoskelet Disord. 2016 Jun 10;17:257. doi: 10.1186/s12891-016-1112-x.

  PMID: 27286829 DERIVED

MeSH Terms

Conditions

Musculoskeletal Pain

Condition Hierarchy (Ancestors)

Muscular Diseases; Musculoskeletal Diseases; Pain; Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Study Officials

• Maria Larsson, PhD

  Närhalsan Research and development, Region of Västra Götaland

  STUDY DIRECTOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: DIAGNOSTIC
• Intervention Model: PARALLEL
• Sponsor Type: OTHER GOV
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: October 6, 2014
• First Posted: October 15, 2014
• Study Start: August 1, 2009
• Primary Completion: January 1, 2011
• Study Completion: January 1, 2012
• Last Updated: October 27, 2014

Record last verified: 2014-09