PAST, PRESENT AND FUTURE

RESEARCH IN PHYSIOTHERAPY
CH.V. DHARMA RAO
MPT in Cardio-Pulmonary


RESEARCH- DEFINITION


Acc to The Learners Dictionary of current
English a careful investigation or enquiry
specially through search for new facts in any
branch of knowledge.
Acc to Clifford and Woody
Research comprises

defining and redefining
problems, formulating hypothesis
or suggested solutions;

collecting organizing and
evaluating data;

making deductions and reaching
conclusions;

and at last carefully testing the
conclusions to determine whether
they fit the formulating
hypothesis.


PAST
The
techniques
used in
Physical
Therapy were
used well
before the
name
Physical
Therapy
came into
existence.
History is filled
with moments
of milestones
and of pride.
PRESENT
The recent
development
s are owed
mainly to
international
collaboration
s especially in
research and
its
disseminatio
n
FUTURE
We need to
perform a
thorough
reflection and
strategic
planning in our
doctoral
programmes,
practice
autonomy and
imparting
professionalism
among
therapists.
Impact analysis
of such
paradigm shift is
thus warranted.
PAST Research in PT
Journals are acknowledged as crucial sources of evidence-based
information relevant to physiotherapy practice. The first research about
physical therapy in the United States was published in March 1921 in The
PT Review. The first RCT in Physical Therapy evaluated Ultra-Violet
radiation therapy and was published in 1929 by Dora Colebrook in Medical
Research Council Special Report Series.

Initially the RCTs were published in medical journals and not until
1967, for the first time an RCT evaluating physical therapy intervention
was published in a physical therapy journal. This unique credit goes to
author- Landen B whose study evaluated superficial heat vs. cold in LBP
and was published in Physical Therapy journal.

PAST Research in PT (Cntd)
The first systematic review was published in 1975 by Kolind-Sorensen which
was on lateral ankle ligament injuries in a Danish journal Ugeskr Laeger.
The first evidence-based clinical practice guideline was published in the year
1987, a report of the Quebec task force on spinal disorders which was on
activity-related spinal disorders by Spitzer W in Spine. In the recent past,
systematic review of systematic reviews also came to be published, on Spinal
Manipulation in Chronic LBP.
PRESENT RESEARCH - PT
The rapid growth of evidence as witnessed by the presence of
1 record in 1929 to 100 records in 1972,
to 1000 records in 1986,
5000 in 1999 and to 10,000 in 2005 is an indicator of a rapid shift towards
research and evidence-based practice.
Presently as on March 2010, there are 15,920 records in Physiotherapy
Evidence Database which includes 2257 systematic reviews and 13,096
randomized controlled trials and 567 clinical practice guidelines in
physiotherapy alone.
PRESENT RESEARCH IN PT (Cntd)
As we observe the growth of evidence when analyzed specialty-wise,
Musculoskeletal holds the highest position with more than 2,000 records
followed by Cardiothoracic with less than 1,250 records.

Region-wise, 1,037 studies were on treatment of lumbo-pelvic disorders
and condition-wise, there were 173 records surprisingly for incontinence
alone. Regarding dissemination of this evidence, it is a rare occurrence
that only 3% of this number (340 out of 11,494 records as on September 3,
2007) was published in general medical journals
PRESENT RESEARCH - PT (Cntd)
It is not a matter of pride that 97% of physiotherapy evidence is published in
physiotherapy journals like Physical Therapy, Physiotherapy, Journal of
Physiotherapy (formerly Australian Journal of Physiotherapy) and
Physiotherapy Canada. It is indeed a matter of question and uncertainty why
physiotherapy evidence is not published in general medical journals.

The need of the present hour to improve inter disciplinary awareness and multi
disciplinary collaboration in clinical practice is achievable only if physical
therapy scientific community works in liaison with other medical community
towards solving this issue, if we really mean to aim global professional
autonomy in practice.

FUTURE RESEARCH PT
The existing Researcher clinician gap should be minimized in order that-
improved application of best research findings and evidence into practice;
and also for generation of best research evidence from expert clinical
practice shall go hand in hand towards betterment of our society and our
profession.

Research or science in Physical Therapy has changed from positivism
(verifiable by observation) to hermeneutics (based on understanding) and
then finally to pragmatism (based on actions). Physical Therapy research
was based upon two supposedly different philosophies- positivism and
phenomenology.
FUTURE RESEARCH PT (Cntd)
Positivism relied on quantitative research methods and phenomenology relied
on qualitative ones. Combining science (which is objective and is based on the
body) and art (which is subjective and is based on the mind) using an
inextricably blended mixed model of quantitative-qualitative research is
essential.

Professional autonomy is achievable through the following five steps outlined
by Professor Stanley Paris in his keynote address at Biennial conference of
New Zealand Society of Physiotherapy (NZSP) in 2008, as- definition of scope
of practice; research; clinical doctorate programs; marketing; and, maintenance
and advancement of our autonomy.
REFERENCE:
JOURNAL OF PHYSIOTHERAPY, 2010 1
ST
ISSUE. Pg 58-67
Article pre-publication history:
Date of submission: 4th April 2010 Reviewer: Peter A Huijbregts Sent for
1st revision: 8th April 2010
Date of 1st resubmission: 11th April 2010 Reviewer: Prof Maureen
Simmonds
Sent for 2nd revision: 18th April 2010
Date of 2nd resubmission: 20th April 2010.
Date of acceptance: 24th April 2010.
Date of publication: 27th June 2010.