Approaches to osteoarthritis: a qualitative study among physical therapists in Maharashtra, India

Osteoarthritis (OA) is a major and growing problem in India. Better knowledge dissemination and implementation of evidence-based practice in Indian physical therapy require a better understanding of approaches to OA (i.e. perceptions of the condition and its management by Indian physical therapists (PTs)) which was the aim of our study.

We used qualitative content analysis to analyze semi-structured interviews with 19 PTs from Maharashtra state, purposefully selected to represent both sexes, different ages and different educational and professional backgrounds.

We identified a main overarching theme of meaning, OA as a degenerative and irreversible condition with the four descriptive themes Assessment, Standardized treatment protocol, Leadership and Patient compliance as PTs' approaches to OA. The descriptive themes indicate that much focus seems to be on pain, physical impairments and biomechanics, with initial treatments being mainly passive. Communication appears to be mainly unidirectional with the PTs instructing the patients, who are expected to comply with PTs instructions. Clinical practice guidelines (CPGs) were not mentioned.

Our findings can inform the design of awareness campaigns on evidence-based OA management and increase the understanding of the educational needs of students and PTs in non-Western countries. It is important to recognize that CPGs are mainly based on studies carried out in Western countries and that there are context-specific barriers to implementation in other parts of the world that have large populations.