Physiotherapy: its prescription and implementation for orthopaedic out-patients

During a three-month period, 1462 (29%) of the new out-patients seen by 18 orthopaedic surgeons were prescribed physiotherapy. The rates of referral among the surgeons ranged widely, from 15% to 56%, and the differing characteristics of the patients did not account for these variations. For specific conditions examined, physiotherapy appeared to be one of a range of possible therapies. The majority of prescriptions gave clinical details and specified the type of treatment, but its duration was specified in less than half; the frequency and aims of treatment were hardly ever given. Nearly 90% of the patients completed their course. Fourteen different types of treatment were applied, but only four of these--heat, exercises, electrical stimulation, and traction--were applied to more than 3% of the patients. Physiotherapists nearly always carried out the treatments prescribed and augmented them in nearly a quarter of cases, usually with heat and/or exercises.