A survey of physical therapy goals and interventions for patients with back and knee pain

The physical therapy management of patients with pain often lacks a theoretical or conceptual basis. The purpose of this study was to compare treatments of patients with back and knee pain with a treatment framework (conceptual model) that we developed. This framework emphasizes physiological recovery, or reduction of impairments (eg, reduction of swelling), followed by emphasis on the reduction of disabilities. Expectations were derived concerning treatment goals and interventions in the course of treatment.

Patients with back pain (n = 1,085) and patients with knee trauma (n = 416) were treated by 83 Dutch physical therapists.

Survey data were gathered on impairments and disabilities and on treatment goals and interventions.

For both groups of patients, two out of a maximum of eight treatment goals were directed at alleviating impairments in accordance with the framework. Goals directed toward the alleviation of disabilities did not show a similar relationship to the framework. For two treatment goals, the course of treatment was in accordance with the framework for both groups of patients.

The framework is only partially reflected in Dutch physical therapist practice. The use of such a framework, however, may be a helpful tool in gaining more insight into physical therapy in daily practice.