Rotator cuff disorders: A survey of current (2018) Italian physiotherapy practice

BACKGROUND: Shoulder pain is a common musculoskeletal complaint and disorders of the rotator cuff (RC) are widely regarded as the most common cause. Where clinical care is required, physiotherapists play an integral role. Previous studies have reported physiotherapy practice across other countries as a means of determining current practice and understanding whether practice changes over time in response to emerging research evidence. AIM: To investigate the practice of Italian physiotherapists, in order to determine current practice for the assessment and management of RC disorders. METHODS: A cross sectional online survey. A 20-item questionnaire based on one clinical vignette was developed using Survey Monkey Software. Data were analyzed descriptively and difference in proportions between those with no specific education compared to those with a specific education (i.e. 'Master's Degree,' '1-2 days Training Course' or 'Other) were analysed using the chi-squared test. RESULTS: A total of 805 participants accessed the survey with a total of 436 completed responses (54%). Fifty-five percent of respondents were male (239/436). Seventy-one percent of respondents (309/436) reported having specific education with regards to RC disorders. The methods of diagnosing RC disorders were variable across the respondents as well as the requests for imaging (184/436, 42%), the adoption of manual therapy techniques (251/436, 58%), the duration of treatment (231/436, 53% visit the patient six times at least) and the administration of physical examination tests (175/436, 40%). Advice (279/436, 64%) and some form of exercise therapy (268/436, 62%) were the most popular choices of treatment. DISCUSSION AND CONCLUSION: This current study is the first to describe Italian physiotherapy practice for RC disorders. Italian physiotherapy practice is in line with other European countries. Italian physiotherapy practice also aligns with current recommendations with regards to minimal use of imaging and prescription of therapeutic exercise. However, there is heterogeneity across the responses particularly with regards the use of manual therapy, physical examination tests, and duration of treatment. Furthermore this study is a platform for future research to explore whether Italian physiotherapy practice changes over time.