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How Evidence Based Physiotherapy Helps in Better Treatment

“Your recovery is going well. Your knee should be normal by another two weeks.”

“According to our Short Form-36 report, your recovery score is at 75*, which means we can expect your knee to be normal by the end of another two weeks.”

Imagine you’re the patient and you hear your physio say either of these two sentences. Which one would you prefer to listen to? Which one is more assuring and seemingly trustworthy? Most people would choose the second one. The difference? Data and metrics served as evidence of progress.

A crucial part of treatment and recovery includes its quantification. As much as the above example helps us understand its importance for patients, it is even more important for physios to analyze the incoming data because it solves two problems for them. One, it helps them confidently decide the next course of action. Two, it helps them monitor progress AND patient adherence. But how is this related to patient adherence?

There is little doubt that people tend to trust numbers more than vague sentences, especially in healthcare (even when they don’t understand what the numbers may refer to!). But during recovery, why should that matter at all if the patient understands the metrics and jargon? That’s because patients are more likely to carry out their treatment (in full or with sincerity) when they are motivated, which is driven by progress. Since the extent of most injuries is tough to see externally, stats provide the only source of quantifiable progress other than sensation (which can be misleading!). Again, the importance of the patient-physio relationship cannot be stressed enough. Data-driven physiotherapy promotes a healthy patient-clinician relationship in all aspects possible.

Keeping the patient happy is one part of the deal. The other half of the treatment is now the treatment itself. Here, when we use the term “evidence,” we’ll deal with how a patient’s recovery progresses and how the learnings from previous cases help. And no point in guessing, it all involves data. While recovery schedules heavily rely on previously done research, the lack of customization often forces physiotherapists to try out a new combination of exercises or medication too. While this involves necessary risk, it’s riskier to not keep a close eye on the responses. 

This is where data-driven gadgets come in. From monitoring basic vitals and mobility, some applications even allow simulations and visualization. These ground-breaking advances are key in dosage-based exercises and setting realistic targets, depending upon the patient. This can be seen in spinal and orthopedic care, where parameters like resistance level, distribution of resistance, range of motion, and repetition are taken into consideration. When this data was made available accurately, patient compliance went as high as 92%. Eventually, all these permutations and conditions go into the database for future cases, serving as evidence for the probability that a certain set of exercises and/or medication are likely to work out well. While there are always exceptions, metrics help therapists change the course as required promptly. In short, no argument can be made to say that data-driven healthcare, especially in physiotherapy, will give rise to inefficient or riskier treatment.

Now while we have established the fact that evidence-based physiotherapy is beneficial for all, the industry practice will suggest otherwise. As mentioned above, there is an acute need for data-driven healthcare but the quantification of the effect itself is lacking. We know that data will only make treatments shorter and more efficient but by how much? What’s the difference or the impact? Unfortunately, the lack of statistical analysis here reflects the sorry state of affairs. While it won’t be right to say that data-centered physiotherapy is a utopia, we are far from its execution. And it begins with physios and clinics acknowledging this problem and making it their priority to not just collect and analyze data, but also put that research out for others to refer to and build upon. 

However, we must understand that this transition is going to take time. The present lack of data-driven equipment, the linear rise in the patient count, and continuous trial and error will make the transition rough. There’s a high probability that some of them may not work and many new findings will contradict each other. The key here is patience and constant updating. Being a part of the healthcare community, therapists will always have to keep themselves up to date with recent discoveries and allow technology to assist their expertise. Slowly but eventually, physiotherapy will make that breakthrough and help patients receive affordable and effective treatment.

References:

  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3284660/
  2. https://www.sciencedirect.com/topics/nursing-and-health-professions/short-form-36#:~:text=To%20score%20the%20SF%2D36,normative%20value%20for%20all%20scales.
  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8074736/
  4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7525464/
  5. https://davidhealth.com/global-content/7-reasons-why-data-driven-device-based-exercise-therapy-will-change-spine-and-orthopedic-care/
  6. https://www.researchgate.net/publication/342457961_Data-driven_Personalization_of_Physiotherapy_Care_Pathway_Case_Posture_Scanning_Preprint
  7. https://www.btetechnologies.com/therapyspark/enhance-through-data-driven-client-assessments/
  8. https://www.physio-pedia.com/Evidence_Based_Practice(EBP)_in_Physiotherapy

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