Abstract
Background:
Pregnancy, childbirth and the postpartum period involve significant physiological changes, predisposing patients to musculoskeletal and pelvic health (PH) dysfunction symptoms. These symptoms can negatively influence returning to running (RTR) postpartum. To optimise RTR, research highlights the central role of musculoskeletal and PH physiotherapists in assessing whole-systems readiness. However, to date, no study has investigated current physiotherapy practices.
Purpose:
This research project aimed to investigate the current practice of United Kingdom (UK) based, Health and Care Professions Council (HCPC) registered physiotherapists assessing postpartum RTR readiness within musculoskeletal and PH settings. The objectives were to establish whether physiotherapists assess postpartum RTR readiness, investigate current practice, and explore any associations between current practice and professional characteristics.
Methods:
An observational cross-sectional survey was conducted online using the ‘Online Surveys’ platform. The survey was designed using current evidence and expert consensus, and following piloting, was open for a six-week period. Participants included UK based, HCPC registered musculoskeletal and PH physiotherapists assessing postpartum patients. Participants were recruited online and via social media using purposive and snowball sampling. Data analysis included descriptive and inferential statistics using Fisher’s exact tests with a significance threshold at p<0.05.
Results:
129 survey responses were completed. Participants widely varied in years’ experience, clinical grades, postgraduate training, and clinical skillsets. 5.4% (7/129) of respondents were musculoskeletal physiotherapists, 50.4% (65/129) were PH physiotherapists and 44.2% (57/129) had a combined skillset of musculoskeletal and PH.
All respondents (100%, 129/129) assessed postpartum RTR readiness. 97.7% (126/129) completed musculoskeletal assessments, evaluating muscle strength (72.2%, 91/126), functional loading and impact (both 97.6%, 123/126). 70.5% (91/129) assessed PH function prioritising pelvic floor endurance (97.8%, 89/91), coordination (95.6%, 87/91) and strength (93.4%, 85/91). Time postpartum (94.6%, 122/129), postpartum recovery status (91.5%, 118/129) and delivery type (89.9%, 116/129) were common additional factors considered.
Statistical association analysis revealed PH physiotherapists less frequently assessed musculoskeletal function than other skillsets (p=.001); musculoskeletal physiotherapists frequently assessed muscle strength (p=.035) but less frequently evaluated functional loading compared to other skillsets (p=.044); and combined skillset physiotherapists more frequently considered patient physical activity status (p=.003). More experienced physiotherapists conducted assessments from six weeks postpartum (p=.014) and more often in patients without symptoms (p=.026) compared to other experience levels. Less experienced physiotherapists rarely assessed breathing (p=.017) and prolonged bleeding (p=.040).
Conclusion:
UK physiotherapy practice assessing postpartum RTR readiness broadly reflects guideline recommendations, evaluating musculoskeletal and PH function alongside wider biopsychosocial factors. Variations in practice were identified based on professional characteristics. Due to non-probability sampling and potential self-selection bias findings should be viewed with caution, but can aid physiotherapists’ clinical reflection.
Future research should investigate the specific functional loading and impact assessment tasks used and international physiotherapy practice surveys could enable practice comparison.
Pregnancy, childbirth and the postpartum period involve significant physiological changes, predisposing patients to musculoskeletal and pelvic health (PH) dysfunction symptoms. These symptoms can negatively influence returning to running (RTR) postpartum. To optimise RTR, research highlights the central role of musculoskeletal and PH physiotherapists in assessing whole-systems readiness. However, to date, no study has investigated current physiotherapy practices.
Purpose:
This research project aimed to investigate the current practice of United Kingdom (UK) based, Health and Care Professions Council (HCPC) registered physiotherapists assessing postpartum RTR readiness within musculoskeletal and PH settings. The objectives were to establish whether physiotherapists assess postpartum RTR readiness, investigate current practice, and explore any associations between current practice and professional characteristics.
Methods:
An observational cross-sectional survey was conducted online using the ‘Online Surveys’ platform. The survey was designed using current evidence and expert consensus, and following piloting, was open for a six-week period. Participants included UK based, HCPC registered musculoskeletal and PH physiotherapists assessing postpartum patients. Participants were recruited online and via social media using purposive and snowball sampling. Data analysis included descriptive and inferential statistics using Fisher’s exact tests with a significance threshold at p<0.05.
Results:
129 survey responses were completed. Participants widely varied in years’ experience, clinical grades, postgraduate training, and clinical skillsets. 5.4% (7/129) of respondents were musculoskeletal physiotherapists, 50.4% (65/129) were PH physiotherapists and 44.2% (57/129) had a combined skillset of musculoskeletal and PH.
All respondents (100%, 129/129) assessed postpartum RTR readiness. 97.7% (126/129) completed musculoskeletal assessments, evaluating muscle strength (72.2%, 91/126), functional loading and impact (both 97.6%, 123/126). 70.5% (91/129) assessed PH function prioritising pelvic floor endurance (97.8%, 89/91), coordination (95.6%, 87/91) and strength (93.4%, 85/91). Time postpartum (94.6%, 122/129), postpartum recovery status (91.5%, 118/129) and delivery type (89.9%, 116/129) were common additional factors considered.
Statistical association analysis revealed PH physiotherapists less frequently assessed musculoskeletal function than other skillsets (p=.001); musculoskeletal physiotherapists frequently assessed muscle strength (p=.035) but less frequently evaluated functional loading compared to other skillsets (p=.044); and combined skillset physiotherapists more frequently considered patient physical activity status (p=.003). More experienced physiotherapists conducted assessments from six weeks postpartum (p=.014) and more often in patients without symptoms (p=.026) compared to other experience levels. Less experienced physiotherapists rarely assessed breathing (p=.017) and prolonged bleeding (p=.040).
Conclusion:
UK physiotherapy practice assessing postpartum RTR readiness broadly reflects guideline recommendations, evaluating musculoskeletal and PH function alongside wider biopsychosocial factors. Variations in practice were identified based on professional characteristics. Due to non-probability sampling and potential self-selection bias findings should be viewed with caution, but can aid physiotherapists’ clinical reflection.
Future research should investigate the specific functional loading and impact assessment tasks used and international physiotherapy practice surveys could enable practice comparison.
| Original language | English |
|---|---|
| Title of host publication | IFOMPT (International Federation of Orthopaedic Manipulative Physical Therapists), Basel, 4-6 July 2024 |
| Publication status | Submitted - 2023 |
| Event | IFOMPT 2024 (International Federation of Orthopaedic Manipulative Physical Therapists), Basel: The world conference of musculoskeletal and manual physical therapy. - Basel, Switzerland Duration: 4 Jul 2024 → 6 Jul 2024 Conference number: 50 https://www.ifomptbasel2024.org/frontend/index.php |
Conference
| Conference | IFOMPT 2024 (International Federation of Orthopaedic Manipulative Physical Therapists), Basel |
|---|---|
| Abbreviated title | IFOMPT 2024 |
| Country/Territory | Switzerland |
| City | Basel |
| Period | 4/07/24 → 6/07/24 |
| Other | The main theme for the IFOMPT 2024 conference is "crossing bridges" - Crossing bridges between research, clinical practice, education, patient's perspectives and the needs of society. The many challenges and changes that musculoskeletal and manual physical therapy are facing require critical reflection on the future from different perspecives. The conference will be a key event to discuss, advocate and share. But we will also dedicate ourselves to celebrating and making IFOMPT's 50th anniversary a very special one. |
| Internet address |
Keywords
- Postpartum
- running
- assessment
- Physiotherapy
- UK