Moving into the 21st century

In the last few years, MPA has continued to be a key player in the slow but steady drive towards specialisation within the physiotherapy profession, always striving to uphold the standards of excellence already attained while seeking to assist members to move forward to specialist status.

With high clinical standards well established and the specialisation process ongoing, the MPA National Committee turned some of its attention to the evidence-base behind clinical practice. MPA continued to support musculoskeletal physiotherapy research, by generous ongoing donations to the Physiotherapy Research Foundation. It also sought to find new ways to support members in their endeavours to interpret the plethora of

emerging research and clinical trials, by the production of resource materials which reviewed the latest evidence and made recommendations for best practice. Once again MPA led the way by commissioning the production of evidence-based clinical statements (formerly referred to as position statements) outlining recommendations for best practice in the treatment of specific musculoskeletal disorders. To date, evidence-based clinical

statements have been produced for low back pain, neck pain, osteoarthritis of the kneejoint, shoulder pain, and patello-femoral pain. MPA also commissioned and funded the production of two atlases of clinical outcome measures, respectively for low back pain and cervical spine disorders.

MPA was always aware of ethical issues, and as knowledge about occasional adverse events associated with spinal manipulation increased, in 2000 MPA produced the first APA ‘Clinical guidelines for the pre-manipulative testing of the cervical spine’. These were revised and updated in 2005 and became the ‘Clinical guidelines for the assessment of vertebrobasilar insufficiency in the management of cervical spine disorders’. Further

resources and evidence-based clinical statements are planned to follow.

To conclude this ongoing history, we can do no better than to finish with a co-authoured quote from long standing member Dr Dale Larsen and founding member Associate Professor Pat Trott:

‘As primary contact practitioners dealing with clients with problems that are attributed to disorders of the neuromusculoskeletal system, contemporary physiotherapists must be accountable for their clinical decisions in an environment that presents competing demands and constraints, including evidence-based practice, an information explosion in the health sciences, funding restrictions, and ethical issues.

‘For the discipline of musculoskeletal physiotherapy to remain viable in the 21st century and beyond, practitioners must be cognisant, and adapt to new knowledge from basic and applied research. They also need to be critical of the available evidence, yet at the same time remain reflective of the way in which various treatment hypotheses and protocols are presented and evaluated. In this environment, physiotherapists have of necessity become more holistic in their patient care. Our pioneers have established a solid foundation of skilled clinical reasoning enabling us to practise autonomously, to make clinical decisions collaboratively, and to apply new knowledge to support sound patientcentred clinical practice. In this, our 40th year, we salute those who have gone before, and we thank them for their hard work and foresight’.