Physio Consumer Database

Physiotherapy Choices is a database designed for use by consumers of physiotherapy services. It catalogues only the best research evidence of the effectiveness of various physiotherapy treatments, so it can be used to assist informed choices about physiotherapy interventions. Consumers would usually be patients, but might also be their families, health service managers, and insurers. The Physiotherapy Choices site can be searched easily by a lay person.

As an example of how the database might be used, consider how someone might find out about the best treatments for shoulder pain that develops while working at a computer. They could search for Physiotherapy Choices on their internet browser, or log on to www.physiotherapychoices.org.au, and click on the SEARCH button. In the Search window they would be invited to choose an ending to a number of statements from a short list of responses.

For example, the first statement The health problem... comes with a short list of possible endings in plain language, including:

...affects mainly children.

...affects mainly sportspeople.

...affects older adults mainly.

...arises or is treated in the workplace.

A logical choice would be the last option.

The next statement The symptom experienced is… could be completed by selecting ...pain. Technical terms for symptoms (like muscle shortening, reduced joint compliance and oedema) are simplified to tightness, stiffness and swelling. The user does not need to deal with technical, anatomical terms like scapula and upper trapezius. A colour-coded body chart is supplied which allows users to simply click the region where the symptom occurs. In our example the user could click the option that covers the shoulder, upper arm, and shoulder blade.

Finally, there is a free-text box where the user can enter any terms, including technical terms, that they are sure of, such as Parkinson’s disease, anterior cruciate ligament or incontinence. In this example it might be worth entering computer to see if this locates the most relevant research.

All items of information that define the search are optional, so users need not be concerned if they cannot find a suitable ending for every statement.

Physiotherapy Choices also helps the user interpret the information retrieved by the search, by providing a summary of each piece of research in lay terms. The search described above would retrieve a lay summary of a rigorous review of clinical trials in this area (a consumer summary of a Cochrane systematic review of physiotherapy interventions for work-related complaints of the arm, neck, or shoulder). The review identified four individual trials in which interventions gave positive results. The interventions were: exercise when compared to massage; adding breaks during computer work; massage combined with manual therapy when compared to manual therapy alone; and manual therapy and exercises compared to exercises alone. The review also found conflicting results about other treatment comparisons.

With an increasing number of consumers seeking information on the internet and many finding it difficult to distinguish between high and low quality information, it is good to have a source of high-quality, interpretable information you can rely on.

www.physiotherapychoices.org.au