Physiotherapists' reasons for selection of treatment techniques: a cross-national survey

Within the framework of evidence-based physiotherapy practice, a questionnaire survey was conducted to ascertain physiotherapist's reasons for their selection of treatment techniques. The underlying interest lay in the utilisation of journal literature when selecting treatment techniques, which represent an aspect of the clinical reasoning process. One hundred and eighty physiotherapists in England and 141 physiotherapists in Australia participated. The results surprisingly indicate no major differences between the two national groups in the reasons they provided for their choice of treatment techniques, despite two decades of degree level education in Australia. Use of journal literature, and in particular research literature, as a basis for selecting techniques was virtually absent. For almost all techniques, selection was based primarily upon what was taught at initial training. Attendance at a practice-related course was favoured for specific techniques such as passive mobilisation/manipulation and McKenzie. Prior experience with patients was also a primary reason reported. Clear theoretical implications for physiotherapy as a scientific discipline are drawn. Within the context of the recent UK Department of Health evidence-based practice initiative, the practical implication is apparent: namely, that the profession must be able to demonstrate an effective scientific foundation for treatments within an increasingly competitive resource environment