Physiopedia has recently published a new Toolkit for Achilles Tendinopathy. The “Tendinopathy Toolkit” is a resource to assist in clinical decision-making for management of acute and chronic Achilles tendinopathy. It includes a summary of the evidence for common physiotherapy interventions (eg. manual therapy, exercise, ultrasound, LLLT, bracing, taping, outcome measures) with a summary of the evidence and clinical implications. The remaining items in the toolkit include an algorithm to provide guidance as to when each intervention may be effective, details on each of articles which informed the toolkit, guidance on exercise prescription, calculation of laser dosage and a summary of medical and surgical interventions.
Translation of knowledge to practice in health care is a significant challenge. A project was undertaken by a unique partnership of physical therapy researchers, educators and expert clinicians to address the gap between evidence and practice in the management of Achilles Tendinopathy. Physiotherapy clinicians in British Columbia requested evidence-informed guidance on the management of tendinopathy. To address this need the provincial Physical Therapy Knowledge Broker assembled a team of researchers, educators and expert clinicians with the mandate to develop, disseminate and implement a toolkit of decision aids to guide clinical decision-making for Achilles Tendinopathy.
The ‘Tendinopathy Toolkit’ includes:
- A tabulated summary of the evidence for manual therapy, exercise, low level laser therapy, ultrasound, extracorporeal shock wave therapy, iontophoresis using dexamethasone, taping, orthotics, night splints and braces, heel raise inserts, needling techniques, and the appropriate outcome measures for this population [targeted ‘take home messages’ and clinical implications for each were also included]
- An algorithm to guide the sequence of interventions
- Appendices including:
- a) exercise programs
- b) low level laser dosage calculation
- c) tabulated details for each article reviewed and
- d) a review of common medical interventions.
The second phase of the initiative – utilization of strategies to enhance implementation and uptake of the toolkit – is currently being undertaken.
This Physical Therapy Knowledge Broker project was supported by the University of British Columbia (BC) Department of Physical Therapy, The Physiotherapy Association of BC, Vancouver Coastal Research Institute and the Providence Healthcare Research Institute. It has been developed by a team of researchers, educators and expert clinicians that make up the BC Physical Therapy Tendinopathy Task Force, it includes Dr. Joseph Anthony, Allison Ezzat, Diana Hughes, JR Justesen, Dr. Alex Scott, Michael Yates, Alison Hoens.
Dr Alex Scott will from the Tendinopathy Taskforce will be presenting at the upcoming IFOMPT conference and World Congress of Manual and Musculoskeletal Physiotherapy on Monday 1st October followed by a focused symposium on Tendinopathy on Tuesday 2nd October. If you are unable to attend the IFOMPT conference you can follow it here.