Provision of physiotherapy follow-up services for patients with blunt chest wall trauma: An international survey study exploring barriers and enablers

Abstract

Purpose

The aims of this study were to (a) explore the current landscape in physiotherapy follow-up services and (b) the perceived barriers and enablers influencing the provision of physiotherapy follow-up services for patients with blunt chest wall trauma, discharged from a healthcare setting.

Major Findings

A total of 125 completed surveys were included from 18 countries. 70 (56%) respondents reported having no available follow up services at their organisation. Levels 1 and 2/Major Trauma Centres or Trauma Units were more likely to provide physiotherapy follow-up services than a Level 3/Local General Hospital (OR: 2.6, 95% CI: 1.2–5.5, p = .015). Themes were identified that described the enablers and barriers to provision, which included; patient factors, available family support, funding and economic impact, referrals and discharge process, and guidance/local policies. These themes were mostly driven by a lack of recognition and understanding of the potential for longer term complications by both patients and their family members and clinical teams.

Conclusions

The results of this study suggest that there is a low rate of provision of specialised follow-up services offered by physiotherapists, despite evidence highlighting the long-term complications associated with blunt chest trauma. It is important that physiotherapists recognise that a need exists to engage with these patients in the post-discharge recovery period. Where services do exist, there is a lack of standardisation evident. Future work should focus on demonstrating benefit for physiotherapy intervention throughout the entire continuum of patient recovery.