Physiotherapy management of people with lower limb amputation

This thesis explores the self-reported clinical practice of physiotherapists in their provision of care to people with lower limb amputation. Understanding the clinical practice of physiotherapists in lower limb amputation management is important because it provides the basis for comparisons with established clinical practice guidelines. Such comparisons can confirm areas of amputation management that physiotherapists provide, identify areas of care that physiotherapists can potentially contribute, and contextualise the role of physiotherapists across different phases of care. Currently, no study has investigated and compared the clinical practice of physiotherapists in lower limb amputation management to established clinical practice guidelines. To address this, a survey was conducted to obtain details about the professional profile and clinical practice of Australian physiotherapists involved in lower limb amputation management. The collected findings were then compared to a local clinical practice guideline; Care of the Person Following Amputation: Minimum Standards of Care. The study had three main findings. Firstly, Australian physiotherapists reported to be adequately skilled in caring for people with amputation but state that they received very limited theoretical and clinical experience during their higher education, and report limited professional development. Secondly, Australian physiotherapists coordinated their management with other health professionals and demonstrated comprehensive care beyond their scope of practice, however during a transition of care, physiotherapists were not aware if a comprehensive care plan was developed before their care started. Lastly, Australian physiotherapists demonstrate adherence to relevant clinical practice guidelines based upon consistency between reported clinical practice and recommended practice of relevant minimum standards of care. These findings highlight the multidimensional role of physiotherapists in lower limb amputation management across different phases of care. Future research is needed to obtain greater detail about the clinical practice of physiotherapists in managing people with lower limb amputation, using broader forms of data collection, such as semi-structured interviews or auditing clinical practice. Furthermore, future research investigating the barriers and facilitators of clinical practice guideline implementation may offer insights into how clinical practice is shaped. Lastly, future research into the development of a physiotherapy-specific clinical practice guideline in amputation management may have important clinical practice implications for the physiotherapy profession, contributing to the landscape of clinical resources available for physiotherapists in lower limb amputation management.