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A campaign for retaining electrophysical agents in physiotherapy training and practice.

Dear colleagues,

I am trying to initiate a campaign to retain electrophysical agents (EPAs) in our professional training and practice. Please offer your support to share and provide ideas.

There is increasing influence from a group of advocates who propose EPAs (or EPT) should be taken out from physiotherapy entry-level training or even clinical practice due to the lack of evidence to support the clinical effectiveness of EPAs. It is foreseeable that such an act will undoubtedly impose a negative impact on our profession by weakening the scientific training for our students and reducing the scope of the profession.

I propose the campaign to consist of addressing the importance of EPAs training for our students, pointing out the blind spots of the evidence against EPAs and updating the scope of EPAs. To facilitate the reading, the rationale here is presented in point-form.

If EPAs are taken out from a stand-alone subject from the entry-level training:

  1. Students will learn much less scientific knowledge about the mechanism of EPAs
  2. They may not be inspired to develop new EPAs
  3. They may not be able to criticize when OTHER PROFESSIONALS prescribe various EPAs to the patients.
  4. They share less common knowledge in therapeutic machines with other health professionals like surgeons, radiographers/ radiologists.

It is unfair to claim lacking evidence as the main reason to exclude EPAs:

  1. Some advocates have a bias in selectively reporting the evidence
  2. Research evidence is a good guideline in clinical practice, but should not be considered as the Bible.
  3. Evidence keeps changing
  4. Plenty of our practice is not supported by evidence (eg. evidence shows Physiotherapy is not significantly different from Wait-and-See in management Tennis Elbow, Smidt et al., 2002)
  5. I agree that some (or even most) modalities such as SWD have some evidence to show the absence of clinical effectiveness, it should not be inclusive to all the EPAs. The value of each modality should be judged on a case-by-case basis.
  6. Few modalities do have positive evidence to support their clinical effectiveness including lazer and ESWT.

In addition, in this generation, EPAs should not be still limited to therapeutic machines. It is more appropriate to update the spectrum of EPAs as the technologies which help to achieve the diagnostics, therapeutic and assistive purposes in physiotherapy practice:

  1. Real-time ultrasound
  2. Robotic therapy
  3. Virtual reality and augmented reality training
  4. Wireless sensors(accelerometer + gyroscope) for ROM measurement
  5. Exoskeletons
  6. Electromyography biofeedback
  7. 3D printed prosthesis

I sincerely seek for your support to the campaign by sharing the message with your network, raising the awareness of the issues with your peers, showing more evidence and cases to support the importance of EPAs in our profession. A more constructive way is helping to build up new evidence for the EPAs but it is rather a long-term goal.

Best regards, Lo Chi Ngai

LO CHI NGAI

2 months ago

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lochingai197
lochingai197

Dear Prof Oscar Ronzio ,

Thanks for your support. I would to share more information with you on other personal platforms like FB, LinkedIn or email for further discussion.

Best regards,

Prof Oscar Ronzio
Prof Oscar Ronzio

Dear Lo Chi Ngai. You have our support. Fortunately, in Latin America, EPAs are not in danger to be removed from the entry level curricula. In general, we have from 60 to 100 teaching hours of these modalities. Of course, you can always find a speaker in a congress saying that EPAs have no evidence and we always try to ask questions after the lecture to expose their lack of knowledge in our field.
May be we can work in a graphical campaign to spread it in ISEAPT social networks. Another goal is to suggest a minimum of teaching hours in the WCPT educational guidelines. We have to consult the publications about this topic in different countries to prepare a strong motion for wcpt. Best regards,

Oscar

lochingai197
lochingai197

Dear Dr Laakso,

Thanks for your reply.

Although I have no previous experience of running a campaign, I am willing to try because it is such an important issue.

Campaign: EPAs stay in Physiotherapy practice! #EPAstay

The issue

There is increasing influence from a group of advocates who propose EPAs (or EPT) should be taken out from entry-level physiotherapy training or even clinical practice due to the lack of evidence to support the clinical effectiveness of EPAs. It is foreseeable that such an act will undoubtedly impose a negative impact on our profession by weakening the scientific training for our students and reducing the scope of the profession.

Goal

This campaign is to raise the awareness in the profession to review, retain and update the values of EPAs in our training and practice.

Platform

The campaign will be run on various social media including Facebook, LinkedIn with #EPAstay

Promotion within the profession

If colleagues encounter advocates who promote dropping the use of EPAs in any open media or conference, please friendly remind them to be fair and reasonable: judge the evidence of each EPA modality on case-by-case rather than inclusive and update the current definition of EPAs considering the latest technologies in our practice.

Plan for success

The expected duration of the campaign will last for at least 6 months. Therefore, it will consist of three series: 1. PT students interview on the EPAs training in their program 2. Researchers interview on the option on current evidence 3. Clinicians interview on their EPAs practice + modern EPAs. Will consider if a survey can be conducted among colleagues on the perception on the campaign.

Therefore, I want to call for help if colleagues can support the campaign, it will be grateful if anyone show your hand so we can work together with reasonable occasional work on the FB page or other media, possible research collaboration (but likely to be unfunded =.=”). If someone can help to design a logo for the campaign, it will be awesome! Also, please offer your help to bridge the communication with ISEAPT if support can be provided to promote the campaign on their FB page or other channels.

Best regards, Chris

Last updated 1 month ago

L.Laakso335
L.Laakso335

Dear Lo Chi Ngai, I am in full support. The ISEAPT sub-group of the WCPT is very concerned by this issue as well and is conducting a Focused Symposium in Geneva next year on this topic. Those who can make it are encouraged to attend. But it is also important that a ground-swell approach comes from physiotherapists themselves. Did you have something specific in mind when you mentioned a campaign?

Regards, Liisa Laakso

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