Physiotherapy's Role in Health Outcomes of Older People: A Report

This report critically examines the role of physiotherapy in managing the health of older people, particularly those experiencing chronic lower back pain. It reviews literature from databases like PUBMED and CINAHL, focusing on articles published within the last five years and written in English. The report includes a critical appraisal of three scholarly papers. The first paper explores cross-disciplinary care partnerships in physiotherapy, emphasizing the importance of physiotherapists in preventing falls and managing osteoarthritis in older adults. The second paper investigates the feasibility of training peers to support older adults with chronic low back pain after physiotherapy discharge. The report also discusses ethical aspects and research design considerations, including the use of keywords and inclusion/exclusion criteria in the literature search. The report highlights the significance of physiotherapy in improving the well-being and health outcomes of older people, and addresses the need for continued research and collaboration to enhance patient care.

To examine the role of physiotherapy in managing the health
of older people.

Table of Contents
Topic: “To examine the role of physiotherapy in managing the health of older people.”...............3
INTRODUCTION...........................................................................................................................3
MAIN BODY...................................................................................................................................3
Literature search..........................................................................................................................3
Critical appraisal of literature search..........................................................................................4
Ethical aspects...........................................................................................................................10
Research design.........................................................................................................................10
CONCLUSION..............................................................................................................................11
REFERENCES..............................................................................................................................13

Topic: “To examine the role of physiotherapy in managing the health of older people.”
INTRODUCTION
The Literature review will be based on examining the role of physiotherapy in managing
the health outcome of older people. In this the older people will be targeted who are goping
through chronic lower back pain. Physiotherapy also referred to as the physical therapy and is
also one of the medical health profession. It is significant in effectively treating people and
maintain mobility within the person. It is significant in effectively treating the chronic and acute
pain and also use evidence based kinesiology to provide best possible treatment to the people. It
is really necessary for patients who are going through issues such as chronic back pain and any
other problem in body to make use of physiotherapy. It has also been analysed that
Physiotherapists help people affected by injury, illness or disability through movement and
exercise, manual therapy, education and advice. Physiotherapy is being used to enhance health
outcome of patients who are suffering from joint pain or any other type of pain. It assists in
improving the well-being of older people which is really necessary. This study will focus on
critically evaluating and interpreting on the three scholarly papers. The main topic of the study is
role of the physiotherapy in effectively managing the health of the older people. Present report
will lay emphasis on the literature search done for the paper. It will also focus on critical
evaluation based on literature review. It will also discuss about the research design which will be
used in report. Report will follow ethical code of conduct.
MAIN BODY
Literature search
Literature was search by making use of various data bases such as PUBMED, CINAHL. It was
also being analysed that review of literature was being done by collecting data from relevant and
authentic websites. It was also being analysed that currently 998 articles were being searched. It
was being analysed that the articles which has been used for study are not much older. The
articles that are selected for study are not older than 5 years (Testa & Rossettini, (2016). It
is also being evaluated that articles were being published in English language was been selected
for study. No other article which was published in other language was being selected for study.
This was the inclusion and exclusion criteria that was being used for the present report. It was
also being analysed that articles were being selected from the relevant and published websites.

Researchers has also followed the ethical code of conduct while gaining and gathering
information. It is also being analysed that in order to select the articles various key words was
also being used. It included physiotherapy, older people, health care, cross-disciplinary, nurses
etc. In this literature search AND and OR criteria were also being used by researcher so that
better information can be gained and relevant articles can be selected. In this the search was
being made by using physiotherapy impact in managing health or effects of physiotherapy on
health of patients. It was also being evaluated that only relevant and authentic articles are being
search for analysis of present literature. Out of 500, then 100 articles were selected and from that
also 3 relevant articles are being selected. This has assisted researcher in getting the end results
and also it has assisted in making sure that better research is been obtained from research.
Inclusive and exclusive criteria are being used for present research. It is also being analysed that
researchers have only made use of articles in English language, if there were other articles which
were in other language it was not being taken.
Critical appraisal of literature search
Paper 1: Ackerman, I.N., Soh, S.E. and Barker, A.L., (2018). Opportunities for cross-
disciplinary care partnerships in physiotherapy. J Physiother.64(2). pp.69-71.
Physiotherapy has significantly been practised effectively within the stream based
paradigm. This is linked with the assessment and the care on the frequent basis. Physiotherapists
are considered to be highly significant in improving the physiotherapy collaboration which
eventually tends to significantly exist within the health and care sector. This is significant
because it helps in mainly facilitating the key provision which in turn is mainly linked with the
holistic healthcare. It tends to mainly focus upon the whole person rather than specific health
conditions. Developing the cross-disciplinary care partnership within the area of the
osteoarthritis management and fall prevention. However, physiotherapist in turn has significantly
excelled in the main discrete field of osteoarthritis management and fall prevention.
Physiotherapist tends to act as the leader in order to effectively develop and implement the new
intervention programs. Also, it complies with the service delivery roles and also leads to the
development of the clinical practice guidelines. Osteoarthritis management and falls tends to
largely affect the older age group. However, falls is considered to be as one of the major reason
which in turn tends to cause injury and might lead to hospitalization among the older age group.
According to the 2016 data from the landmark Global Burden of the Disease study, falls tends to

mainly account for 4.4 million years lived with the disability globally (which tends to represent
4.2% of the total years lived with disability. Also, 3.6 million years of life has been lost
worldwide among the people who in turn are aged 70 years. High degree of burden related with
the fall in turn has been significantly faced by the older age group. Osteoarthritis also affects the
older group of people. It is one of the most common arthritis where the knee and hip joint are
most frequently involved.
There seems to be considerable degree of overlap between the falls risk factor within the
older population and has physical impairment which is mainly connected with the Osteoarthritis.
The physical consequence linked with the fall is likely to impose high degree of burden upon the
family and other individual. This is because falls mainly leads to physical injuries like head
injuries, fractures and wound (Garagorri-Gutiérrez & Leirós-Rodríguez, (2020). There has been
level one evidence linked with the meta- analysis with the 88 randomized controlled trials which
tends to involve over 19000 participants and has well designed exercise programs which tends to
incorporate balanced set of activities which helps in decreasing the fall risk among older people.
Also, the physiotherapists tend to mainly focus on effectively providing the patient with the key
relevant combination which is mainly linked with the provision of feedback and staff training.
The physiotherapists tend to mainly focus upon the prevention of the fall linked with the main
component. It is of crucial importance to effectively focus upon the exercise, pain management
and weight loss. It is considered to be of key significance importance to screen as well as manage
the fall risk with the people (Ackerman, Soh, and Barker, 2018). There seems to be high degree
of potential failure with the main transaction which is linked with the fall prevention evidence
related with the clinicians on the frequent set of basis. High degree of greater attention has been
given to the falls which leads to the key prevention of the fall and Osteoarthritis with the shift
within the professional attitude. This is considered to be highly appropriate for the up- skilling.
However, high degree of level up evidence tends to significantly exist in order to effectively
prevent the falls among the older people. There seems to be high degree of clear set of
opportunities for the physiotherapists ion order to effect the change within the clinical practice.
Also, hospital based care and community health and private practice is considered to be of
crucial importance which in turn is useful in the prevention of the fall. However, there seems to
be high degree of prevalence which is mainly linked with the fall and Osteoarthritis. This in turn
develops the great degree of capacity for the physiotherapists. This is relevant in developing the

new degree of expertise which is useful in effectively managing the conditions on a
contemporary manner (Reed et.al., (2020).
Given both the high degree of prevalence associated with the Osteoarthritis and high
degree of fall rate will in turn tend to develop new set of expertise which is useful in effectively
managing the key conditions. The continued siloed approach for the fall prevention is considered
to be neither sustainable nor efficient as the population tends to grow in age. Nesting evidence
based falls is linked with the prevention with the Osteoarthritis management. This is one of the
key evidence based practice which in turn is considered to be useful in enhancing the
physiotherapy collaboration. This is relevant in effectively minimizing the gaps associated with
the patient care.
There are various risk factors which are also associated with falls for older people who are
suffering from musculoskeletal problems (Dimitrios, (2016). It includes age, gender, co-
morbidities. Physiotherapists make sure that all these factors are been taken into consideration
while taking care of the older aged patients. The data which was been published in fall study of
2016 provided the details that 4.4 million of people live with disability because of the fall. So for
this proper care needs to be provided to people (Probst, (2017). This will assist in making sure
that no such injury is been faced by patients because of falling. In this the physiotherapist needs
to be engaged in reflecting on their fields of practice as it is really necessary for them to do so. It
has also been evaluated that There seems to be high degree of potential failure with the main
transaction which is linked with the fall prevention evidence related with the clinicians on the
frequent set of basis. It is also being analysed that people can face injury because of falling and
this is the reason because of which they require physiotherapist.
There has been a detail that Osteoarthritis initiative has provided a link between falls and
need OA (Radder et.al., (2020).. In this the physiotherapist are been involved in providing
adequate care to individuals so that their health outcome can be enhanced. In trial one meta-
analysis of 88 randomised controlled trial was being done. It is also being analysed that falls can
lead to lowering down of self-confidence. In the meta analysis done there were about 19000
participants which were selected for study and they all were above the age of 65 (Ferão &
Traebert, (2017). In this the health care professionals have done partnership with physiotherapist
so that they can work with them to prevent the cases related to fall. It is really necessary to do so
that health outcome of elderly aged patients can be improved. In this the physiotherapist needs to

be involved in doing risk assessment so that they can prevent falls and also it will assist them in
making sure that no further type of injury is been faced by elderly aged patients. It is also being
evaluated that physiotherapist needs to be make use of better cross referral pathways so that
patients can be saved from fall.
There are various pros and cons for the review of literature. Bias is being reduced by
following the systematic method in review. The main con of the reviewing of literature provides
that it can consume more time than others.
Paper 2: Cooper, K., Jehu, L.M., Klein, S., Smith, B.H. and Schofield, P., (2018). Training
peers to support older people with chronic low back pain following physiotherapy discharge: a
feasibility study. Physiotherapy, 104(2), pp.239-247.
One of the key significant objective linked with this paper is to effectively determine the
acceptability as well as the high degree of feasibility related with the training programme. The
objective of the peer volunteer is to significantly support the older adults with the chronic low
back pain. For this study, feasibility study has been carried out within the community based
setting. For the present research, 17 adults who has chronic low back pain or tends to have
experience of supporting others with chronic low back pain. Also, 12 participants who in turn
has significantly completed the volunteer training (Learmonth, Ensari & Motl, (2016).
One of the key intervention associated with this research paper is that, volunteers will be
part of the blended or face to face peer supporting training programme which in turn has been
usually based upon the mental health foundation. 17 participants who in turn has significantly
enrolled within the training programme and 12 participants has also completed the training on
the timely manner (Andersson-Marfor et.al., (2019). However, the training has been evaluated in
a positive manner. However, 2 participants have significantly passed the majority of the self-
efficacy scores and has also effectively passed on the knowledge quiz. It is considered to be
highly feasible to effectively develop, evaluate and implement the peer support training
programme for effectively facilitating the chronic low back pain (Cooper and et.al. (2018).
However, chronic low back pain management among the older adults tends to effectively follow
discharge from the physiotherapy. Also, blended delivery of the training is significant because it
helps in facilitating the effective degree of recruitment from the greater number of the family
support (McGowan & Goff, L. (2016).

Supported self – management of the chronic low back pain is considered to be highly
feasible and is recommended. Exercise is considered to be as one of the key significant strategy
through which it is useful in managing the chronic low back pain and also osteoarthritis. Core of
the self- management practices helps in maintaining chronic low back pain (Nygaard et.al.,
(2019). Hence, peer support is one of the most promising method which in turn tends to highly
facilitate chronic low back pain self-management without any sort of the additional burden
linked with the health services. This is of utmost importance because it helps in benefiting for
the peers in order to support the workers and also helps in increasing the degree of self-esteem,
positive feeling and confidence.
In this physiotherapist were been engaged in making sure that patients learn about self-
management so that they can be involved in doing exercise on their own. This will assist them in
enhancing health outcome of patients and also because of this they will be able to make sure that
these patients do not face any issue related to chronic back pain in future. For the present study 4
males and 13 females are being selected. In this the intervention which is being used is face to
face support training (Palmer et.al., (2019). Also, 12 participants who in turn has significantly
completed the volunteer training. This has assisted physiotherapist in making sure that health
outcome of elderly aged patients is been improved (Fisioterapi et.al., (2020). Support from peer
is really necessary so that patients can self-manage themselves, it will also assist in making sure
that in future they do not face any such type of issues. Physiotherapy can be given to them so that
their pain in lower back can be reduced. This will assist them in making sure that no risk related
to falls is been faced by them and it will assist in making sure that well-being of patients is been
increased (Patman et.al., (2017). The main role of physiotherapist is to make sure that mobility
and physical ability of patient is been increased. In this they make sure that age related issues are
also being managed by them. In this they make sure that elderly age patients do not face any
such problem in future. This has assisted them in improvising their health outcome (Palmer et.al.,
(2019). Older adults also need to make sure that they do not face problem related to falls in
future and also they do not face issue related to lower back pain in the future. While collecting
the data researchers has also made sure that ethical code of conduct is being followed. This has
assisted them in collecting better data and also because of this they have been able to gain trust
of workers. This is relevant in developing the new degree of expertise which is useful in
effectively managing the conditions on a contemporary manner (Dimitrios, (2016) .

Paper 3: Kalu, M. E., Maximos, M., Sengiad, S., & Dal Bello-Haas, V. (2019). The Role of
Rehabilitation Professionals in Care Transitions for Older Adults: A Scoping Review. Physical
& Occupational Therapy In Geriatrics, 37(3), 123-150.
Aim: To effectively identify the key existing set of theories as well as the conceptual
models which tends to inform care transition intervention and also mainly focuses on exploring
whether the key role associated with the rehabilitation professionals in turn has been stated
explicitly or implied in those theories as well as models (Calner, Isaksson and Michaelson,
(2017).
Methods: The researcher in turn has significantly searched upon the multiple database
and tends to include the articles which has been significantly published from the year 2000 to
2018. Also, distinct mention of the care transition among older adults i.e., >65 years from the
one care setting to the another. In this article randomised controlled trial was being done. This
article has been taken from the published data bases. In this article the method which was being
used was quantitative in nature (Radder et.al., (2020). They have made use of statistical analysis
for getting the results. In this researchers have made use of exploratory design. This has assisted
researcher in getting answer to research questions. All these methods were being used so that
researcher can get solution of problem and also this will assist them in knowing about how
physiotherapy can be useful in managing the health outcome of elderly aged patients.
Results: Two theories associated with the System of care philosophy and Middle range
theory has been significantly identified (Kalu, Maximos, Sengiad and Dal Bello-Haas, 2019).
However, six conceptual models has been significantly identified which in turn mainly comprise
of 4Cs of Transitional Model, Coleman’s Model,Health Belief Model, Quality Cost Model of the
Advanced Practice Nurses Transitional Care, Ideal Transition in Care and Care Transition
Framework. In this the health care professionals have made use of various care model so that the
health outcome of patients can be enhanced. In this they have made use of occupational therapy
so that better support can be given to elderly aged patients. It has helped in making sure that
well-being is been enhanced. The care setting is being given to patients who has been above the
age of 65 (Yitayeh & Teshome, (2016). The physiotherapist made sure that mobility of patients
has been improved. This has assisted in enhancing wellbeing and also the quality of life of
elderly aged patients has been enhanced. In this the conceptual models which tends to inform
care transition intervention and also mainly focuses on exploring where the rehabilitation has

assisted in enhancing health outcome of patients or not. The results were as expected, it was
being analysed that physiotherapy assists in managing the health outcome of elderly aged
patients and also their wellbeing is maintained through it (de Abreu Pereira, Castiglione &
Kasawara, (2017).
Ethical aspects
The ethical code of conduct was being followed by researcher in the whole research. It was
being analysed that the participants which were involved in study, researchers made sure that no
harm is been caused to them. In this they also made sure that the private data of participants have
been kept confidential so that the trust can be maintained (Calner, Isaksson & Michaelson,
(2019). Researcher has made sure that the ethical code of conduct is been followed in the
research. Professional values form the basis for the principles that are included in a code of
ethics. The core ethical principles of beneficence (do good), nonmaleficence (do not harm),
autonomy (control by the individual), and justice (fairness). The objectives of research were
made well aware and known to the patients who were engaged in study. It was also being
evaluated that researchers made sure that they are honest and transparent. Integrity and
transparency was being followed in the whole research. This has also helped researcher in
achieving set target and mission (Yitayeh & Teshome, (2016). In this researcher also made sure
that objectivity is maintained throughout research. The personal data of participants are being
kept secured so that trust of them can be gained. Researchers made sure that no harm will be
done to people who will be engaged in research. This has assisted them in making research better
and also because of this they have been able to gain solution to problem. It has also been
evaluated that researcher made sure that no harm is been given to thoughts, values and belief of
any participants which has been engaged in the research. In this they have made sure that
sentiments of any participant is not being hurt. This has assisted in gaining trust of participants. It
has also assisted in collecting better data.
Research design
Here, it is identified that the study could have been done in more effective way and
outcomes obtained from it may be stronger. So, as analysed above the research design is based
on review and critique of 3 research articles. This has resulted in obtaining relevant secondary
data and info about topic from articles selected (Schoonenboom and Johnson, 2017). Besides

that, there are several alternative methods and research design which could have been used. It is
because it would have given different results. In this first of all researcher could have developed
research question by using PICO framework. This will be easy in identifying patient,
intervention, outcomes, etc. With that it will give a clear understanding of what entire study is
based on and then accordingly data and info is collected. Besides that, it would be easy to
identify research articles and then gather data from it. Furthermore, quantitative research could
have been conducted so that primary data is obtained. In that either survey or questionnaire can
be used in it which will be easy to collect fresh data and info. Besides that, with help of
quantitative study it will be simple to understand role of physiotherapy in managing health of
people (Wahl et.al., (2018). In this the experience of nurse, doctors, health care professional and
patients is found out and then examined. Along with it, interview can be conducted as well by
which experience of patient is find out with help of physiotherapy. Also, nurse role can be easily
identified from it regarding managing health of old age people through physiotherapy. Therefore,
in depth info and data is gathered in regarding topic and how health care professionals are able to
manage health of older people (Kraal et.al., (2017).
There is another research design which could have been used that is descriptive. It is
because in this it would have enabled in including theories and concepts of health and social care
and examining role of physiotherapy in old age people (Avella, 2016). Thus, data and info can
have presented in clear way. Thus, need of research could be analysed along with role of
managing health. In addition, exploratory research design can be used as well. It will enable in
exploring topic in depth and gathering data and info. In this as well theories can be used and
relate with managing health (Ummels et.al., (2020). Thus, more data and info is collected to get
in depth overview about topic. Hence, on basis of that study is conducted. So, focus can be on
analysing more articles in depth and then interpreting data on basis of it. Thus, both primary and
secondary data method can be used in it. This will provide more relevant and accurate data. Also,
the outcomes could have been stronger as well. so, quantitative study can be undertaken in order
to obtain effective and accurate data about topic. With that role of physiotherapy can be
explained and factors as well that is taken into consideration (Kraal et.al., (2018).

CONCLUSION
From the above study it has been summarised that there are various interventions which has been
used by physiotherapist. key intervention associated with this research paper is that, volunteers
will be part of the blended or face to face peer supporting training programme which in turn has
been usually based upon the mental health foundation. It has also been analysed that the health
care professionals are provided with responsibility to manage health outcome of elderly aged
people by making sure that they self-manage themselves. For this aspect physiotherapist also
make sure that elderly aged people do not face any type of fall related risk as this has increased
the chances of them facing injury. It has lower down self-esteem and confidence level of patients
and has negatively affected their health outcome. It has been evaluated from research that
physiotherapist was been engaged in making sure that patients learn about self-management so
that they can be involved in doing exercise on their own. This has assisted in enhancing health
and well-being of elderly aged patients. It has also been evaluated from the report that there has
been use of quantitative methods in research article which has been selected for study.