Table 3 Comparison of clinical management characteristics of Australian osteopaths who report sending referrals to podiatrists with those who do not report referring
Yes (n = 651) | No (n = 341) | p-value | Odds Ratio (OR)* [95%CI] | |
|---|---|---|---|---|
Discuss with patients (‘often’) | ||||
Diet | 239 (36.8%) | 136 (39.9%) | 0.34 | – |
Smoking and drug use | 115 (1.7%) | 64 (18.8%) | 0.68 | – |
Physical activity | 591 (90.9%) | 295 (86.5%) | 0.03 | 1.56 [1.04, 2.35] |
Occupation Health & Safety | 346 (53.4%) | 160 (46.9%) | 0.05 | – |
Pain counselling | 175 (26.9%) | 91 (26.7%) | 0.95 | – |
Stress | 314 (48.4%) | 175 (51.5%) | 0.35 | – |
Nutrition | 158 (24.3%) | 94 (27.6%) | 0.26 | – |
Medication | 262 (40.3%) | 129 (37.9%) | 0.47 | – |
Patient presentations (‘often’) | ||||
Neck pain | 642 (98.8%) | 329 (96.5%) | 0.01 | 2.93 [1.19, 7.23] |
Thoracic pain | 600 (92.3%) | 309 (90.6%) | 0.36 | – |
Low back pain | 645 (99.2%) | 332 (97.6%) | 0.04 | 3.11 [1.00, 9.57] |
Hip musculoskeletal pain | 500 (76.9%) | 244 (71.8%) | 0.08 | – |
Knee musculoskeletal pain | 324 (50.0%) | 167 (49.1%) | 0.79 | – |
Ankle musculoskeletal pain | 226 (34.9%) | 107 (31.4%) | 0.27 | – |
Foot musculoskeletal pain | 197 (30.4%) | 97 (28.4%) | 0.53 | – |
Shoulder musculoskeletal pain | 539 (83.1%) | 262 (77.1%) | 0.02 | 1.46 [1.05, 2.02] |
Elbow musculoskeletal pain | 164 (25.4%) | 87 (25.6%) | 0.94 | – |
Wrist musculoskeletal pain | 122 (18.8%) | 66 (19.4%) | 0.84 | – |
Hand musculoskeletal pain | 74 (11.5%) | 47 (13.9%) | 0.27 | – |
Postural disorders | 469 (72.4%) | 206 (60.4%) | < 0.01 | 1.71 [1.03, 2.26] |
Degenerative spine conditions | 411 (63.4%) | 188 (55.1%) | 0.01 | 1.41 [1.08, 1.84] |
Headache disorders | 673 (68.0%) | 219 (22.1%) | 0.43 | – |
Migraine disorders | 264 (40.7%) | 136 (40.0%) | 0.82 | – |
Spine health maintenance | 303 (46.8%) | 155 (45.5%) | 0.68 | – |
Chronic or persistent pain | 405 (62.5%) | 225 (66.0%) | 0.28 | – |
Tendinopathies | 286 (44.1%) | 124 (36.4%) | 0.02 | 1.38 [1.06, 1.81] |
Temporomandibular joint disorders | 115 (17.7%) | 68 (20.1%) | 0.37 | – |
Non-musculoskeletal disorders | 65 (10.1%) | 61 (18.0%) | < 0.01 | 0.51 [0.35, 0.75] |
Patient subgroups (treat ‘often’) | ||||
Up to 3 years of age | 96 (14.8%) | 60 (17.6%) | 0.24 | – |
4 to 18 years of age | 186 (28.6%) | 84 (24.6%) | 0.18 | – |
Over 65 years of age | 386 (59.4%) | 186 (54.5%) | 0.14 | – |
Aboriginal & Torres Strait Islander peoples | 7 (1.1%) | 0 (0%) | 0.05 | – |
Pregnancy | 237 (36.5%) | 107 (31.4%) | 0.11 | – |
Non-English speaking | 24 (3.7%) | 9 (2.6%) | 0.38 | – |
Sport injuries | 350 (53.8%) | 151 (44.4%) | < 0.01 | 1.46 [1.12, 1.90] |
Worker injury (compensable) | 68 (10.5%) | 35 (10.3%) | 0.91 | – |
Work injury (non-compensable) | 238 (36.6%) | 103 (30.2%) | 0.04 | 1.33 [1.01, 1.77] |
Traffic injury (compensable) | 36 (5.6%) | 18 (5.3%) | 0.85 | – |
Traffic injury (non-compensable) | 73 (11.2%) | 41 (12.1%) | 0.68 | – |
Post-surgery | 52 (8.0%) | 27 (8.0%) | 0.98 | – |
Manual therapy (use ‘often’) | ||||
Counterstrain | 293 (45.1%) | 127 (37.2%) | 0.01 | 1.38 [1.06, 1.81] |
Muscle energy technique | 546 (84.0%) | 242 (71.0%) | < 0.01 | 2.15 [1.57, 2.94] |
High-velocity, low-amplitude manipulation | 441 (67.8%) | 191 (56.0%) | < 0.01 | 1.65 [1.26, 2.17] |
Joint manipulation | 281 (43.4%) | 112 (32.8%) | < 0.01 | 1.56 [1.19, 2.06] |
Soft tissue technique | 584 (90.0%) | 264 (77.4%) | < 0.01 | 2.62 [1.83, 3.76] |
Myofascial release | 426 (65.6%) | 186 (54.5%) | < 0.01 | 1.59 [1.22, 2.09] |
Visceral techniques | 56 (8.6%) | 42 (12.3%) | 0.06 | – |
Lymphatic pump | 52 (8.0%) | 32 (9.4%) | 0.46 | – |
Autonomic balancing | 93 (14.3%) | 64 (18.8%) | 0.06 | – |
Biodynamics | 88 (13.5%) | 67 (19.6%) | 0.01 | – |
Functional technique | 176 (27.1%) | 94 (27.6%) | 0.87 | – |
Balanced ligamentous tension | 216 (33.2%) | 133 (39.0%) | 0.07 | – |
Chapman’s reflexes | 16 (2.5%) | 8 (2.4%) | 0.91 | – |
Trigger point therapy | 199 (30.6%) | 59 (17.4%) | < 0.01 | – |
Osteopathy in the Cranial Field | 141 (21.7%) | 92 (27.0%) | 0.06 | – |
Facilitated positional release | 115 (17.7%) | 51 (15.0%) | 0.29 | – |
Dry needling | 170 (26.2%) | 64 (18.8%) | 0.01 | 1.52 [1.10, 2.11] |
Exercise prescription | 500 (77.0%) | 233 (68.3%) | < 0.01 | 1.55 [1.16, 2.08] |
Shockwave therapy | 11 (1.7%) | 7 (2.1%) | 0.68 | – |
Ultrasound | 14 (2.2%) | 13 (3.8%) | 0.13 | – |
Transcutaneous Electrical Nerve Stimulation (TENS) | 7 (1.1%) | 12 (3.5%) | < 0.01 | 0.29 [0.11, 0.76] |
Instrument manipulation | 0 (0%) | 2 (0.6%) | 0.05 | – |
Instrument soft tissue | 8 (1.2%) | 4 (1.2%) | 0.94 | – |
Sport taping | 93 (14.3%) | 29 (8.5%) | < 0.01 | 1.79 [1.15, 2.79] |
Expanded practice scope (‘definitely’) | ||||
Prescribing rights | 175 (26.9%) | 82 (24.0%) | 0.32 | – |
Referral rights to orthopaedic surgeon | 475 (73.1%) | 228 (66.9%) | 0.04 | 1.34 [1.01, 1.79] |
Referral rights to paediatrician | 350 (53.8%) | 190 (55.7%) | 0.57 | – |
Referral rights to sports medicine specialist | 542 (83.5%) | 248 (72.7%) | < 0.01 | 1.90 [1.39, 2.60] |
Referral rights to rheumatologist | 424 (65.2%) | 205 (60.1%) | 0.11 | – |
Referral rights to other medical specialist | 1 (0.2%) | 0 (0%) | 0.46 | – |
Expanded diagnostic imaging rights | 551 (84.8%) | 271 (79.5%) | 0.03 | 1.44 [1.02, 2.02] |
Research (‘strongly agree’) | ||||
Help patients understand osteopathy | 284 (43.6%) | 159 (46.6%) | 0.36 | – |
Help general practitioners and other health professionals understand osteopathy | 441 (70.3%) | 229 (70.5%) | 0.96 | – |
Provide scientific evidence | 324 (52.4%) | 191 (59.5%) | 0.04 | 0.75 [0.57, 0.98] |
Irrelevant to the development of osteopathya | 348 (56.4%) | 215 (67.2%) | < 0.01 | 0.63 [0.47, 0.84] |