Choosing Wisely releases physical therapy recommendations

The American Physical Therapy Association (APTA) has released a list of five practices that it says are of questionable value to those undergoing physical therapy. The list, issued as part of the American Board of Internal Medicine (ABIM) Foundation's Choosing Wisely campaign, is intended to offer evidence-based ways to support conversations about the delivery of care that is based on individuals' particular circumstances.

APTA's recommendations:

1. Don't use passive physical agents, except when necessary, to facilitate participation in an active treatment program.
2. Don't prescribe underdosed strength training programs for older adults. Instead, match the frequency, intensity and duration of exercise to the individual's abilities and goals.
3. Don't recommend bed rest following a diagnosis of acute deep vein thrombosis after the initiation of anticoagulation therapy unless significant medical concerns exist.
4. Don't use continuous passive motion machines for the postoperative management of those who have undergone uncomplicated total knee replacement.
5. Don't use a whirlpool for wound management.

To help those undergoing physical therapy understand what the recommendations mean for them, APTA has partnered with Consumer Reports to create a free consumer-friendly summary in both English and Spanish.

The Choosing Wisely campaign covers more than 300 tests and procedures that provider organization partners say are overused and unnecessary. APTA is the first nonphysician group to release a list, which it created by soliciting ideas from members and then convening a workgroup to consider the 170 submissions. Workgroup members—physical therapists representing a broad range of clinical expertise, practice settings and patient/resident populations—reviewed existing literature and ranked the recommendations based on pre-established criteria. The final five recommendations that ultimately were approved by the APTA Board of Directors were selected through a survey open to all APTA members.

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