To describe the current practice of physiotherapists working with children with lower limb deficiencies in Australia, including physiotherapy interventions, outcome measures and care settings.
This cross-sectional study utilised a purpose-developed 37-item, anonymous online survey of paediatric physiotherapists who have worked with children with lower limb deficiency in Australia in the past three years. Questions focused on pre- and post-surgical interventions; prosthetic fitting; long-term rehabilitation and management; treatments and outcome measures. Participants were recruited via social media (closed “Facebook” groups) from April to September 2024 using snowball recruitment. Collected data were analysed using descriptive statistics (quantitative data) and thematic analysis (qualitative data).
Nineteen physiotherapists, from four states in Australia participated in the study. Most respondents were experienced (> 5 years) (74%), worked in urban centres (84%), private practice (58%) or a specialist hospital (32%). Few therapists reported having protocols or clinical guidelines for any stage of the patients’ management. Interventions and practices varied across the phases of care, the most frequent being: advice and education (all phases); strength training and non-weight-bearing upright mobility (pre-prosthetic phase); balance and gait training (prosthetic rehabilitation phase) and strength training and stretching (long-term management phase).
The most common clinician-administered outcome measures were the Ten Meter Walk Test, the Six Minute Walk Test and the Berg Balance Scale. The most commonly reported patient-and-parent-reported outcome measure was the Paediatric Evaluation of Disability Inventory (PEDI).
Thematic analysis highlighted the importance of the multidisciplinary team, strengths-based, patient-centred care, resilience building and fostering sports and community participation. Respondents identified a desire for more physiotherapy- specific information, resources and training for this patient population.
This study provides a snapshot and insights into current physiotherapy management of children with lower limb deficiency in Australia. The results highlight the broad scope of physiotherapy practice in paediatric lower limb deficiency and the need for further research into specific interventions and outcome measures for this population. Clinicians expressed a desire for evidence-based guidelines and resources to support best care for this unique patient population.
• Research into effective physiotherapy interventions for paediatric limb deficiency is required
• Guidelines for clinicians are needed
amputee
limb deficiency
