Impacts of an Advanced Practice Physiotherapy Model of Care for Adults With a Peripheral Musculoskeletal Disorders Referred to an Orthropaedic Outpatient Clinic

Impacts of an Advanced Practice Physiotherapy Model of Care for Adults With a Peripheral Musculoskeletal Disorders Referred to an Orthropaedic Outpatient Clinic: a Prospective Observational Study

The goal of this prospective observational study is to evaluate advanced practice physiotherapy and orthopedic surgeon care and clinical outcomes for new patients with a peripheral musculoskeletal disorders consulting at the orthopedic outpatient clinic of the Hôpital Jean-Talon.

The main questions it aims to answer are: 1. To describe the models of care at the Hôpital Jean-Talon orthopedic outpatient clinic; 2. To assess change in pain, disability, quality of life and pain catastrophizing at 6, 12 and 26 weeks after the initial evaluation; 3. To assess interprofessional collaboration between the advanced practice physiotherapists and orthopedic surgeons; 4. To assess patient satisfaction with care; 5. To assess waiting time before an initial consultation.

Researchers will compare patients cared in the advanced practice physiotherapy and orthopedic surgeon group and the orthopedic surgeon only group.

Study Overview

• Status: Completed
• Conditions: Musculoskeletal Disorders
• Intervention / Treatment: Other: Advanced practice physiotherapy and orthopedic surgeon management; Other: Orthopedic surgeon management

• Study Type: Observational
• Enrollment (Actual): 104

Contacts and Locations

Study Locations

• Canada
  • Quebec
    • Montréal, Quebec, Canada, H1T 2M4
      • Centre de recherche de l'Hôpital Maisonneuve-Rosemont

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: N/A

• Sampling Method: Non-Probability Sample

Study Population

Adults with a peripheral musculoskeletal disorders

Description

Inclusion Criteria:

• Adults with peripheral musculoskeletal disorders
• New consultation at the Hôpital Jean-Talon orthopedic outpatient clinic
• Legally able to consent
• Understand and speak French or English
• Beneficiaries of the provincial universal health insurance coverage (RAMQ)

Exclusion Criteria:

• Patients directly referred from the emergency department (not considered as patients referred to the outpatient clinic).

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Advanced practice physiotherapy and orthopedic surgeon group; Patients cared by both an advanced practice physiotherapist and an orthopedic surgeon.	Other: Advanced practice physiotherapy and orthopedic surgeon management; Management of their musculoskeletal condition by an advanced practice physiotherapist and an orthopedic surgeon.
Orthopedic surgeon only group; Patients cared only by an orthopedic surgeon.	Other: Orthopedic surgeon management; Management of their musculoskeletal condition by an orthopedic surgeon.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Brief pain inventory severity	Pain questionnaire (0-10; higher score=worse)	6 weeks (change from baseline)
Brief pain inventory severity	Pain questionnaire (0-10; higher score=worse)	12 weeks (change from baseline)
Brief pain inventory severity	Pain questionnaire (0-10; higher score=worse)	26 weeks (change from baseline)
Brief pain inventory inventory	Pain interference (disability) questionnaire (0-10; higher score=worse)	6 weeks (change from baseline)
Brief pain inventory inventory	Pain interference (disability) questionnaire (0-10; higher score=worse)	12 weeks (change from baseline)
Brief pain inventory inventory	Pain interference (disability) questionnaire (0-10; higher score=worse)	26 weeks (change from baseline)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Adverse events	Rate of adverse events	12 weeks
Treatment and compliance	Treatment received and % of treatment compliance	12 weeks
Shortened Disability of the Arm, Shoulder and Hand (QuickDASH)	Disability questionnaire for upper extremity disorders (0-100; higher=worse)	6 weeks (change from baseline)
Shortened Disability of the Arm, Shoulder and Hand (QuickDASH)	Disability questionnaire for upper extremity disorders (0-100; higher=worse)	12 weeks (change from baseline)
Shortened Disability of the Arm, Shoulder and Hand (QuickDASH)	Disability questionnaire for upper extremity disorders (0-100; higher=worse)	26 weeks (change from baseline)
Hip disability and Osteoarthritis Outcomes Score (HOOS)	Disability questionnaire for hip disorders (0-100; higher=better)	6 weeks (change from baseline)
Hip disability and Osteoarthritis Outcomes Score (HOOS)	Disability questionnaire for hip disorders (0-100; higher=better)	12 weeks (change from baseline)
Hip disability and Osteoarthritis Outcomes Score (HOOS)	Disability questionnaire for hip disorders (0-100; higher=better)	26 weeks (change from baseline)
Knee injury and Osteoarthritis Outcomes Score (KOOS)	Disability questionnaire for knee disorders (0-100; higher=better)	6 weeks (change from baseline)
Knee injury and Osteoarthritis Outcomes Score (KOOS)	Disability questionnaire for knee disorders (0-100; higher=better)	12 weeks (change from baseline)
Knee injury and Osteoarthritis Outcomes Score (KOOS)	Disability questionnaire for knee disorders (0-100; higher=better)	26 weeks (change from baseline)
Foot and Ankle Ability Measure (FAAM)	Disability questionnaire for ankle/foot disorders (0-100; higher=better)	6 weeks (change from baseline)
Foot and Ankle Ability Measure (FAAM)	Disability questionnaire for ankle/foot disorders (0-100; higher=better)	12 weeks (change from baseline)
Foot and Ankle Ability Measure (FAAM)	Disability questionnaire for ankle/foot disorders (0-100; higher=better)	26 weeks (change from baseline)
EQ-5D-5L	Health-related quality of life questionnaire (to be converted in QALYs 0-1; higher=better)	6 weeks (change from baseline)
EQ-5D-5L	Health-related quality of life questionnaire (to be converted in QALYs 0-1; higher=better)	12 weeks (change from baseline)
EQ-5D-5L	Health-related quality of life questionnaire (to be converted in QALYs 0-1; higher=better)	26 weeks (change from baseline)
EQ-5D-VAS	Health-related quality of life questionnaire (0-100; higher=better)	6 weeks (change from baseline)
EQ-5D-VAS	Health-related quality of life questionnaire (0-100; higher=better)	12 weeks (change from baseline)
EQ-5D-VAS	Health-related quality of life questionnaire (0-100; higher=better)	26 weeks (change from baseline)
Pain Catastrophizing Scale (PCS)	Health-related quality of life questionnaire (0-50; higher=worse)	6 weeks (change from baseline)
Pain Catastrophizing Scale (PCS)	Health-related quality of life questionnaire (0-50; higher=worse)	12 weeks (change from baseline)
Pain Catastrophizing Scale (PCS)	Health-related quality of life questionnaire (0-50; higher=worse)	26 weeks (change from baseline)
Patient perceptions of team effectiveness (Patient-PTE)	Perceptions of team effectiveness questionnaire (24-144; higher=better)	0 week (post initial consultation)
modified validated version of the 9-item visit-specific satisfaction questionnaire (VSQ-9)	Patient satisfaction questionnaire (0-100; higher=better)	0 week (post initial consultation)
Modified MedRisk	Patient satisfaction questionnaire (0-100; higher=better)	12 weeks
Modified MedRisk	Patient satisfaction questionnaire (0-100; higher=better)	26 weeks
Provider perceptions of team effectiveness (Prodiver-PTE)	Perceptions of team effectiveness questionnaire (26-156; higher=better)	Through study completion (once)
Waiting time	Waiting time (time in days and minutes)	Pre-intervention
Adverse events	Rate of adverse events	26 weeks
Treatment and compliance	Treatment received and % of treatment compliance	6 weeks
Treatment and compliance	Treatment received and % of treatment compliance	26 weeks

Collaborators and Investigators

• Sponsor: Ciusss de L'Est de l'Île de Montréal
• Collaborators: CIUSSS du Nord-de-l'Île-de-Montréal

Study record dates

Study Major Dates

• Study Start (Actual): November 15, 2022
• Primary Completion (Actual): January 2, 2024
• Study Completion (Actual): January 2, 2024

Study Registration Dates

• First Submitted: November 7, 2022
• First Submitted That Met QC Criteria: January 26, 2023
• First Posted (Actual): February 6, 2023

Study Record Updates

• Last Update Posted (Actual): July 11, 2025
• Last Update Submitted That Met QC Criteria: July 8, 2025
• Last Verified: August 1, 2024

More Information

Terms related to this study

• Keywords: Physiotherapy; Observation; Advanced practice; Musculoskeletal disorders; Orthopedic
• Additional Relevant MeSH Terms: Pathologic Processes; Musculoskeletal Diseases
• Other Study ID Numbers: v3

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: Data will be available upon resonable request

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No