Principal Physiotherapist Glasgow, Scotland, United Kingdom
Background: Following the pilot study completed early in the pandemic, musculoskeletal (MSK) virtual clinics (VC) were continued, to further assess and evaluate the benefit to people with CF (pwCF). It was considered that virtual MSK services in CF could facilitate resolution of pain and improve quality of life more swiftly than accessing local services. Our service does not have permanent MSK specialist and relies on local services with a waiting list of 20 weeks.
Methods: VC for MSK pain were offered twice weekly over 10 months by a physiotherapist from the CF team. Anonymous online patient satisfaction questionnaires and perceived resolution of symptoms were assessed.
Results: 6 pwCF accessed the service and averaged 2.4 treatment sessions. 56% responded to a satisfaction survey. All were seen between 7-10 days from referral. MSK problems included peripheral joint, spinal and chest wall pain with 90% presenting with chronic issues.74% considered that being seen by a CF MSK specialist was important, and preferable to a generalist. 75% described a positive change in quality of life (QoL), 10% reported complete resolution of their symptoms with a further 55% reporting their pain had somewhat improved. 95% reported to be either very satisfied or satisfied with this service.
75% stated a preference for face-to-face consultation with 25% finding VC to be a ‘convenient and safer alternative’.
Discussion:
UK national standards of care for physiotherapy [1] recommend that ‘all individuals with CF should be screened for MSK issues, with referral pathways to access specialists where appropriate’. With advancing age and an increase in physical activity linked to variant specific therapies we are seeing an increase in MSK complications. Pain negatively impacts on ability to participate in self-management thus impacting on health and wellbeing as seen in QoL parameters. For those not having resolution of their pain this may be due to the chronic nature of their issue.
Conclusions: We have demonstrated that pwCF feel specialist CF MSK input is valuable and significantly reduced their pain within a short time frame. We are routinely screening for MSK issues during annual review and also during virtual MDT clinics. If pwCF can been seen swiftly by a specialist service, we would anticipate the detection of MSK issues sooner therefore resolution of problems before they become chronic thus enhancing QoL.
Acknowledgements:
References:
[1] Cystic Fibrosis Trust. Standards of Care and Good Clinical Practice for the Physiotherapy Management of Cystic Fibrosis (2020). London: Cystic Fibrosis Trust; 2020.
