TRENDS IN PHYSIOTHERAPY RESEARCH IN SOUTH AFRICA 1980-1989 J Mitchell* SUMMARY A survey of the main papers published in the South African Journal of Physiotherapy over the past 10years (1980to 1989) was conducted to establish the trends in research methodo­ logy, subject topic and qualifications of the first authors. It was found that there is a significant increase in the number of experimental trials used and a similar decrease in the number of surveys conducted from the first to the second five-year periods (1980 to 1984 and 1985 to 1989). Statistical analyses of data were more often used in the second period. There is a marked increase in the number of articles on education/admin­ istration in the second period. In this period from 1985 to 1989, there are fewer first authors with a Diploma in Physiotherapy only, a medical degree or a technical qualification, while there are more first authors with postgraduate qualifications. These findings support the observation that there is a growing aware­ ness of the need for a more scientific approach to Physiother­ apy research. OPSOMMING ’n Opname studie van die vernaamste artikels wat oor die laaste 10 jaar (1980-1990) gepubliseer is in die SA Tydskrif Fisioterapie om neigings in die metodes van ondersoek, onderwerpe asook die kwalifikasies van die eerste outeurs te bepaal. Daar is 'n betekenisvolle verhoging in die gebruik van eksperimentele proefnemings en ’n soortgelyke daling in die aantal opname studies vanaf die eerste tot die tweede vyfjaar periodes (1980-1984 en 1985-1989). Daar is meer gebruik gemaak van statistiese evaluering in die tweede periode. Daar is meer artikels met betrekking tot onderwys/adminis- trasie in die tweede periode. Tussen 1985-1989 was daar minder eerste outeurs met slegs 'n diploma in Fisioterapie, ’n mediese graad of tegniese kwalifikasie en wel meer eerste outeurs met nagraadse kwalifikasies. Hierdie bevindings on- dersteun die waarneming dat navorsing in Fisioterapie meer wetenskaplik moet geskied. INTRODUCTION A survey o f articles published in the South African Journal o f Physiotherapy between the years 1984 and 19891 suggests a need for more experimental and clinical trials in the field o f physiotherapy in South Africa. A survey o f papers published between 1973 and 1982 in Physiotherapy Canada2 found an increase in m ore scientifically orientated research over this time period, which suggested “a grow­ ing com mitm ent to research” (p 158) in Canada. T o establish whether a similar trend is occurring in physiother­ apy in South Africa, a survey o f all major articles published over the ten years between 1980 and 1989 in the South African Journal o f Physiotherapy was carried out. An emphasis was placed on trends in research methodology, subject topic and the qualifications o f the first author. The findings of this survey are reported in this paper. METHOD The ten years between 1980 and 1989 under review were divided into two five-year periods: 1980 to 1984 and 1985 to 1989. T h e m ajor p apers published in the South African Jo u rn al o f Physiotherapy during these periods were studied to establish the following:- Research methodology This was classified as descriptive (D ) if the article was princi­ pally a description o f a technique, case study o r basic principles. A clinical tria l (C) involved a comparison o f therapeutic modalities or a study o f some aspect o f treatm ent in the clinical situation. A lterna­ tively, an experim ental tria l (E ) was one carried o u t under specific scientific experimental control. A paper reporting a review o r a retrospective study, with o r without the use o f a questionnaire, was classed as a survey (S). N ote was m ade too o f th e use o f statistical analyses o f data. S u b je c t to p ic The subject topics covered by each article were grouped into the following categories:- • applied basic science eg anatom y (Apl) • cardiopulmonary system/therapy (C-P) • education/administration (Ed) • electrotherapy/equipm ent (E-Q ) • geriatric factors/therapy (G ) • musculoskeletal system/therapy (M-S) • neurological system/therapy (N ) • paediatric factors/therapy (P) • psycho-social factors (P-S) • other eg community/industrial/occupational factors/therapy (O) A u th o r s h ip T he qualifications o f the first au th o r only were recorded as follows:- • physiotherapy, diplom a (P T (Dip)) • physiotherapy, Bachelor’s degree (P T B)) • physiotherapy plus another Bachelor’s degree (P T + B) • physiotherapy plus an H o n o u rs/M aster’s degree (P T + H/M ) • physiotherapy plus a D octorate o f Philosophy (P T + PhD ) • medical doctor (M BBCh) • any other graduate (G rad) • any other postgraduate (Postgrad) • non-degree eg oth er diplom a (Nondeg) • qualification not specified (NS) T he analyses o f the papers published in each five-year period were com pared to establish the trends in research methodology, subject topic and authorship. * J Mitchell MSc, BSc (Physiotherapy), Lecturer, Anatomy for Therapists. Department of Anatomy and Human Biology, University of the Witwatersrand Medical School, 7 York Road, Parktown 2193 Physiotherapy, November 1990, vol 46 no 4 Page 17 R ep ro du ce d by S ab in et G at ew ay u nd er li ce nc e gr an te d by th e P ub lis he r (d at ed 2 01 3. ) _ medical e lectronics Made in West Germany INFRARED LASER LSI 2030 A unique module system with the latest attachment now available. $ Automatic Pointsearcher & Electrode. $ FLA 09 Laser-Shower for Surface treatment (raying area of 90mm2, 1-6 mW adjustable) $ LED Applicator (red light stimulation). ❖ Dental Applicator with 2 Fibreoptics. ❖ Timer. The LSI 2030 with the Polyfrequenz-spectrum and Alphafrequenz is world wide used in medicine for all needs. Technical Data: 785 nm I Power supply 220V/110V 4mW (1 -7 mW) | or with maintenance free rechargeable battery Unit is specially designed for EASY handling. Please contact; L A S E R - C D S M E D T E C H C . C . 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NO. 90/0 42 86 /07 PHONE: (011) 803-9320/1/2/3 FAX: (011) 803-7085 * SPECIALIST SUPPLIERS TO THE PHYSIOTHERAPY PROFESSION Bladsy 18 Fisioterapie, November 1990, deel 46 no 4 R ep ro du ce d by S ab in et G at ew ay u nd er li ce nc e gr an te d by th e P ub lis he r (d at ed 2 01 3. ) RESULTS Trend in research methodology (Table I) TABLE 1: TREND IN RESEARCH MERHODOLOGY Research Methodology 1980- n 1884 % 1985-1989 n % D 58 71 53 69 C 6 7 6 8 E 6 7 12 16 S 12 156 6 8 ST 5 6 10 13 TABLE III: TREND IN AUTHORSHIP Authorship 1980- 1984 1985- 1989 n % n % PT(Dip)l 19 23 8 10 PT (B) 18 22 16 21 PT + B 1 1 3 4 PT + H/M 10 12 17 22 PT + PhD - - 2 3 MBBCh 14 17 9 12 Grad 4 50 1 1 Postgrad 9 11 12 16 Non-deg 5 6 3 4 NS 2 2 6 8Key C = Clinical trial Note:D = D escriptive ie descrip- E = E xperim ental trial N (1 9 8 0 -1 9 8 4 ) = 82 tion o f a tech n iq u e, c ase S = Survey N (1985 -1989) = 77 study o f basic principles S T = U se o f statistical an a- _________________________________lysis________________________________________ The most obvious trend over the years from 1980 to 1984 and from 1985 to 1989 was the significant increase in the num ber of experimental trials reported (7% to 16% o f papers). The num ber of surveys decreased similarly from 15% to 8%, but the num ber of descriptive papers decreased by only 2 (71% to 69% ). However, a m arked increase in the use of statistical analyses of data (6% to 13%) was evident. Trend in subject topic Key m en t P -S = Psycho-social factors A pl = A pplied basic science eg G * G eriatric factorsfTherapy o = O t h e r e g C o m - A n ato m y M -S = M usculoskeletal sys- m unity/Industrial/O ccupatio C - P = C ardiopulm onary sys- tem /Therapy nal factors/therapy tem /therapy N = N e u r o l o g i c a l sy s- N ote E d = Education/A dm inistra- tem /Therapy N (1980- 1984) = 82 tion P = Paediatric facto rs/T h er- N (1985 -1989) = 77 E - Q = E lectrotherapy/Equip- apy Table II shows a detailed analysis o f the num bers o f articles on particular topics published during the ten-year period under review (1980 to 1989). On comparing the two five-year periods, the greatest increase was in papers on education/administration (9% to 21%), whereas the num ber of articles related to geriatric factors/therapy decreased markedly (11% to 3% ), followed by those on paediatric factors/therapy (15% to 10%). Trend in authorship (Table III) The findings of the ten-year survey indicate that there were significantly fewer authors with a Diploma in Physiotherapy (PT (Dip)) only (23% to 10%) in the second five-year period, while there were similarly more authors with some postgraduate qualification (11% to 16%) in the same period. The num bers of all physiothera­ pists with postgraduate qualifications, such as an H onour’s or M as­ te r’s degree or a D octor o f Philosophy, also increased (12% to 22% and 0% to 3% ). The num ber of medical doctors writing papers in this Journal during this period decreased (17% to 12%). Key P T + H /M = Physiotherapy N o n d e p = N o n - d e g r e e eg P T (D ip ) = P h ysiotherapy, plus an H o n o u rs/M a ste rs d e- o th e r diploma Diploma g ree NS = qualification n o t sped* P T (B ) = Physiotherapy, Ba- M B B C h = M edical d o c to r tied ch elo r’s d egree G ra d ** A ny o th e r g rad u a te N ote P T + B = Physiotherapy plus Postg rad = any o th e r post- N (1 9 8 0 -1 9 8 4 ) » 82 a n o th e r B achelor’s d eg ree g rad u a te N (1985 -1 9 8 9 ) = 77 DISCUSSION Although this survey reviews publications in the South African Journal o f Physiotherapy over two relatively short periods of five years each (1980 to 1984 and 1985 to 1989), it does indicate general trends in current physiotherapy research in South Africa. The majority of the papers (71% and 69% ) are still descriptive in nature, which suggests that many authors are not orientated towards scientifically-based research. T he small num ber of clinical trials reported does not change much (7% to 8% ) from one to the other five-year period. This may be due to the fact that clinically- based research is notoriously difficult to carryout to completion. The decrease in surveys (15% to 8% ) during these periods may be indicative of a waning interest, am ong researchers, in retrospective studies and reviews, or o f the inherent difficulties of such research. The m arked increase in experimental trials (7% to 16%) suggests an increased awareness o f the value and necessity of such trials in physiotherapy research am ong som e researchers. However, the num ber of reports of such trials (11% of the articles over ten years) is still extremely low when com pared with the num ber of descriptive articles (70% of all papers over ten years), and when com pared with research trends in Canada (1973 to 1982)2, w here data-based re ­ search (reporting original data) increased from 33% to 45% , and descriptive papers decreased from 45% to 25% during this time. Comparisons with other W estern countries are not possible at pres­ ent because of a lack o f information about their current research trends. The significant increase in the use of statistical analyses of data from the one five-year period to the other (6% to 13%) suggests that researchers are tending towards a m ore scientific approach to the analysis and interpretation of their results. T he marked increase in papers on education/administration between 1980 to 1984 and 1985 to 1989 (9% to 21% ) confirms the suggestion, m ade in the report o f an earlier survey of the South African Journal o f Physiotherapy', that there is generally interest in and concern for the standards o f physiotherapy education and a d ­ ministration, which have a bearing on the image of the profession in South Africa. The increase in cardiopulmonary research (9% to 17%) is indicative of a m ajor research interest at present. T he decrease in the num ber o f articles on geriatrics (11% to 3% ), paediatrics (15% to 10%) and psycho-social factors (9% to 5% ) is surprising considering the widespread interest in community-based medicine and allied disciplines. This decrease may be due to the difficulties of human- or patient-based research in the field o r clinical setting. The decrease in the num ber o f papers on electrother­ TABLE II: TREND IN SUBJECT TOPIC Subject 1980- 1984 1985- 1989 n % n % Apl 6 7 2 3 C-P 7 9 13 17 Ed 7 9 16 21 E-Q 7 9 5 7 G 9 11 2 3 M-S 12 15 12 16 N 8 10 8 10 P 12 15 8 10 P-S 7 9 4 5 O 7 9 7 9 Physiotherapy, November 1990, vol 46 no 4 Page 19 R ep ro du ce d by S ab in et G at ew ay u nd er li ce nc e gr an te d by th e P ub lis he r (d at ed 2 01 3. ) apy/equipm ent (9% to 7% ) and on the applied basic sciences (7% to 3% ) suggests a waning interest in these topics am ong researchers. T h e finding in this survey that m ore au th o rs (physiotherapists and oth er professionals) with postgraduate qualifications are p u b ­ lishing their research indicates an awareness o f the need for scientific research, as was suggested in the earlier survey1. This increase also shows that m ore physiotherapists are obtaining higher qualifications which will equip them b etter for conducting such research. CONCLUSION T his survey has shown som e grow th in S o u th A frica in physiotherapy research. T h e studies u n d er review reflected an awareness o f the need, within the profession o f physiotherapy, for higher scientific standards o f research. However, these changes are not as yet enough to p rom ote the profession o f physiotherapy as an acknowledged science as well as an art. REFERENCES 1. Mitchell J. Publication of our research: A journal survey. South African Journal o f Physiotherapy 1990;46(3):7-10 2. Dean E. Physiotherapy Canada survey (1973-1982): A trend to research. Physiotherapy Canada 1985;37(3):158-161. PHYSIOTHERAPISTS WORK IN THE UNITED STATES We handle all Licensure and Visa paperwork. Minimum commitment of one year required. Write or phone collect: THERAPY RESOURCE NETWORK P O Box 5430 355 N Main Street Plymouth, Ml 48170, USA 091 (313) 455-6660 CAMBRIDGE COLLOCATION: EUROPEAN MEDICAL AND PROFESSIONAL RECRUITMENT Physiotherapy vacancies In the UK: we have vacancies for physiotherapists in the private health sector in the UK. Excellent salaries and working conditions. Please contact: Maureen Johnston Brown or Margaret Lamb, Cambridge Collocation, 191 Huntingdon Road, Cambridge CB3 ODL, England. Telephone: (0)223 276891 Fax: (0( 223 276871 Employment Agencies Act 1973 Licence No SE 118181 VAT No 538357911 PHYSIOTHERAPY DEPARTMENT Lecturers, Junior Lecturers (full­ tim e and p a rt-tim e ) as well as sessional lecturers and c lin ica l instructors are needed to join in the challenging, stimulating and rew arding work o f this d e p a r t­ m ent - in c o n ju n c tio n w ith the Physiotherapy Department of the Johannesburg Hospital. Lecturers will be expected to participate in m anagem ent, planning, clinical w ork, re sea rch as w e ll as teaching. For further enquiries, c o n ta ct Prof. M. G o o d m a n , D e p a rtm e n t o f Physiotherapy, M edical School, York R oad, P arktow n 2193, or phone (O il) 488-3450/1. H . | W IT S U N IV E R S IT Y L The university consistently opposes apartheid. Beheer Fisioterapeut TYGERBERG-HOSPITAAL, PAROWVALLEI Besoldiging: Die minimum aanvangsalaris sal bereken word tussen R38 697 — R44 796 plus 'n 10% nie- pensioendraende toelae per jaar. Vereistes: • Registrasie as Fisioterapeut by die SA Mediese en Tandheelkundige Raad. • Ondervinding in die bestuur en administrasie van 'n fisioterapiedepartement. • Deelname aan voortgesette fisioterapie-onderrig- programme. • Ondervinding van kliniese onderrig aan studente. Pligte: • Bestuur en administrasie van die Departement Fisioterapie, Tygerberg-Hospitaal (33 poste) in samewerking met die Hoof van Departement. • Deelname aan kliniese onderrig en evaluering van studente. • Reel van voortgesette onderrigprogramme vir fisioterapie-personeel. • Indiensopleiding van fisioterapie-assistente. • Demonstrasies aan ander groepe gesondheids- werkers met betrekking tot hantering van pasiente. • Bywoning van Kommissie vir Administrasie se Bestuurskursusse (indien nie alreeds voltooi nie). Navrae: Mej. S H Irwin-Carruthers, tel. (021) 931-1311 bylyn 300. Aansoeke moet gedoen word op die voorgeskrewe vorm Z.83 (by enige staatsdiensdepartement verkryg- baar) en gerig word aan die Direkteur-Generaal, Per- soneelbestuursdienste, Posbus 659, Kaapstad 8000. Sluitingsdatum: 30 November 1990. LINTAS 6887 Bladsv 20 Fisioterapie, November 1990, deel 46 no 4 R ep ro du ce d by S ab in et G at ew ay u nd er li ce nc e gr an te d by th e P ub lis he r (d at ed 2 01 3. )