Is it time physiotherapist to use electro-physical agents (EPAs) again ?

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Electrophysical agents (EPA)s are now supported by a significant evidence base which continues to develop year by year. The implications for the delegates of the focused symposium, is that they will re-consider what EPAs can contribute to optimising the clinical management of their patients/clients

It’s time to smash the myths about electrophysical agents (EPAs) and put them back in the physical therapy toolbox where they belong. That will be the message from one of the profession’s leading names in EPA research, in an agenda-setting session at the WCPT Congress in May.

With the advance registration deadline for congress just hours away, Jan Bjordal, Professor at the University of Bergen’s physical therapy research group, has called on physical therapists to consider recent research about EPAs which indicates that they are effective and evidence based.

“We are fighting myths created 20 years ago,” he says. “EPAs have been on the decline, and there’s a myth that there are very few studies about them and they are of poor quality. Looking at PEDro [the Physiotherapy Evidence Database], it’s clear that over the past 10 years the number of studies has trebled. EPA studies are also now associated with high quality trial design.”

Bjordal’s systematic review of the use of low-level laser therapy for neck pain, published in The Lancet in 2009, found that the therapy reduces acute neck pain immediately after treatment and chronic neck pain up to 22 weeks after completion of treatment.

He emphasises that EPAs are not a substitute for activity treatment programmes. But they can be a substitute for painkiller drugs.

“I think it’s very important to get across to our patients that we have something that can be taken with very few side effects that competes with drugs. Sure, there are some methods we should abandon. But I’ve invested the last 15 years of my life in studying what kind of EPAs can substitute painkiller anti inflammatory drugs and we have solutions to that now. We have shown in the laboratory that laser therapy is just as effective as drugs in reducing inflammation and pain, but you have to do it with the right dose.”

“When it comes to musculoskeletal pain I think we have the complete toolbox compared to other professions – we just have to use all the tools in the box.”

ref ,WCPT congress