Physiotherapist's Management of Suspected Cauda Equina Syndrome in the United Kingdom: A National Survey.

The answers are responses to written case scenarios, so they show what clinicians say they would do, not what they do with a real patient in front of them. Respondents may have reported what they believed to be the correct action rather than their actual practice. Recruitment through social media and online discussion boards likely over-sampled physiotherapists who use those channels. Only 235 of 475 people who consented completed all three vignettes and 216 were analysed; the authors say the low response rate limits how far the findings generalise. The survey did not record whether respondents were in advanced practice roles or could request MRI themselves, so the influence of that on their decisions cannot be worked out. The survey cannot show whether the clinicians who chose to assess the patient first would have referred afterwards, and arranging that assessment could delay referral for a time-critical condition. The options were presented as lists and respondents could pick several, which the authors suggest may have led some to tick everything as a precaution.

The authors report no funding. One author has received speaker fees for education on cauda equina syndrome and has co-authored a book on clinical reasoning in suspected cauda equina syndrome. The remaining authors declare no conflicts of interest.

Do not read these percentages as what physiotherapists actually do in clinic. They are answers to three written case scenarios, not real consultations, and the authors note that respondents may have reported what they thought was the right action rather than what they would really do. The survey also cannot show whether the clinicians who chose to assess the patient themselves first would have referred afterwards.