Dr Carrie Falling
Lecturer, School of Physiotherapy, University of Otago, and Early Career Researcher Representative, Pain@Otago Research Theme, NZ
Dr Carrie Falling is a Lecturer at the School of Physiotherapy (University of Otago) and Early Career Researcher Representative of Pain@Otago Research Theme. Her clinical background is in primary care physiotherapy, most commonly working with patients suffering from painful musculoskeletal conditions. Her research interests include understanding pain experiences in people with primary chronic immune conditions, such as inflammatory bowel diseases, as well as persistent pain populations. Carrie’s two programmes of research include: the Clinical Assessment of Pain (CAP) Programme and the Chronic Overlapping Pain Conditions (COPCs) Programme. The CAP Programme is focused on exploring novel methods of assessing and analysing painful experiences using routinely collected data in conditions such as inflammatory bowel disease, colorectal cancer, and surgical populations. This includes the use of bedside assessments to examine potential mechanisms of pain, as well as the use of developmental trajectories and machine learning applications to predict patient outcomes. Carrie’s COPC Programme is focused on the care of people suffering with conditions such as temporomandibular disorders, irritable bowel syndrome, and fibromyalgia. This research is particularly interested in the development of equitable health services that reflect best-practice recommendations for care.
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It’s a Total Pain in the Mouth! Physiotherapists’ Perspectives of Temporomandibular Disorders
Authors: Loren Davidson, BPhty(Hons), Allyson Calder, PhD, Carrie Falling, PhD
Temporomandibular disorders (TMDs) are the most common cause of orofacial pain, significantly impacting individuals’ physical, social, and psychological well-being. However, pathways for seeking care are well-understood to be problematic. Patients report TMD care to be uncoordinated, inconsistent, and expensive. Primary care providers report a lack of confidence in diagnosing and managing patients with TMD. This research explored the perspectives of 11 New Zealand physiotherapists regarding TMDs, including pathoetiology and management approaches. Findings from a reflexive thematic analysis of participant interviews, indicated themes related to (1) processes that assist physiotherapists to access and apply their theoretical and experiential knowledge (knowledge activation); (2) greater clinician self-efficacy leads to greater willingness to engage in TMD patient care, and less self-efficacy prompts patient referral to other health providers; and (3) opportunities for empowering greater patient access to best-practice TMD care. Overall findings reflected a lack of confidence in physiotherapists to manage patients with TMD. Interviews suggested this was consequent to a perceived lack of theoretical TMD knowledge, transferrable physiotherapy skillset, and clinical practice experience. Inconsistencies in TMD care may be supported by the development of cross-disciplinary upskilling resources to standardize provider knowledge and skills related to TMD.
Temporomandibular disorders (TMDs) are the most common cause of orofacial pain, significantly impacting individuals’ physical, social, and psychological well-being. However, pathways for seeking care are well-understood to be problematic. Patients report TMD care to be uncoordinated, inconsistent, and expensive. Primary care providers report a lack of confidence in diagnosing and managing patients with TMD. This research explored the perspectives of 11 New Zealand physiotherapists regarding TMDs, including pathoetiology and management approaches. Findings from a reflexive thematic analysis of participant interviews, indicated themes related to (1) processes that assist physiotherapists to access and apply their theoretical and experiential knowledge (knowledge activation); (2) greater clinician self-efficacy leads to greater willingness to engage in TMD patient care, and less self-efficacy prompts patient referral to other health providers; and (3) opportunities for empowering greater patient access to best-practice TMD care. Overall findings reflected a lack of confidence in physiotherapists to manage patients with TMD. Interviews suggested this was consequent to a perceived lack of theoretical TMD knowledge, transferrable physiotherapy skillset, and clinical practice experience. Inconsistencies in TMD care may be supported by the development of cross-disciplinary upskilling resources to standardize provider knowledge and skills related to TMD.