The Foot and Ankle Special Interest Group (FASIG) would like to request your help in filling out the "Physical Therapist Foot Care Survey" below. Your help in completing the survey and sending it back to the Orthopaedic Section is very important so that we can use the results to establish a database of physical therapists currently providing various levels of foot and ankle care. In addition to gaining insight into the number of therapists actively involved in providing foot and ankle services, the information obtained from the survey will allow the FASIG to develop a referral data base of physical therapists who can provide various levels of foot and ankle care. In appreciation your efforts in filling out and returning the survey, the FASIG will place your name in a drawing for the new upcoming Foot and Ankle Home Study course.

Again, thank you for taking the time to fill-out and return this important survey!

1) What is your current primary practice environment?
General/Acute inpatient
Rehabilitation inpatient
Rehabilitation outpatient
Outpatient - Hospital Based
Outpatient - Private Practice
Outpatient - Non-Private Practice
Home Health
Other - Specify:

2) What is your major job responsibility(s)? (33.3% or more of the day - Select all that apply)
Staff PT
Senior PT
Supervisor
Director/Chief
Clinical Instructor
Clinical Coordinator
Other - Specify

3) Primary patient population seen in your practice?
Sports Medicine
Performing Arts
Diabetes
Pediatric
Geriatric
Amputee
Wound care(non-diabetic)
Other - Specify

4) The number of patients/clients seen per week with foot and ankle conditions?
0
1-3
4-7
8-12
greater than 12

5) Types of foot and ankle conditions you treat each month? (Check all that apply)
Posterior tibialis tendonitis/dysfunction
Achilles tendonitis/rupture
Plantar fasciitis
Ankle sprain
Stress fracture of leg or foot
Tarsal tunnel syndrome
Hallux limitus/rigidus
Fracture of the Ankle, Foot or Toes
Hallux Valgus/Bunion
Bunionette (5th toe)
Metatarsal head pain
Mortons toe
Mortons neuroma
Interdigital neuroma
Chronic lateral ankle instability
Chronic lower leg pain (shin splints)
Claw or hammer toe
Diabetic foot care
Sesamoiditis
Rheumatoid foot & ankle problems
Plantar fibromas

6) Please indicate a percentage of the frequency of physical therapy visits you see for each patient/client with foot and ankle conditions?
a) 3 times per week
b) 2 times per week
c) once per week
d) once per 2 weeks
e) once per month
f) other

7) Please indicate the percentage of time that you use the following specific treatment interventions in your management program. Please provide an answer for each intervention. a) Patient/Client education
b) Manual stretching
c) Joint mobilization
d) Soft tissue mobilization/myofascial release
e) Strengthening exercises
f) Home stretching program
g) Physical Agents (heat, cold)
h) Electrotherapeutic modalities
i) Fabrication of foot orthoses
j) Footwear assessment/recommendations

8) There is a wide variety of foot orthoses that can be used in the management of patients/clients with foot and ankle disorders. Please indicate the types of foot orthoses you utilize in your practice.
Over-the-counter foot orthoses purchased by patient elsewhere
Pre-fabricated foot orthoses dispensed by the therapist or office
Pre-fabricated foot orthoses with modifications done by therapist
Foot orthoses fabricated in the practice location by physical therapist
Foot orthoses fabricated in the practice location by another health care professional
Foot orthoses fabricated from a cast sent to outside laboratory

9) The state in which you currently practice

10) In your state is direct access available?
Yes
No

11) If you answered YES in question #10, do you see foot and ankle patients/clients via direct access?
Yes
No

12) If the state in which you currently practice does permit direct access for physical therapy and you answered NO in question #9, would you please provide a reason for not seeing patients/clients with foot and ankle disorders via direct access? (eg: insurance reimbursement issues; malpractice issues)
Reason(s):

13) Do you participate in Primary Care Physical Therapy?
Yes
No

14) If you answered yes in question #13, do your practice privileges allow you to… (Select all that apply)
Order/request radiographs
Order/request other imaging procedures (bone scan, CT scan, MRI)
Order/request blood or other laboratory tests
Order/request medications
Order/request casts/braces
Order/request other tests/procedures/equipment