Factors Associated With Physical Therapy Engagement During the Period of Posttraumatic Amnesia

Abstract Background and Purpose. Little information is available on factors associated with physical therapy use. Identifying the characteristics of people who use physical therapy and some of the factors associated with its use is a useful first step in determining whether disparities exist in physical therapy use. The purpose of this study was to identify factors associated with physical therapy use by community-based older people. Subjects. The subjects were community-based people 65 years of age or older who participated in the Medicare Current Beneficiary Survey and had at least one physician encounter (N=38,312 person-years across 20,227 individuals). Methods. Logit and ordinary least squares regression analyses were conducted to identify factors associated with physical therapy use. Results. Several measures of health and function were associated with physical therapy use. Several demographic, insurance, and geographic characteristics also were associated with physical therapy use. Income, education, having supplemental private insurance, participating in a managed care plan, and physical therapist supply were positively associated with physical therapy use. Age was negatively associated with physical therapy use. For people who saw a physical therapist, amount of physical therapy received was positively associated with income, having supplemental private insurance, living in a metropolitan area, physical therapist supply, and being African American. Amount of physical therapy received was negatively associated with being in a managed care plan. Discussion and Conclusions. Variation in physical therapy use, explained by factors other than need, suggests potential underuse or overuse of physical therapy by community-based older people.

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Out-of-Pocket Spending for Ambulatory Physical Therapy Services From 2008 to 2012: National Panel Survey

Physical Therapy ◽

10.2522/ptj.20150018 ◽

2015 ◽

Vol 95 (12) ◽

pp. 1680-1691 ◽

Cited By ~ 4

Author(s):

Julia Chevan ◽

Daniel L. Riddle ◽

Shelby D. Reed

Keyword(s):

Physical Therapy ◽

Urban Areas ◽

Medical Expenditure Panel Survey ◽

Public Funding ◽

Data File ◽

Medical Expenditure ◽

Panel Survey ◽

Factors Associated ◽

Episode Of Care ◽

Episodes Of Care

Background Out-of-pocket (OOP) expenditures are incurred as insurers and employers shift some of the burden of health care costs onto consumers. As cost-sharing increases, OOP expenditures could be a barrier to physical therapy care. Objective The purposes of this study were: (1) to identify factors associated with any OOP physical therapy spending and (2) to identify factors associated with higher spending among individuals incurring OOP costs. Design The study was a retrospective analysis using the 4 most recently available panels of data from the Medical Expenditure Panel Survey (MEPS) encompassing 2008–2012. Methods A data file containing episodes of physical therapy care for 2,189 people was created. Logistic regression was used to identify factors related to having an OOP expenditure. A multivariable generalized linear model was used to identify factors related to mean OOP expenditures. Results On average, an episode of care encompassed 9.9 visits, with mean total expenditures of $1,708 (median: $792). Fifty-four percent of episodes of care had an OOP expenditure. For individuals with OOP expenditures, the mean OOP expenditure for an episode of care was $351 (median: $144). Being female or non-Hispanic and having a higher income were associated with higher odds of incurring an OOP expenditure, whereas being in worse general health, >65 years of age, or nonwhite and having public funding were associated with lower odds of incurring an OOP expenditure. Amounts of OOP spending were higher in urban areas and in all census geographic regions relative to the Northeast region. Limitations Estimates are based on household-reported survey data, limited to ambulatory care, and do not include institutionalized individuals. Conclusions At 54%, the proportion of individuals with OOP expenditures for physical therapy is lower than for general medical care. Several predictors were found of having OOP expenditures and of the magnitude of those expenditures.

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Factors Associated With Nonadherence to Pelvic Floor Physical Therapy Referral for the Treatment of Pelvic Pain in Women

Physical Therapy ◽

10.1093/ptj/pzz050 ◽

2019 ◽

Vol 99 (7) ◽

pp. 946-952 ◽

Cited By ~ 2

Author(s):

Frank Aguirre ◽

Jessica Heft ◽

Amanda Yunker

Keyword(s):

Physical Therapy ◽

Pelvic Floor ◽

Medical Records ◽

Myofascial Pain ◽

Physical Therapist ◽

Private Insurance ◽

Pain Syndrome ◽

Myofascial Pain Syndrome ◽

Factors Associated ◽

Pelvic Floor Physical Therapy

Abstract Background Patients with pelvic pain due to pelvic floor myofascial pain syndrome are often referred for pelvic floor physical therapy, the primary treatment option. However, many patients do not adhere to the treatment. Objective The purpose of this study was to examine the adherence rate and outcomes of patients referred for physical therapy for pelvic floor myofascial pain syndrome and identify risk factors associated with nonadherence. Design This was a retrospective cohort study. Methods ICD-9 codes were used to identify a cohort of patients with pelvic floor myofascial pain syndrome during a 2-year time period within a single provider's clinical practice. Medical records were abstracted to obtain information on referral to physical therapy, associated comorbidities and demographics, and clinical outcomes. “Primary outcomes” was defined as attendance of at least 1 visit. Secondary outcomes included attendance of at least 6 physical therapist visits and overall improvement in pain. Statistical analysis was performed using chi-square, Fisher exact, and independent t tests. Nonparametric comparisons were performed using Wilcoxon signed rank test. Multivariate analysis was completed to adjust for confounders. Results Of the 205 patients, 140 (68%) attended at least 1 session with physical therapy. At least 6 visits were attended by 68 (33%) patients. Factors associated with poor adherence included parity and a preexisting psychiatric diagnosis. The odds of attending at least 1 visit were 0.75 (95% confidence interval = 0.62–0.90) and 0.44 (95% confidence interval = 0.21–0.90), respectively. Patients who attended ≥ 6 visits were more likely to have private insurance (78%) and travel shorter distances to a therapist (mean = 16 miles vs 22). Patients with an improvement in pain (compared with those who were unchanged) attended an average of 3 extra physical therapist visits (mean = 6.9 vs 3.1). Limitations Limitations include reliance on medical records for data integrity; a patient population derived from a single clinic, reducing the generalizability of the results; the age of the data (2010–2012); and the likely interrelatedness of many of the variables. It is possible that maternal parity and psychiatric diagnoses are partial surrogates for social, logistic, or economic constraints and patient confidence. Conclusions Initial adherence to pelvic floor physical therapy was less likely for multiparous women and women with a history of psychiatric diagnosis. Persistent adherence was more likely with private insurance or if the physical therapist location was closer. Pain improvement correlated with increased number of physical therapist sessions.

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Factors Associated with Publication of Research Projects from a Canadian Master of Science Degree Programme in Physical Therapy

Physiotherapy Canada ◽

10.3138/ptc-2018-0089 ◽

2020 ◽

Vol 72 (1) ◽

pp. 71-80

Author(s):

Brittany M. McEachern ◽

Ian Winningham ◽

Kevin Wood ◽

Jack Tang ◽

Tim VanDerWeide ◽

...

Keyword(s):

Physical Therapy ◽

Research Projects ◽

Degree Programme ◽

Master Of Science ◽

Factors Associated ◽

Science Degree

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Delivery of Physical Therapy in the Acute Care Setting: A Population-Based Study

Physical Therapy ◽

10.2522/ptj.20100337 ◽

2012 ◽

Vol 92 (2) ◽

pp. 251-265 ◽

Cited By ~ 15

Author(s):

Janet K. Freburger ◽

Kendra Heatwole Shank ◽

Stefanie R. Knauer ◽

Richard M. Montmeny

Keyword(s):

North Carolina ◽

Physical Therapy ◽

Hospital Discharge ◽

Acute Care ◽

Joint Replacement ◽

Acute Care Hospitals ◽

Population Based ◽

Discharge Data ◽

Factors Associated ◽

Hospital Variation

BackgroundPopulation-based studies on physical therapy use in acute care are lacking.ObjectivesThe purpose of this study was to examine population-based, hospital discharge data from North Carolina to describe the demographic and diagnostic characteristics of individuals who receive physical therapy and, for common diagnostic subgroups, to identify factors associated with the receipt of and intensity of physical therapy use.DesignThis was a cross-sectional, descriptive study.MethodsHospital discharge data for 2006–2007 from the 128 acute care hospitals in the state were examined to identify the most common diagnoses that receive physical therapy and to describe the characteristics of physical therapy users. For 2 of the most common diagnoses, logistic and linear regression analyses were conducted to identify factors associated with the receipt and intensity of physical therapy.ResultsOf the more than 2 million people treated in acute care hospitals, 22.5% received physical therapy (mean age=66 years; 58% female). Individuals with osteoarthritis (admitted for joint replacement) and stroke were 2 of the most common patient types to receive physical therapy. Almost all individuals admitted for a joint replacement received physical therapy, with little between-hospital variation. Between-hospital variation in physical therapy use for stroke was greater. Demographic and hospital-related factors were associated with physical therapy use and physical therapy intensity for both diagnoses, after controlling for illness severity and comorbidities.LimitationsData from only one state were examined, and the studied variables were limited.ConclusionsThe use and intensity of physical therapy for stroke and joint replacement in acute care hospitals in North Carolina vary by clinical and nonclinical factors. Reasons behind the association of hospital characteristics and physical therapy use need further investigation.

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Reamputation in patients with diabetic-related minor amputations who underwent physical therapy during their hospitalization. A single-facility retrospective cohort study

10.21203/rs.3.rs-52938/v2 ◽

2020 ◽

Author(s):

Shinsuke Imaoka ◽

Koji Sato ◽

Masahide Furukawa ◽

Minoru Okita ◽

Toshio Higashi

Keyword(s):

Cohort Study ◽

Physical Therapy ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Care Center ◽

Functional Independence Measure ◽

Functional Independence ◽

Ankle Dorsiflexion ◽

Factors Associated ◽

Minor Amputation

Abstract Background: Diabetic foot lesions are a major cause of non-traumatic lower limb amputations; they can interfere with daily life, reduce physical function and lower a patient’s quality of life. Physical therapy is necessary to prevent such social disadvantage. Patients at high risk of reamputation may require physical therapy to prevent reamputation. The purpose of this study was to elucidate the factors that influence re-amputation in patients with minor amputations who were treated with physical therapy during their hospitalization.Methods: This was a retrospective cohort study of 245 consecutive hospitalized patients who presented to our Wound Care Center between January 2015 and February 2018 and received physical therapy after a minor amputation. Participants were identified from admission records (to surgical and physical therapy units) stored in the electronic medical records. We examined reamputations that occurred in the ipsilateral lower extremity during the 1-year post-discharge outpatient period. The maximum follow-up period was１year. We used Cox proportional hazards analysis to examine factors affecting the risk of reamputation.Results: Of the 129 patients enrolled, 42 patients (32.5%) underwent reamputations during an average observation period of 6.2 months (range, 2.1 to 10.9 months). The factors associated with reamputation were a requirement for hemodialysis, ankle dorsiflexion angle, and ambulation Functional Independence Measure score.Conclusions: We identified a requirement for hemodialysis, ankle dorsiflexion angle, and functional independence measure (FIM) ambulation as the factors associated with reamputation in patients with diabetes who had undergone minor amputation. In the future, developing a physical therapy program that focuses on these factors could help reduce reamputations.

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Current status of Brazilian interprofessional education: a national survey comparing physical therapy and medical schools

Revista da Associação Médica Brasileira ◽

10.1590/1806-9282.65.10.1241 ◽

2019 ◽

Vol 65 (10) ◽

pp. 1241-1248

Author(s):

Cyntia Pace Schmitz Correa ◽

Lina Santana Hermuche ◽

Alessandra Lamas Granero Lucchetti ◽

Oscarina da Silva Ezequiel ◽

Giancarlo Lucchetti

Keyword(s):

Developing Countries ◽

Physical Therapy ◽

Health Education ◽

Interprofessional Education ◽

Institutional Support ◽

Nationwide Survey ◽

Medical Schools ◽

Current Status ◽

Factors Associated ◽

Education School

SUMMARY OBJECTIVES To investigate how many Brazilian medical and physical therapy schools have initiatives and courses related to IPE in their curricula, assessing the barriers and factors associated with their implementation and comparing the differences between both programs. METHODS This nationwide survey was carried out in 2017 and included representatives of all physical therapy and medical schools in Brasil. Offers of interprofessional activities and related opinions and barriers were evaluated. RESULTS A total of 76 (33.9%) of the medical and 159 (41.4%) of the physical therapy schools answered the questionnaires. At least 68.4% of the medical schools and 79.2% of the physical therapy schools have IPE initiatives, although the number of mandatory courses and clerkships is still low. Despite recognizing IPE’s importance in health education, school representatives see the lack of integration of programs, conflicting schedules, and the lack of institutional support as barriers. In physical therapy, there is a smaller perception of barriers and greater incorporation of mandatory programs in the curriculum. CONCLUSION These results will help in the development of future interventions that can enhance IPE in curricula in developing countries.

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