Use and perceived need of physical therapy following severe lower-extremity trauma

Details

• Personal Author:
  Avery J ; Bosse MJ ; Castillo RC ; MacKenzie EJ ; Webb LX
• Description:
  Objective: To examine the utilization of physical therapy (PT), the level of perceived need for PT, and the proportion of patients with perceived need receiving no PT in a cohort of severe lower-extremity trauma patients treated at level I trauma centers. Design: Longitudinal, observational study of severe lower-extremity trauma patients. Patients were interviewed by a research coordinator and examined by an orthopedic surgeon and a physical therapist during initial admission, and at 3, 6, 12, and 24 months postdischarge. Setting: Eight level I trauma centers. Participants Of 601 patients age 18 to 65 enrolled in the parent study over a 40-month period, 550 with unilateral study injuries and followed up at least once over the 2-year study period were included in this analysis. Interventions: Not applicable. Main Outcome Measure: Patient reported number of PT visits at each follow-up time point, inpatient rehabilitation admissions, and their perceived need for PT. Perceived need for PT was also assessed by an orthopedic surgeon and a physical therapist. Overall, concordance between physician, physical therapist, and patient's assessment of need for PT was low, with ? statistics ranging between .12 and .41. Results: Amputation and reconstruction patients used comparable amounts of PT services. Regardless of the criteria used to evaluate need, the proportion of patients with perceived need for PT receiving no PT services increased over the course of the follow-up, from 23% to 46% at first follow-up to over 68% by 2 years. Factors associated with increased risk for having a perceived need but receiving no therapy included lack of private insurance, pain, lower levels of education, lower fitness levels at time of injury, being a smoker, and having severe muscle injury. Conclusions: The results suggest a significant proportion of patients in the severe lower-extremity trauma population have perceived need for PT, yet receive no PT services. [Description provided by NIOSH]
• Subjects:
  • Aging
  • Men
  • Musculoskeletal System
  • Occupational Health
  • Safety
  • Women
• Keywords:
  • Physical-therapy
  • Traumatic-injuries
  • Extremities
  • Foot-injuries
  • Bone-structure
  • Age-groups
  • Humans
  • Men
  • Women
  • Author Keywords: Leg
  More +
• ISSN:
  0003-9993
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  Maryland ; North Carolina ; OSHA Region 3 ; OSHA Region 4
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  86
• Issue:
  9
• NIOSHTIC Number:
  nn:20037742
• Citation:
  Arch Phys Med Rehabil 2005 Sep; 86(9):1722-1728
• Contact Point Address:
  Renan C. Castillo, MS, Center for Injury Research and Policy, Johns Hopkins Bloomberg School of Public Health, 624 N Broadway, Rm 544, Baltimore, MD 21205
• Federal Fiscal Year:
  2005
• Performing Organization:
  Johns Hopkins University
• Peer Reviewed:
  True
• Start Date:
  20050701
• Source Full Name:
  Archives of Physical Medicine and Rehabilitation
• End Date:
  20280630
• Download URL:
  https://stacks.cdc.gov/view/cdc/191728/cdc_191728_DS1.pdf
• File Type:
  [PDF - 149.40 KB]
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:2ab32eaa4e6826643f6a870c48e5010f097d6b1d282edf3c530ddb74732b27443c98f554e4956c4bac1f203c12e0c8ab42fe7099c72ad0bf3902bd23b6ae9a01