Can experienced physiotherapists identify which patients are likely to succeed with physical therapy treatment?

Published online

Journal Article

Background: The purpose of the study was to determine if clinician predicted prognosis is associated with patient outcomes. Methods: The study was a secondary analysis of data that were collected in 8 physiotherapy outpatient clinics. Nine physiotherapists with post-graduate training in manual therapy (mean 20.3 years of experience) were asked at baseline to project the outcome of the patients evaluated. In total, 112 patients with low back (74 %) or neck (26 %) pain were treated pragmatically with interventions consisting of manual therapy, strengthening, and patient-specific education. Outcomes measures consisted of percent change in disability (Oswestry or Neck Disability Index), self-reported rate of recovery (0-100 %), and percent change in pain (numerical pain rating scale). Hierarchical logistic regression determined potential factors (clinician predicted prognosis score (1-10) at baseline, dichotomised as poor (1-6) and good (7-10); symptom duration categorised as acute, subacute or chronic; same previous injury (yes/no); baseline pain and disability scores; within-session improvement at initial visit (yes/no); and presence of ≥ one psychological factor) associated with meaningful changes in each of the three outcomes at discharge (disability and pain > 50 % improvement, rate of recovery ≥82.5 % improvement). Results: Clinician predicted prognosis (OR 4.15, 95%CI = 1.31, 13.19, p = 0.02) and duration of symptoms (OR subacute 0.24, 95%CI = 0.07, 0.89, p = 0.03; chronic 0.21, 95%CI = 0.05, 0.90, p = 0.04) were associated with rate of recovery, whereas only clinician predicted prognosis was associated with disability improvement (OR 4.28, 95 % CI 1.37, 13.37, p = 0.01). No variables were associated with pain improvement. Conclusions: Clinician predicted prognosis is potentially valuable for patients, as a good predicted prognosis is associated with improvements in disability and rate of recovery.

Full Text

Duke Authors

Cited Authors

  • Cook, CE; Moore, TJ; Learman, K; Showalter, C; Snodgrass, SJ

Published Date

  • 2015

Published In

Volume / Issue

  • 5 /

Start / End Page

  • 3 -

PubMed ID

  • 29340172

Pubmed Central ID

  • 29340172

International Standard Serial Number (ISSN)

  • 2057-0082

Digital Object Identifier (DOI)

  • 10.1186/s40945-015-0003-z

Language

  • eng

Conference Location

  • England