What Are Typical Outcomes Associated with Physical Therapy for Foot & Ankle Patients?
| Autor: | Judith F. Baumhauer MD, MPH, Christopher Neville PT, PhD, Kostantinos Vasalos DPT, Chad Condidorio DPT, Kathleen Fear PhD, Jeff Houck PT, PhD |
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| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: | |
| Zdroj: | Foot & Ankle Orthopaedics, Vol 4 (2019) |
| Druh dokumentu: | article |
| ISSN: | 2473-0114 24730114 |
| DOI: | 10.1177/2473011419S00102 |
| Popis: | Category: Outcomes Introduction/Purpose: It is unclear whether patients attending physical therapy, post-op or for conservative care, achieve clinically important differences (CID) on the patient reported outcome information system (PROMIS) scales. Key PROMIS outcomes physical function (PF) and pain interference (PI) match well with treatments provided in physical therapy. Physical therapy may also influence depression (Dep). Documentation of PROMIS outcomes associated with physical therapy are useful to help set patient expectations. The purpose of this analysis was to document expected PROMIS PF, PI, and Dep outcomes after physical therapy for foot and ankle diagnoses by 1) reporting average improvement and 2) examining whether severity of symptoms (PROMIS Scales) at the start of physical therapy are associated with a 0.5 standard deviation (CID) improvement at the end of therapy. Methods: PROMIS scales were available at the start and end of physical therapy treatment for 377 patients with foot and ankle ICD10 codes. Clinical categories(>n=20) of patients were identified for 6 groups(n=309): Achilles Rupture(n=24), Fracture(n=34), Ankle Pain(n=105), Foot Pain(n= 50), Ankle Sprain(n=51), and Achilles Non-Rupture(n=45). ANOVA models followed by pairwise comparisons were used to assess differences between start and end scores for all patients (n=377) and across diagnoses (n=309). Minimal CID was defined as improvement of t-score 3-5 and CID as above 5 (0.5 SD) consistent with published data. PROMIS scales were also converted to 0.5 standard deviation(SD) increments to document proportions of patients with symptoms relative to normal of the US population at start and end of physical therapy. Chi-square analysis was used to examine the association of PROMIS symptoms PF and PI at the start and end of care in 0.5 SD increments. Results: Across ALL patients the largest improvements occurred in PF (6.5, p |
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