Researchers Find Physical Therapists Have Positive Effect In Primary-Care Role

April 16th, 2019
By: Content Staff

For patients dealing with newly diagnosed musculoskeletal disorders, even a small improvement upon the traditional medical treatment can be a big deal, and a study from Sweden suggests that physical therapists have the ability to give these patients that little edge they need.

The study, published in Therapeutic Advances in Musculoskeletal Disease, showed that patients seeking primary care for a musculoskeletal disorder (MSD) who are triaged to a physical therapist (PT) have outcomes that are just as good, if not better than those who are seen by a physician general practitioner (GP). The findings were summarized by PT in Motion, a publication of the American Physical Therapy Association.

The study involved just 55 patients ages 16 to 67 who were seeking treatment for a new MSDs. Patients were not allowed to participate if they required home visits, were already receiving treatment for the MSD, were dealing with a chronic condition or did not speak English or Swedish, PT in Motion reported.

Researchers worked with three primary-care health centers in Gothenberg, Sweden – one serving patients at the low end of the socioeconomic ladder, one serving more affluent patients and another serving a diverse population. According to PT in Motion, these primary-care centers are usually the first step for Swedes seeking health care. A nurse evaluates the patient and determines what kind of health-care provider the patient will see next.

According to PT in Motion, researchers and nurses at these primary-care centers split up a group of patients who normally would be referred to a PT. One group was assigned to a PT, and the other was a control group assigned to a GP. Both groups filled out questionnaires rating the severity of their pain and disability and their health-related quality of life. Patients completed the questionnaires at their initial consultation and four additional times over the next year, PT in Motion reported.

Analysis showed that while all the patients improved at approximately the same rates, the PT patient group consistently reported outcomes that were slightly better than those of the control group. The one statistically significant difference was found in the scores for health-related quality of life, with the PT group reporting better outcomes than the control group, PT in Motion reported.

"Only positive effects were notable, and no adverse events regarding the triaging process were reported," the researchers wrote about the study’s PT patient group.

Researchers also sought to determine whether the PT group developed different attitudes about their MSDs, shifting more responsibility for their care to the patient and away from employers and/or medical professionals. The study found that the PT group was more likely to decrease slightly what authors call "externalization" of the condition to health-care providers, PT in Motion said.

"This study indicates that early contact with both GPs and [PTs] can reduce the risk for patients developing chronic conditions with subsequent need for more comprehensive treatment," the researchers wrote. "As the effects of [PT] treatment were at least as good as [treatment as usual], it is clearly feasible to impose management modifications which can free medical competence for other patient groups. It is important to take care of even the group of patients with short-term or low-intensive musculoskeletal conditions to prevent the development of chronic disorders.

"While it cannot be irrevocably concluded that initiation of treatment by a [PT] is better for all patients with [MSDs] than [is] medical advice and treatment by a GP, there is nothing to indicate that this triage model for managing patients with [MSDs] in primary care is in any way detrimental to patient health or worse than standard care. Triaging to [PTs] for primary assessment in primary care seems to lead to at least as positive health effects as primary assessment by GPs and can be recommended as an alternative management pathway for patients with MSDs."

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