Advising exercise to patients with osteoarthritis or sciatica may be a highly recommended approach to treatment, but it's an approach that may not be widely used by physicians, according to a recent factorial experiment (abstract). Researchers found that out of 192 primary care physicians studied, fewer than a third said that they would advise physical activity as part of a course of treatment for patients presenting symptoms of either condition. The results of the study were published online in early October in Arthritis Care & Research.
In the experiment, the physicians watched 2 videos of (actor) patients who presented with pain from undiagnosed sciatica or knee osteoarthritis that had been diagnosed. Afterwards, the physicians were interviewed to find out what recommendations they would make.
Results showed that 30.2% of physicians would give exercise advice to the osteoarthritis patient, and 32.8% would provide this advice to the patient presenting with sciatica. The study pointed to a general tendency for physicians with fewer years in practice to advise lifestyle changes more frequently than their more veteran peers. These newer physicians were also found to be more likely to prescribe nonsteroidal anti-inflammatory drugs, but less likely to order tests.
The low rate of exercise advice runs counter to widely accepted recommendations from the American College of Rheumatology and the American Pain Society. APTA's Physical Therapist's Guide to Osteoarthritis of the Knee webpage provides information on why exercise plays an important role in treatment, and the association's PTNow research portal provides members with access to evidence-based research on physical therapy and sciatica.
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