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  • PTJ Special Issue Podcasts: Physical Therapy for Pain May Reduce Overall Costs, Opioid Use

    For some patients, physical therapy can both decrease overall health care utilization and save money down the road—especially if delivered sooner rather than later. These were the takeaways from 2 articles in a May 2018 special issue on nonpharmacological management of pain published by PTJ (Physical Therapy), APTA's scientific journal. PTJ Editor-in-Chief Alan Jette, PT, PhD, FAPTA, interviewed authors of each of the studies via podcast.

    One study, coauthored by Xinliang “Albert” Liu, PhD, examined the effect of timing of physical therapy on downstream health care use and costs for patients with acute low back pain (LBP) in New York state. The patients were categorized by whether and how soon they received physical therapy after seeing a physician for LBP: at 3 days, 4–14 days, 15–28 days, 29–90 days, and no physical therapy. Patients who received physical therapy within 3 days (30%) incurred the lowest costs and utilization rates, while those who didn’t see a PT at all saw the greatest of both.

    In the PTJ podcast, Liu observed that among those who did not receive physical therapy there was “greater variety in health care utilization and costs," pointing out that factors influencing costs include age, living in nonmetropolitan areas, type of insurance coverage, comorbidities, and whether they were prescribed opioids or other medications. He cautioned that “we don’t have the evidence” yet to say that all patients with LBP should be referred immediately to physical therapists, but he hopes that future research can “identify subgroups that would potentially benefit from physical therapy and lower their health care utilization and costs.”

    A separate study explored downstream health care utilization and costs for Veterans Affairs patients who received physical therapy, opioids, or both after hip surgery. After 2 years, patients who received only physical therapy had lower overall health care costs than those who only received opioids and had fewer return visits for surgical fixes or replacements. Among the 56% of patients who received both, those who received physical therapy first had lower costs, had fewer opioid prescriptions, and were less likely to use opioids long-term.

    Coauthor Daniel Rhon, PT, DPT, DSc, told Jette, “Perhaps when you see a physical therapist first, there is more appropriate pain education and pain management…and that sends the patient down this pathway that results in better outcomes. I think there’s a prevailing thought…that you need to be pain-free before you get to physical therapy, and that it’s going to be really painful, and some physicians and some patients might wait” to refer a patient to physical therapy.

    Research-related stories featured in PT in Motion News are intended to highlight a topic of interest only and do not constitute an endorsement by APTA. For synthesized research and evidence-based practice information, visit the association's PTNow website.

    Successful WCPT Efforts in Africa Subject of Capitol Hill Meeting

    The World Confederation for Physical Therapy (WCPT) is making a difference in the lives of people in need of rehabilitation in conflict-affected countries in Africa, thanks to an innovative program supported by the Leahy War Victims Fund, a special USAID program created by US Sen Patrick Leahy (VT) and funded by Congress. Recently, WCPT leaders and APTA staff shared that success story with Leahy's office.

    The visit to Capitol Hill allowed WCPT President Emma Stokes and CEO Jonathon Kruger to personally thank representatives for the Leahy War Fund grant that helped the confederation strengthen the physical therapy profession in West Africa, particularly in the strife-ridden countries of Mali, Niger, and Senegal. The program, known as the SUDA Project, has bolstered the physical therapy associations in those countries, improved the quality and standards of physical therapist education programs, and established a model for capacity-building that can be transferred to other low-resource countries.

    The Leahy War Victims Fund, an initiative focused on providing assistance to people with disabilities in countries experiencing conflict, provided a $1.2 million grant to the SUDA Project. In addition to thanking representatives of the program for its support, Stokes and Kruger also outlined ideas for expanding or replicating the project in other countries.

    “Our meeting provided a wonderful opportunity to give feedback on the SUDA project and to explore future opportunities for the current administration to fund projects that support the development of the global physical therapy profession,” said Kruger. “WCPT is very grateful for the support provided by APTA President Sharon Dunn, PT, PhD, as well as APTA CEO Justin Moore, PT, DPT, and his team to make this meeting happen,” added Stokes.

    "APTA was pleased to be able to facilitate a meeting between WCPT and Senator Leahy's office," said Justin Elliott, APTA vice president of government affairs. "The SUDA Project is a success by any measure, and the Leahy War Victims Fund made that project possible. APTA and WCPT will continue to work together to support this important arm of USAID."


    2018 - 04 - 24 - Group shot
    From left: Emilio J. Rouco, MA, APTA director of public and media relations;
    Justin Elliott, APTA vice president of government affairs; WCPT President Emma Stokes;
    WCPT CEO Jonathon Kruger.