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Influence of acuity on physical therapy outcomes for patients with cervical disorders
William G Boissonnault1, Mary Beth Badke
1Department of Orthopedics and Rehabilitation, Physical Therapy Program, University of Wisconsin, Madison, WI 53706-1532, USA. boiss@surgery.wisc.edu
Objectives:
To assess the influence of symptom acuity on functional outcomes, pain, and patient perception of recovery after a physical therapy (PT) program for cervical disorders and to determine what variables are associated with patient function at discharge.
Design:
Retrospective case series.
Setting:
Outpatient settings at a tertiary care facility.
Participants:
Patients (N=220) who were seen for PT between June 2003 and November 2005.
Interventions:
A customized rehabilitation program was developed for each patient based on examination findings and included a combination of the following interventions: mobilization or manipulation, flexibility exercises, strengthening exercises, endurance exercises, massage techniques, and heat and cold modalities.
Main Outcome Measures:
Functional outcome, functional improvement, perceived pain, and perceived improvement scores in the CareConnections Outcomes System (formerly TAOS) database.
Results:
Persons whose symptom duration was greater than 6 months (chronic group) had significantly less functional improvement than persons whose symptom duration was less than 1 month (acute group). The median percentage improvement score for patient perceived recovery was also significantly lower for the chronic group than for the acute group. There was no significant difference in the percentage decrease in pain among the acute, subacute (symptom duration, 1-6 mo), and chronic groups. In regression analyses, a model with age (P=.001), symptom duration (P=.05), and inclusion of mobilization and manipulation interventions (P=.02) fit the data well and explained 35.6% of the variance in functional outcome score for all 3 groups combined.
Conclusions:
Patients showed improvements in function after a rehabilitation program for cervical disorders. Patient functional score at discharge is influenced by age, symptom duration, and inclusion of mobilization or manipulation treatments.