Physical Therapy Helps Many
Physical therapists who work with patients diagnosed with hip osteoarthritis know that education, manual therapy and therapeutic exercise can provide significant pain relief and improvements in ROM for many of them. However, there hasn’t been sufficient research into the factors that can predict which patients will respond and by how much, when attending physical therapy. This is important because hip osteoarthritis is one of the most common causes of chronic pain, and chronic pain has often (too often!) been treated with opioids and NSAIDs, rather than physical therapy. As the healthcare system evaluates “pre-habilitation” – physical therapy before surgery in place of opioids – knowing who will benefit most would speed the process.
Predicting Patient Response to PT
One of the few studies that has been conducted is “Predictors of response to physical therapy intervention in patients with primary hip osteoarthritis” by A.A. Wright, C.E. Cook, T.W. Flynn, G.D Baxter and JH Abbott. In that study of 91 patients with hip osteoarthritis, Wright et. al. tried to identify a set of prognostic factors that would aid in identifying patients likely to have a favorable response to physical therapy.
Their final model had five baseline variables:
►unilateral hip pain
►age 58 years or younger
►pain greater or equal to 6 out of 10 on a numeric pain rating scale
►40-meter self-paced walk test time less than 25.9 seconds
►duration of symptoms less than or equal to 1 year
Patients who showed none of the five variables had only a 1% chance of responding favorably to physical therapy. Having at least one of the five variables increased the probability to 32%, while having at least 2 of the variables increased the probability of physical therapy success to 65%, and having 3 or more variables increased the probability of success to 99% or higher.
More Research Needed
The authors note that this study is only the first step in developing baseline variables and that further validation studies are needed. The authors note that this study is only the first step in developing baseline variables and that further validation studies are needed. Read the full abstract here.