Physical Therapy in Knee Osteoarthritis Relieves Physical and Financial Pain

Individuals with knee osteoarthritis can benefit more from intensive physical therapy paired with subsequent booster sessions than from a shorter period of concentrated physical therapy, according to a recent study.

While this strategy is a deviation from current practices, it has been shown to improve outcomes, as well as lower costs. Longer periods of face-to-face work with a physical therapist could also encourage patients to exercise more, helping them maintain health benefits.

In a presentation given on Nov. 8 at the 2015 ACR/ARHP annual meeting in San Francisco, Calif., University of Pittsburgh physical therapy assistant professor Allyn Bove, discussed the comparative differences between treating knee osteoarthritis patients with short, concentrated periods of physical therapy or with extended physical therapy services augmented by booster session.[[{"type":"media","view_mode":"media_crop","fid":"43650","attributes":{"alt":"©Kzenon/Shutterstock.com","class":"media-image media-image-right","id":"media_crop_9463503491133","media_crop_h":"0","media_crop_image_style":"-1","media_crop_instance":"4805","media_crop_rotate":"0","media_crop_scale_h":"0","media_crop_scale_w":"0","media_crop_w":"0","media_crop_x":"0","media_crop_y":"0","style":"font-size: 13.008px; line-height: 1.538em; float: right;","title":" ","typeof":"foaf:Image"}}]]

“A lot of physical therapists would like to have regular follow-ups with patients to adjust home exercise programs and talk about best strategies to manage knee osteoarthritis,” she said. “It would be much like having a conversation about chronic disease with a primary physician or scheduling regular dental appointments.”

Three hundred participants completed a two-year study and were divided into four groups: 12 exercise-only visits; 9 exercise-only visits with three boosters, spread over 12 months; 12 exercise-only session, plus manual therapy; and, 9 exercise-only therapy, plus manual therapy, plus three booster sessions.

Based on patient-reported outcomes, Healthcare Utilization Project data, and the Medicare physician fee schedule, physical therapy with booster session produced the greatest effectiveness at the lower cost, Bove said. Exercise, manual therapy and booster session cost the least, and exercise-plus-booster cost $1,061 more with a gain of 0.082 Quality-Adjusted Life Years.

According to study results, she said, it would cost $13,000 in medication costs, follow-up visits, and additional services to achieve the same healthcare benefits seen with physical therapy sessions that include booster sessions spread out over a 12-month period.

Disclosures:

Funding for the study came from the Agency for Health Research & Quality.

References:

“What Is the Most Cost-Effective Physical Therapy Strategy to Treat Knee Osteoarthritis?” Nov. 8; 2:30 p.m. – 4 p.m. ACR/ARHP 2015.