PMID- 30689552
OWN - NLM
STAT- MEDLINE
DCOM- 20200109
LR  - 20200109
IS  - 1878-6324 (Electronic)
IS  - 1053-8127 (Linking)
VI  - 32
IP  - 5
DP  - 2019
TI  - Explanatory multivariate modeling for disability, pain, and claims in patients 
      with spine pain via a physical therapy direct access model of care.
PG  - 769-777
LID - 10.3233/BMR-171074 [doi]
AB  - BACKGROUND: Direct access physical therapy (DAPT) may result in improved patient 
      outcomes and reduced healthcare costs. Prognostic factors associated with 
      spine-related outcomes and insurance claims with DAPT are needed. OBJECTIVE: To 
      identify factors that predict variations in outcomes for spine pain and insurance 
      claims using DAPT. METHODS: Individuals (N = 250) with spine pain were analyzed. 
      Outcomes were classified into High, Low, or Did Not Meet minimal clinically 
      important difference (MCID) scores. Claims were categorized into low, medium, or 
      high tertiles. Prognostic variables were identified from patient information. 
      RESULTS: Females were more likely to meet High MCID (odds ratio [OR] 2.84 (95% CI 
      = 1.32, 6.11) and Low MCID (OR 2.86, 95% CI = 1.34, 6.10). Higher initial ODI/NDI 
      scores were associated with High MCID (OR 1.04, 95% CI = 1.07, 1.22) and Low MCID 
      (OR 0.91, 95% CI = 0.77, 1.07). Odds of a high claim were lowered by the absence 
      of imaging (OR 0.04, 95% CI = 0.02, 0.09) and an active versus passive treatment 
      (OR 0.38, 95% CI = 0.18, 0.80). CONCLUSION: Females and higher initial disability 
      predicted favorable outcomes. The novel introduction of claims into the 
      prognostic modeling supports that active interventions and avoiding imaging may 
      reduce claims.
FAU - Green, Christopher E
AU  - Green CE
AD  - Division of Physical Therapy, Department of Allied Health Sciences, University of 
      North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
FAU - Pastore, Anthony
AU  - Pastore A
AD  - Division of Physical Therapy, Department of Allied Health Sciences, University of 
      North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
FAU - Cronley, Leah
AU  - Cronley L
AD  - Doctor of Physical Therapy Division, Department of Orthopaedics, Duke University, 
      Durham, NC 27705, USA.
FAU - Walker, Merritt D
AU  - Walker MD
AD  - Doctor of Physical Therapy Division, Department of Orthopaedics, Duke University, 
      Durham, NC 27705, USA.
FAU - Thigpen, Charles A
AU  - Thigpen CA
AD  - ATI Physical Therapy, University of South Carolina, Greenville, SC 29681, USA.
AD  - Center for Effectiveness Research in Orthopaedics, University of South Carolina, 
      Greenville, SC 29681, USA.
FAU - Cook, Chad E
AU  - Cook CE
AD  - Doctor of Physical Therapy Division, Department of Orthopaedics, Duke University, 
      Durham, NC 27705, USA.
FAU - Givens, Deborah L
AU  - Givens DL
AD  - Division of Physical Therapy, Department of Allied Health Sciences, University of 
      North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
LA  - eng
PT  - Journal Article
PL  - Netherlands
TA  - J Back Musculoskelet Rehabil
JT  - Journal of back and musculoskeletal rehabilitation
JID - 9201340
SB  - IM
MH  - Adult
MH  - Back Pain/physiopathology/*therapy
MH  - Disability Evaluation
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Models, Theoretical
MH  - Pain Measurement
MH  - *Physical Therapy Modalities
MH  - Prognosis
MH  - Sex Factors
MH  - Spine/physiopathology
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Prognosis
OT  - direct access
OT  - health care costs
OT  - low back pain
OT  - neck pain
EDAT- 2019/01/29 06:00
MHDA- 2020/01/10 06:00
CRDT- 2019/01/29 06:00
PHST- 2019/01/29 06:00 [pubmed]
PHST- 2020/01/10 06:00 [medline]
PHST- 2019/01/29 06:00 [entrez]
AID - BMR171074 [pii]
AID - 10.3233/BMR-171074 [doi]
PST - ppublish
SO  - J Back Musculoskelet Rehabil. 2019;32(5):769-777. doi: 10.3233/BMR-171074.