PM R. 2021 Jun 28. doi: 10.1002/pmrj.12661. Online ahead of print.
ABSTRACT
INTRODUCTION: Physical therapy and hip arthroscopy are two viable treatment options for patients with non-arthritic hip pain(NAHP); however, patients may experience considerable decisional conflict when making a treatment decision. Interdisciplinary evaluation with a physical therapist and surgeon may better inform the decision-making process and reduce decisional conflict.
OBJECTIVE: Identify the extent to which an interdisciplinary evaluation between a surgeon, physical therapist, and patient influences treatment plans and decisional conflict of persons with NAHP.
DESIGN: Randomized controlled trial.
SETTING: Hip preservation clinic.
PARTICIPANTS: Adults with primary NAHP.
INTERVENTIONS: Participants were randomized to receive a standard (surgeon) or interdisciplinary (surgeon+physical therapist) evaluation. Surgeon evaluations included patient interview, strength and range-of-motion examination, palpation, gross motor observation, and special testing. Interdisciplinary evaluations started with the surgeon evaluation, then a physical therapist evaluated movement impairments during sitting, sit-to-stand, standing, single-leg stance, single-leg squat, and walking. All evaluations concluded with treatment planning with the respective provider(s).
OUTCOME MEASURES: Treatment plan and decisional conflict were collected pre- and post-evaluation. Inclusion of physical therapy(PT) in participants’ post-evaluation treatment plans and post-evaluation decisional conflict were compared between groups using chi-squared tests and Mann Whitney U tests, respectively.
RESULTS: 78 participants (39 in each group) met all eligibility criteria and were included in all analyses. Sixty-six percent of participants who received an interdisciplinary evaluation included PT in their post-evaluation treatment plan, compared to 48% of participants who received a standard evaluation (P = 0.10). Participants who received an interdisciplinary evaluation reported 6.3 points lower decisional conflict regarding their post-evaluation plan (100-point scale; P = 0.04). The interdisciplinary and standard groups reduced decisional conflict on average 24.8 ± 18.9 and 23.6 ± 14.6 points, respectively.
CONCLUSIONS: Adding a physical therapist to a surgical clinic increased interest in PT treatment, but this increase was not statistically significant. The interdisciplinary group displayed lower post-evaluation decisional conflict; however, both groups displayed similar reductions in decisional conflict from pre- to post-evaluation. This study also demonstrated the feasibility of an interdisciplinary evaluation in a hip preservation clinic. This article is protected by copyright. All rights reserved.
PMID:34181823 | DOI:10.1002/pmrj.12661
