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Physical Therapy and Health Outcomes in Patients With Spinal Impairments

DU Jette, DSc, PT, is Associate Professor and Program Director, Graduate Program in Physical Therapy, Graduate School for Health Studies, Simmons College, 300 The Fenway, Boston, MA 02115 (USA) (djette@vmsvax.simmons.edu), and Physical Therapist, Beth Israel HealthCare, 330 Brookline Ave, Boston, MA 02215.
AM Jette, PhD, PT, is Professor and Dean, Sargent College of Allied Health Professions, Boston University, 635 Commonwealth Ave, Boston, MA 02215. He was Chief Research Scientist, New England Research Institutes Inc, 9 Galen St, Watertown, MA 02172, and Professor of Social and Behavioral Sciences, Boston University School of Public Health, 80 E Concord St, Boston, MA 02118, at the time of this study.

Background and Purpose. Little is known concerning the effects of physical therapy on health outcomes in patients with spinal impairments. This research examined the pattern of health outcomes in patients with spinal impairments and the relationship of outcomes to the physical therapy provided. Subjects. Data were obtained from 1,097 patients with spinal impairments who completed an episode of care in any of 68 physical therapy practices across the United States. Methods. Data were derived from the Focus on Therapeutic Outcomes database during 1993 and 1994. Multivariate analyses were used to determine which of the treatment variables, controlled for baseline health status and relevant patient characteristics, were related to outcomes. Results. Improvement occurred in nearly all health scales. Inclusion of endurance exercise was most consistently associated with better outcomes. Inclusion of heat or cold modalities was associated with poorer outcomes. Conclusion and Discussion. This study suggests that physical therapists take a broader view of patient-related goals and documentation of outcomes. It also provides evidence that the type of intervention is related to outcomes.

Key Words: Back pain • Neck pain • Outcome and process assessment

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