Presentation Date
19-10-2021 12:00 AM
Description
Total knee arthroplasty is one of the main options for treatment for patients suffering severe knee pain and limitation. Post-op physical therapy (PT) is universally recommended and it has been associated with improved function. The goal of this study was to identify what patient factors (age, body mass index, home address, insurance type, marital status, highest level of education, and driving distance to clinic) were associated with engagement in and completion of a full course of PT defined as ≥ 2 sessions attended for engagement and ≥16 sessions attended for completion. PT session notes for 259 patients who had undergone TKA between January of 2016 through December of 2019 were reviewed for this study. Patients averaged 69 years old, were 68.7% (n = 178) female, 36.7% (n = 95) identified as of black race, 57.9% (n = 150) identified as of white race and 5.4% (n = 14) identifying as of another race. The majority of patients had BMI greater than 25 kg/m 2 (92.3%, n = 239), received education beyond high school (55.4%, n = 128) and lived with a partner (51.6%, n =131). 35.9% (n = 93) of patients had private insurance, 23.9% (n = 62) had Medicare, 36.3% (n = 94) had Medicare advantage and 3.9% (n = 10) had Medicaid. Analysis showed that increasing distance to clinic negatively impacted engagement with PT (p= 0.008). This association was not seen when analyzing PT completion. In multivariable analysis, only race was significantly associated with PT completion (p=0.024). White patients (81.3%) were more likely to complete PT when compared to black (65.3%) or other (61.5%) patients. These findings suggest that proper PT clinic referral pre-operatively or immediately post-operatively before the first PT session may be an important predictor of creating patient engagement, however it is not a significant predictor for completion of PT regime. Further analysis into specific social-demographic factors pertaining to race need to be conducted to accurately interpret the decreased adherence to completion of PT post TKA observed between white and black patients.
Recommended Citation
Dubic, Michael; Benes, Gregory; David, Justin; Adams, Zachary; Say, Parker; Bronstone, Amy; Leonardi, Claudia; and Dasa, Vinod, "Factors affecting Out Patient Physical therapy attendance following TotalKnee Arthroplasty" (2021). Medical Student Research Poster Symposium. 29.
https://digitalscholar.lsuhsc.edu/sommrd/2021MRD/Posters/29
Included in
Factors affecting Out Patient Physical therapy attendance following TotalKnee Arthroplasty
Total knee arthroplasty is one of the main options for treatment for patients suffering severe knee pain and limitation. Post-op physical therapy (PT) is universally recommended and it has been associated with improved function. The goal of this study was to identify what patient factors (age, body mass index, home address, insurance type, marital status, highest level of education, and driving distance to clinic) were associated with engagement in and completion of a full course of PT defined as ≥ 2 sessions attended for engagement and ≥16 sessions attended for completion. PT session notes for 259 patients who had undergone TKA between January of 2016 through December of 2019 were reviewed for this study. Patients averaged 69 years old, were 68.7% (n = 178) female, 36.7% (n = 95) identified as of black race, 57.9% (n = 150) identified as of white race and 5.4% (n = 14) identifying as of another race. The majority of patients had BMI greater than 25 kg/m 2 (92.3%, n = 239), received education beyond high school (55.4%, n = 128) and lived with a partner (51.6%, n =131). 35.9% (n = 93) of patients had private insurance, 23.9% (n = 62) had Medicare, 36.3% (n = 94) had Medicare advantage and 3.9% (n = 10) had Medicaid. Analysis showed that increasing distance to clinic negatively impacted engagement with PT (p= 0.008). This association was not seen when analyzing PT completion. In multivariable analysis, only race was significantly associated with PT completion (p=0.024). White patients (81.3%) were more likely to complete PT when compared to black (65.3%) or other (61.5%) patients. These findings suggest that proper PT clinic referral pre-operatively or immediately post-operatively before the first PT session may be an important predictor of creating patient engagement, however it is not a significant predictor for completion of PT regime. Further analysis into specific social-demographic factors pertaining to race need to be conducted to accurately interpret the decreased adherence to completion of PT post TKA observed between white and black patients.