Morgan Michael, Shinost Courtney, Mendez Shelby, Klose Jennifer, Lee Griffin, Forte Rachel, Lane Taylor, Klinker Matthew
Department of Physical Therapy and Athletic Training, Northern Arizona University, Phoenix, AZ.
Concentra Medical Centers, Addison, TX.
JOSPT Open. 2025 Jul;3(3):333-353. doi: 10.2519/josptopen.2025.0135. Epub 2025 Apr 30.
To evaluate how initiating physical therapy (PT) early affected (1) case duration and (2) the number of PT visits, in patients with acute work-related musculoskeletal disorders (WMSDs).
A retrospective cohort study of 83 846 patients with WMSDs who were receiving occupational health services between January 1, 2021, and December 31, 2022.
Patients were categorized according to the time from injury to initiating PT (0-2 days, 3-7 days, 8-12 days, and 13+ days). Descriptive statistics were used to analyze case duration and PT visits across 7 diagnostic groups (lumbar spine, thoracic spine, cervical spine, shoulder/humerus, elbow/wrist/hand, knee, and ankle/foot). Kruskal-Wallis tests assessed the impact of PT timing on outcomes.
Initiating PT early (0-2 days) was associated with significantly shorter case durations and fewer PT visits across all diagnostic groups. The median case duration for early PT was 14 days, compared to 28 days for initiating PT later (13+ days). Similarly, the early PT group required fewer PT visits (median: 4) than the late PT group (median: 5). These trends were consistent across all diagnostic groups.
Initiating PT early, particularly within the first 2 days postinjury, was associated with shorter case durations and fewer PT sessions in people with acute WMSDs. Standardizing early PT protocols in occupational health settings could improve case durations and reduce health care use.
评估早期开始物理治疗(PT)对急性工作相关肌肉骨骼疾病(WMSD)患者的(1)病例持续时间和(2)PT就诊次数有何影响。
对2021年1月1日至2022年12月31日期间接受职业健康服务的83846例WMSD患者进行回顾性队列研究。
根据从受伤到开始PT的时间(0 - 2天、3 - 7天、8 - 12天和13天以上)对患者进行分类。使用描述性统计分析7个诊断组(腰椎、胸椎、颈椎、肩/肱骨、肘/腕/手、膝和踝/足)的病例持续时间和PT就诊情况。Kruskal - Wallis检验评估PT时机对结果的影响。
早期(0 - 2天)开始PT与所有诊断组的病例持续时间显著缩短和PT就诊次数减少相关。早期PT的病例持续时间中位数为14天,而后期(13天以上)开始PT的为28天。同样,早期PT组所需的PT就诊次数(中位数:4次)少于后期PT组(中位数:5次)。这些趋势在所有诊断组中都是一致的。
早期开始PT,尤其是在受伤后的头2天内,与急性WMSD患者的病例持续时间缩短和PT疗程减少相关。在职业健康环境中规范早期PT方案可改善病例持续时间并减少医疗保健使用。