Recent research suggests that, when it comes to the treatment of knee osteoarthritis (OA), timing may be everything.
According to the study, presented recently at the American College of Rheumatology Annual Meeting in San Francisco, spacing exercise-based physical therapy sessions over a 12-month period, while using three additional “booster” sessions periodically, may be more cost-effective than alternative physical therapy strategies in the treatment of knee OA.
A media release from the American College of Rheumatology explains that in their 2-year study, researchers compared the cost-effectiveness of four different physical therapy strategies among 300 people with knee OA across several institutions.
Strategy one included 12 visits of exercise therapy alone over a 9-week period; strategy two included eight initial visits of exercise therapy within a 9-week period plus four booster sessions at three time points (two boosters at month 5 and one at months 8 and 11) spaced across a 12-month period; strategy three included 12 visits of exercise therapy plus manual therapy; and strategy four included eight initial visits of exercise therapy plus manual therapy and four booster sessions. Total healthcare costs were estimated using patient-reported outcomes as well as data from the Healthcare Utilization Project and the Medicare physician fee schedule, the release explains.
“We believed there was a need to improve both the magnitude and sustainability of treatment effects of exercise therapy for improving pain and function in people with knee OA,” explains G. Kelley Fitzgerald, PT, PhD, FAPTA, professor and associate dean of graduate studies, University of Pittsburgh School of Health and Rehabilitation Sciences, and the study’s principal investigator, in the release.
According to the researchers, the booster strategies (strategies two and four) significantly lowered healthcare costs and showed greater effectiveness in the treatment of knee OA. Between those two strategies, strategy two cost $1,061 more, but gained .082 more quality-adjusted life years.
Overall, the study suggests that, while exercise therapy remains effective in treating people with knee OA, it might be more effective to supplement exercise with manual therapy and space physical therapy visits over a longer period of time to maximize long-term benefits, the release explains.
“These results indicate that supplementing exercise with manual therapy and spacing physical therapy sessions across a longer period of time may provide greater benefit to individuals with knee osteoarthritis, while simultaneously reducing downstream healthcare utilization,” explains Allyn Bove, PT, DPT, assistant professor, Department of Physical Therapy, University of Pittsburgh School of Health and Rehabilitation Sciences, and the study’s lead investigator, in the release.
[Source: American College of Rheumatology]