Article

There are limited population-based studies of determinants of
physical therapy use for chronic low back pain (LBP) and of the types of
treatments received by individuals who see a physical therapist. The
purposes of this study were: (1) to identify determinants of physical therapy use
for chronic LBP, (2) to describe physical therapy treatments for chronic LBP, and
(3) to compare use of treatments with current best evidence on care for this condition. This study was a cross-sectional, population-based telephone
survey of North Carolinians. METHODS: Five hundred eighty-eight individuals with
chronic LBP who had sought care in the previous year were surveyed on their
health and health care use. Bivariate and multivariable analyses were conducted
to identify predisposing, enabling, and need characteristics associated with
physical therapy use. Descriptive analyses were conducted to determine the use of
physical treatments for individuals who saw a physical therapist. Use of
treatments was compared with evidence from systematic reviews. RESULTS: Of our
sample, 29.7% had seen a physical therapist in the previous year, with a mean of
15.6 visits. In multivariable analyses, receiving workers' compensation, seeing
physician specialists, and higher Medical Outcomes Study 12-Item Short-Form
Health Survey questionnaire (SF-12) physical component scores were positively
associated with physical therapy use. Having no health insurance was negatively
associated with physical therapy use. Exercise was the most frequent treatment
received (75% of sample), and traction was the least frequent treatment received
(7%). Some effective treatments were underutilized, whereas some ineffective
treatments were overutilized. LIMITATIONS: Only one state was examined, and
findings were based on patient report. CONCLUSIONS: Fewer than one third of
individuals with chronic LBP saw a physical therapist. Health-related and
non-health-related factors were associated with physical therapy use. Individuals
who saw a physical therapist did not always receive evidence-based treatments.
There are potential opportunities for improving access to and quality of physical therapy for chronic LBP.

Langue : ANGLAIS