Navigation Links
Will patients stick to physical therapy? Questionnaire can help doctors predict
Date:9/30/2008

Patients' responses to a simple questionnaire can reliably predict whether they will adhere to physical therapy after spine surgery, Johns Hopkins researchers suggest in a new study. The findings could help physicians identify patients who might benefit from additional preoperative preparation to ensure they attend therapy sessions and follow through with prescribed exercise, a factor that can greatly affect their long-term recovery.

"It has long been known that physical therapy after spine surgery greatly improves outcomes, but to date, there has been no easy-to-administer, standardized method for assessing a patient's willingness to adhere to therapy," says Richard L. Skolasky, Sc.D., of the Department of Orthopaedic Surgery at Johns Hopkins University School of Medicine.

In the study, published online in the Oct. 1 Spine, Skolasky and his colleagues demonstrated that spine surgery patients who scored high on the Patient Activation Measure (PAM) questionnaire were 38 percent more likely to attend physical therapy and were rated as significantly more engaged in rehabilitation by their physical therapists compared to patients with low PAM scores.

The PAM, developed in 2004, is a participant-completed, 13-item questionnaire that assesses a patient's ability to play an active role in his or her health care. To date, it has been studied for use with chronic diseases such as HIV, type 2 diabetes and hypertension. This is the first time it has been applied to surgery and physical therapy.

This questionnaire asks patients to rate their agreement to a variety of statements, ranging from strongly agree to strongly disagree. Examples of statements include: When all is said and done, I am the person who is responsible for managing my health condition; Taking an active role in my own health care is the most important factor in determining my health and ability to function; and, I am confident I can follow through on medical treatments I need to do at home.

"Essentially, the test places patients on a continuum of activation ranging from those who don't see an active role on their part as necessary to those who are highly motivated to take an active role in their own health care," says Skolasky.

The researchers recruited 65 Johns Hopkins patients to participate in the study, funded by the Agency for Healthcare Research and Quality. All underwent their first surgical treatment for a degenerative spine disease between August 2005 and May 2006. Eighty-nine percent were non-Hispanic white and 58 percent were female. The mean age was 58 years old.

Before the surgery, each patient completed a PAM questionnaire. Then, for the next six weeks after surgery, patients recorded how often they attended prescribed physical therapy sessions. After the last therapy session, therapists scored the patients' engagement in physical therapy by rating their attitude, need for prompts, understanding the importance of therapy, and activity during sessions.

Results showed that attendance rose in direct correlation to PAM scores. Patients who had the lowest PAM scores attended 55.6 percent of their therapy sessions. In contrast, those with the highest PAM scores attended physical therapy 94.1 percent of the time. Similarly, engagement scale scores also went up as PAM scores increased.

"These results were very encouraging, and since the PAM is easy to administer, it may provide a practical component to a patient's preoperative treatment," says Skolasky.

Skolasky said that before they can bring the PAM into the examination room, they will need to develop a protocol for improving PAM scores. He and his colleagues are planning a randomized clinical trial in which trained interviewers will meet with patients who score low on the PAM and employ various techniques to improve involvement in their own care. Surgical outcomes for these patients would be compared to outcomes of those who receive standard pre-surgery care.

One area Skolasky plans to focus on is improving communication between patients and doctors. He says patients are sometimes resistant to bring up questions or to discuss problems or symptoms with doctors and instead are more comfortable responding to questions doctors give them. Increasing a patient's knowledge about his or her condition and the steps he or she can take to alleviate symptoms or improve recovery may greatly increase PAM scores, Skolasky notes.


'/>"/>

Contact: Eric Vohr
evohr1@jhmi.edu
410-955-8665
Johns Hopkins Medical Institutions
Source:Eurekalert

Related medicine news :

1. New Trend of Healthcare Companies Sending Patients Abroad for Surgery is Dangerous Says James Goldberg Whose Son Died Following Surgery in Thailand
2. MS patients have higher spinal fluid levels of suspicious immune molecule
3. Scams and Shams That Prey on Cancer Patients
4. VA, DoD Electronically Hand Off Records of Wounded Patients
5. Cancer patients who receive neoadjuvant therapy followed by mastectomy may not need radiation
6. How to select anti-hepatitis B virus agents for drug-resistance patients?
7. ALS Patients and Researchers Unite in Boston for 4th Annual Leadership Summit
8. Ovarian and Endometrial Cancer Patients Experience Improved Outcomes When Treated First by a Gynecologic Oncologist
9. Hormone Therapy Not Best for Older Prostate Cancer Patients
10. Whole brain radiation increases risk of learning and memory problems in cancer patients
11. Results From IMPROVE Study Show Therapeutic Effect of New Formulation of Rebif(R) at 16 Weeks in Patients With Multiple Sclerosis
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:9/22/2017)... ... September 22, 2017 , ... First Choice ... celebrating the one year anniversary of its Houston-Fallbrook facility. , “We are ... Facility Medical Director of First Choice Emergency Room Houston-Fallbrook. “It has been a ...
(Date:9/22/2017)... ... ... “Letters From Home”: a moving compilation of letters that remind readers of the ... is the creation of published author, John Allred, a passionate leader of ministry to ... who has traveled and ministered on four continents. , “It is my hope and ...
(Date:9/21/2017)... , ... September 21, 2017 , ... With ProSlideshow Portrait ... and easy to do. Users can select from up to two layers of subject ... click of a mouse all within Final Cut Pro X. , With ...
(Date:9/21/2017)... , ... September 21, 2017 , ... ... learn with Infinity Behavioral Health Services for professionals in the addiction treatment industry ... Payer Audit . , Insurance companies and state and federal governments are ...
(Date:9/21/2017)... ... September 21, 2017 , ... Bill Howe Plumbing’s mission is to create an ... to the community. For over 37 years, they have operated with their mission at ... in San Diego. They were chosen as the Best San Diego plumber in ...
Breaking Medicine News(10 mins):
(Date:9/6/2017)... -- Eli Lilly and Company (NYSE: LLY ... galcanezumab and lasmiditan, two investigational treatments for migraine, at ... taking place Sept. 7-10 in Vancouver ... data from an open-label study evaluating the safety and ... 240 mg) for the prevention of migraine. Galcanezumab is ...
(Date:9/5/2017)... Oramed Pharmaceuticals Inc. (NASDAQ: ORMP ) (TASE: ... on the development of oral drug delivery systems, announced ... the U.S. Food and Drug Administration (FDA) regarding ORMD-0801, ... At the meeting, the FDA gave ... ORMD-0801, would be a Biologics License Application (BLA).  Such ...
(Date:8/29/2017)... , Aug. 29, 2017 ivWatch, LLC, the leading provider ... infiltrations, announced it has been awarded an Innovative Technology contract from ... the country. ... device to aid in the early detection of peripheral IV infiltration ... The Innovative Technology contract ...
Breaking Medicine Technology: