Factors associated with surgeon referral for physical therapy in patients with traumatic lower-extremity injury: Results of a national survey of orthopedic trauma surgeons

Kristin R. Archer, Ellen J Mackenzie, Michael J. Bosse, Andrew N. Pollak, Lee H Riley

Research output: Contribution to journalArticle

Abstract

Background: Variation in referral rates for physical therapy exists at both the individual physician and practice levels. Objective: The purpose of this study was to explore the influence of physician and practice characteristics on referral for physical therapy in patients with traumatic lower-extremity injury. Design: A cross-sectional survey was conducted. Methods: In 2007, a Web-based survey questionnaire was distributed to 474 surgeon members of the Orthopaedic Trauma Association. The questionnaire measured physician and practice characteristics, outcome expectations, and attitude toward physical therapy. Referral for physical therapy was based on case vignettes. Results: The response rate was 58%. Surgeons reported that 57.6% of their patients would have a positive outcome from physical therapy and 24.2% would have a negative outcome. The highest physical therapy expectations were for the appropriate use of assistive devices (80.7%) and improved strength (force-generating capacity) (76.4%). The lowest outcome expectations were for improvements in pain (35.9%), coping with the emotional aspects of disability (44.1%), and improvements in workplace limitations (51.4%). Physicians reported that 32.6% of their patients referred for physical therapy would have no improvement beyond what would occur with a surgeon-directed home exercise program. Multivariate analyses showed positive physician outcome expectations to have the largest effect on referral for physical therapy (odds ratio=2.7, P

Original languageEnglish (US)
Pages (from-to)893-905
Number of pages13
JournalPhysical Therapy
Volume89
Issue number9
DOIs
StatePublished - Sep 2009

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Lower Extremity
Referral and Consultation
Wounds and Injuries
Physicians
Therapeutics
Self-Help Devices
Orthopedic Surgeons
Surveys and Questionnaires
Surgeons
Workplace
Multivariate Analysis
Cross-Sectional Studies
Odds Ratio
Exercise
Pain

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation

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Factors associated with surgeon referral for physical therapy in patients with traumatic lower-extremity injury : Results of a national survey of orthopedic trauma surgeons. / Archer, Kristin R.; Mackenzie, Ellen J; Bosse, Michael J.; Pollak, Andrew N.; Riley, Lee H.

In: Physical Therapy, Vol. 89, No. 9, 09.2009, p. 893-905.

Research output: Contribution to journalArticle

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