To provide empirical evidence on the effect of early physical therapy (PT) within the first year of osteoarthritis (OA) diagnosis on reduction in OA-related comorbidities in patients with OA.
Retrospective cohort study.
The study was conducted using a nationally representative sample of 1 million National Health Insurance enrollees.
Newly diagnosed patients with OA (N=13,545). One-to-one propensity score matching was used to match patients who received PT within the first year of OA diagnosis (PT group; n=3403) with an equal number of patients with OA who did not receive PT (non-PT group).
Main Outcome Measures
The 4-year cumulative risk of comorbidities including coronary artery disease (CAD), diabetes mellitus, dyslipidemia, osteoporosis, gastrointestinal tract ulcer, and renal failure was estimated. A Cox proportional hazards regression analysis was performed to identify the dose-response relation between the PT dosage and the risk of OA-related comorbidities.
A total of 3403 patients (25.1%) received PT within the first year of OA diagnosis. The PT group had a significantly lower 4-year cumulative risk of dyslipidemia (P=.05) and a potentially lower 4-year cumulative risk of CAD (P=.09). After adjusting for other potential confounders, the Cox proportional hazards regression analysis showed that patients with OA who received a high PT dosage had a low risk of CAD and dyslipidemia.
Patients with OA who received PT had a lower risk of OA-related comorbidities such as dyslipidemia or CAD.
List of abbreviations:CAD (coronary artery disease), DM (diabetes mellitus), GI (gastrointestinal), ICD-9 (International Classification of Diseases-Ninth Revision), NHI (National Health Insurance), NSAID (nonsteroidal anti-inflammatory drug), OA (osteoarthritis), PT (physical therapy)
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Archives of Physical Medicine and Rehabilitation
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Estimates of the prevalence of arthritis and other rheumatic conditions in the United States.Part II. Arthritis Rheum. 2008; 58: 26-35
- Rheumatic diseases in China.Arthritis Res Ther. 2008; 10: R17
- Direct and indirect costs of pain therapy for osteoarthritis in an insured population in the United States.J Occup Environ Med. 2008; 50: 998-1005
- All cause and disease specific mortality in patients with knee or hip osteoarthritis: population based cohort study.BMJ. 2011; 342: d1165
- Health care costs in US patients with and without a diagnosis of osteoarthritis.J Pain Res. 2012; 5: 23-30
- Increased prevalence of metabolic syndrome in individuals with osteoarthritis: an analysis of NHANES III data.Postgrad Med. 2009; 121: 9-20
- Current perspectives in NSAID-induced gastropathy.Mediators Inflamm. 2013; 2013: 258209
- Adverse effects of analgesics commonly used by older adults with osteoarthritis: focus on non-opioid and opioid analgesics.Am J Geriatr Pharmacother. 2012; 10: 331-342
- Bone mineral density and osteoarthritis: data from the Baltimore Longitudinal Study of Aging.Osteoarthritis Cartilage. 2004; 12: S45-S48
- Osteoarthritis, bone density, postural stability, and osteoporotic fractures: a population based study.J Rheumatol. 1995; 22: 921-925
- Knee and hip radiographic osteoarthritis predict total hip bone loss in older adults: a prospective study.J Bone Miner Res. 2010; 25: 858-865
- The relationship between osteoarthritis and osteoporosis.J Bone Miner Metab. 2014; 32: 101-109
- Osteoarthritis: National clinical guideline for care and management in adults.Royal College of Physicians (UK), London2008
- American College of Rheumatology 2012 recommendations for the use of nonpharmacologic and pharmacologic therapies in osteoarthritis of the hand, hip, and knee.Arthritis Care Res (Hoboken). 2012; 64: 465-474
- Exercise for lower limb osteoarthritis: systematic review incorporating trial sequential analysis and network meta-analysis.BMJ. 2013; 347: f5555
- Physical therapy interventions for patients with osteoarthritis of the knee: an overview of systematic reviews.Phys Ther. 2008; 88: 123-136
- Ottawa Panel evidence-based clinical practice guidelines for the management of osteoarthritis in adults who are obese or overweight.Phys Ther. 2011; 91: 843-861
- Systematic review of guidelines for the physical management of osteoarthritis.Arch Phys Med Rehabil. 2014; 95: 375-389
- Comparative effectiveness of exercise and drug interventions on mortality outcomes: metaepidemiological study.BMJ. 2013; 347: f5577
- Exercise characteristics and the blood pressure response to dynamic physical training.Med Sci Sports Exerc. 2001; 33 (discussion S493–84): S484-S492
- Short-term effects of moderate intensity physical activity in patients with metabolic syndrome.Einstein (Sao Paulo). 2013; 11: 324-330
- Relationship between resistance training and lipoprotein profiles in sedentary male smokers.Cardiovasc J Afr. 2008; 19: 194-197
- Sixteen weeks of resistance training can decrease the risk of metabolic syndrome in healthy postmenopausal women.Clin Interv Aging. 2013; 8: 1221-1228
- Effect of physical activity on bone strength and body composition in breast cancer premenopausal women during endocrine therapy.Eur J Phys Rehabil Med. 2013; 49: 331-339
- Laser versus ultrasound on bone density recuperation after distraction osteogenesis—a cone-beam computer tomographic analysis.J Oral Maxillofac Surg. 2013; 71: 921-928
- Therapeutic effect of whole body vibration on chronic knee osteoarthritis.Ann Rehabil Med. 2013; 37: 505-515
- Early Helicobacter pylori eradication decreases risk of gastric cancer in patients with peptic ulcer disease.Gastroenterology. 2009; 137 (1648.e1641-2): 1641
- Investigating the utilization of radiological services by physician patients: a population-based cohort study in Taiwan.BMC Health Serv Res. 2013; 13: 284
- Receipt of physical therapy among osteoarthritis patients and its influencing factors.Arch Phys Med Rehabil. 2015; 96: 1021-1027
- Impact of self-rated osteoarthritis severity in an employed population: cross-sectional analysis of data from the national health and wellness survey.Health Qual Life Outcomes. 2012; 10: 30
- Gender-specific correlates of complementary and alternative medicine use for knee osteoarthritis.J Womens Health (Larchmt). 2012; 21: 1091-1099
- Estimating the health-care usage associated with osteoarthritis and rheumatoid arthritis in an older adult population in Ireland.J Public Health. 2014; 36: 504-510
- Problem of immortal time bias in cohort studies: example using statins for preventing progression of diabetes.BMJ. 2010; 340: b5087
- Amiodarone and the risk of cancer: a nationwide population-based study.Cancer. 2013; 119: 1699-1705
- The central role of the propensity score in observational studies for causal effects.Biometrika. 1983; 70: 41-55
- All-cause mortality and serious cardiovascular events in people with hip and knee osteoarthritis: a population based cohort study.PLoS One. 2014; 9: e91286
- Resistance exercise in individuals with and without cardiovascular disease: 2007 update: a scientific statement from the American Heart Association Council on Clinical Cardiology and Council on Nutrition, Physical Activity, and Metabolism.Circulation. 2007; 116: 572-584
- Exercise training and blood lipids in hyperlipidemic and normolipidemic adults: a meta-analysis of randomized, controlled trials.Eur J Clin Nutr. 1999; 53: 514-522
- Exercise and physical activity in the prevention and treatment of atherosclerotic cardiovascular disease.Arterioscler Thromb Vasc Biol. 2003; 23: 1319-1321
- The effects of exercise training on the traditional lipid profile and beyond.Curr Sports Med Rep. 2014; 13: 253-259
- Exercise dose and insulin sensitivity: relevance for diabetes prevention.Med Sci Sports Exerc. 2012; 44: 793-799
- Resistance training versus weight-bearing aquatic exercise: a cross-sectional analysis of bone mineral density in postmenopausal women.Rev Bras Reumatol. 2013; 53: 193-198
- Whole body vibration training—improving balance control and muscle endurance.PLoS One. 2014; 9: e89905
- Whole body vibration training is osteogenic at the spine in college-age men and women.J Hum Kinet. 2012; 31: 55-68
- Physical approach for prevention and treatment of osteoporosis.Arq Bras Endocrinol Metabol. 2010; 54: 171-178
- Health care utilization and workplace interventions for neck and upper limb problems among newspaper workers.J Occup Environ Med. 2001; 43: 265-275
Published online: August 21, 2015
© 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.