Association between weather and utilisation of physical therapy in patients with osteoarthritis: a case-crossover study

Abstract

Background During varied weather conditions, patients with osteoarthritis experience different severity of symptoms and signs. However, weather may also cause barriers or incentives for patients to seek medical services. These factors may result in changes in medical utilisation; however, no studies have investigated whether the probability of physical therapy utilisation among patients with osteoarthritis is associated with changes in meteorological factors. Method By using a secondary data of NHID in Taiwan, we conducted a population-based, retrospective study with case-crossover design for patients initially diagnosed with osteoarthritis between 2000 and 2013. The meteorological factors of months with the lowest treatment rate were used as patients’ own control periods and compared with the parameters of months with high treatment frequency. The risk of exposure to different meteorological factors, including mean temperature, daily highest temperature, daily minimum temperature, diurnal temperature range, relative humidity, and barometric pressure, was estimated and represented by odds ratios (ORs) and 95% confidence intervals (CIs). Results A total of 8,130 patients were recruited. Regardless of univariate or multivariable analysis, increased daily highest temperature enhanced the frequency of physical therapy (OR: 1.04; 95% CI: 1.02–1.05; p < 0.01; OR: 1.07; 95% CI: 1.04–1.10; p < 0.01). When the weather was hotter (> 23 °C), higher diurnal temperature range and humidity resulted in an increase in the utilisation of physical therapy. However, when the weather was colder (< 23 °C), reverse effects were observed. Conclusions An increase in temperature increases the probability of physical therapy resource use. Therefore, temperature, along with other meteorological factors, may play a key role in the utilization of physical therapy among patients with osteoarthritis.

Chronic Sufferers and Environmental Conditions

“…The rise in temperatures above 23 degrees Celsius makes it easier for patients to move around and increases the demand for physical therapy treatment. In our research, the corresponding issue was not observed, given that temperature changes are not accompanied by extreme weather phenomena [24]. Palstam et al (2021) [37] reported that the value of physical therapy is a function of effectiveness in patients versus the sum of environmental, social, and psychological factors.…”

“…It is also possible that low barometric pressure activates the body's baroreceptors [15]. Often, an increase in barometric pressure or a change in ambient temperature, as well as increased humidity, cause a decrease in the path of pain and changes in the viscosity of synovial fluid, reducing its production and eliminating the elasticity of the already affected peri-articular structures [24]. Apart from weight receivers, both low but also high ambient temperatures with a high relative humidity activate the thermoreceptors of the skin with the parallel secretion of inflammatory substances (endothelial growth factor, interleukin-1 [IL-1]), creating or increasing inflammation in the joints [19].…”

The Influence of Weather Conditions on the Diurnal Variation in Range of Motion in Older Adults with Knee Osteoarthritis

“…It appears that increased barometric pressure intensifies discomfort, impacting these patients due to lower pain thresholds. Cold temperatures elevate synovial fluid viscosity and alter periarticular structures’ compliance, making joints stiffer and more sensitive to mechanical stress during activities [ 53 ]. These factors aggravate osteoarthritis symptoms, affecting patient mobility and healthcare accessibility [ 46 ].…”

Evidence of heat sensitivity in people with Parkinson’s disease

“…Our finding that heat sensitivity also influences anxiety is concerning given its negative impact on quality of life (Chuquilín-Arista et al 2020 ). Regarding arthritis, previous research has demonstrated an influence of hot weather on arthritis pain (Aikman 1997 ; Timmermans et al 2015 ), and access to physical therapy for arthritis pain increases in heat (Wu et al 2022 ).…”