Associations between treatment goals, patient characteristics, and outcome measures for patients with musculoskeletal disorders in physiotherapy practice

Abstract

Background Goal setting is linked to person-centred care and is a core component in physiotherapy, but the associations between goal classes, patient characteristics and outcome measures for musculoskeletal disorders has not been investigated. The study’s purpose was to examine 1) how goals used in clinical practice for patients with musculoskeletal disorders (MSD) are distributed in classes based on ICF, 2) if goal classes were associated with patient characteristics and 3) whether goal classes were associated with treatment outcome. Methods Data analysis from a longitudinal observational study (N = 2591). Goals were classified in symptom, function/structure, activity/participation and non-classifiable. Associations between patient characteristics and goal classes were examined using x2 and one-way ANOVA. Association between goal classes and outcomes were examined using multiple logistic and linear regression models. Outcomes are reported at 3 months or end of treatment if prior to 3 months. Results There was a high variability in goals used for patients with MSD. 17% had symptom goals, 32.3% function/structure, 43.4% activity/participation and 7.4% non-classifiable goals. We found significant associations between goal classes and age, gender, severity, region of pain/diagnosis and emotional distress (all p < .001). Activity/participation goals were associated with better outcomes on GPE (OR 1.80, 95% CI 1.23–2.66). Non-classifiable goal was associated with poorer outcomes on pain intensity (B .87, 95% CI .32–1.43). Conclusion There is an association between goal classes and patient characteristics. Including activity/participation in the main goal was associated with better outcomes for GPE and having a non-classifiable goal was associated with poorer outcomes for pain intensity. Trial registration The project is approved by the Regional committee for Medical and Health Research Ethics in Norway (REC no. 2013/2030). https://clinicaltrials.gov/ct2/show/NCT03626389.

The perceptions of individuals with musculoskeletal disorders towards prognosis: An exploratory qualitative study

“…However, the perception of a poor prognosis is often linked to a decline in an individual's ability to complete ADLs. Setting goals linked to activity participation and functional ability has been linked to patient‐centred care and improvements in outcomes in the management of MSDs (Amundsen et al., 2021). Therefore, when setting goals, physiotherapists may wish to consider targeting leisure activities to frame goals in a positive way and motivate individuals.…”

The association between different outcome measures and prognostic factors in patients with neck pain: a cohort study

“…Patients seeking health care for chronic musculoskeletal (MSK) pain report problems with a variety of everyday life health domains that includes physical activity, vitality, mental well-being, sleep, work, and social relationships [ 1 – 4 ]. They also report a wide range of goals for treatment, and it is shown that goals set by patients with low back pain included a mixture of health domains [ 3 , 5 , 6 ]. In response to these challenges, a set of core outcome measures covering a range of health domains including pain, disability, and health-related quality of life (HRQoL) have been suggested [ 7 – 9 ].…”

Internet-Based Information Sharing With Families of Patients With Stroke in a Rehabilitation Hospital During the COVID-19 Pandemic: Case-Control Study

“…Without communication and coordination, isolated efforts to rehabilitate the stroke survivor are unlikely to achieve their full potential." It is recommended that patient assessment in stroke rehabilitation be based on the International Classification of Functioning, Disability and Health [11]. Therefore, family information, such as family caregiving abilities and home environment, is useful for medical workers.…”

“…The guidelines for adult stroke rehabilitation published by the American Heart Association/American Stroke Association [ 10 ] indicate that “Communication and coordination between a large team, including the patient and his or her families, physicians, nurses, physical and occupational therapists, speech-language pathologists [is] paramount in maximizing the effectiveness and efficiency of rehabilitation. Without communication and coordination, isolated efforts to rehabilitate the stroke survivor are unlikely to achieve their full potential.” It is recommended that patient assessment in stroke rehabilitation be based on the International Classification of Functioning, Disability and Health [ 11 ]. Therefore, family information, such as family caregiving abilities and home environment, is useful for medical workers.…”

“…Activities to intervene during hospitalization should be selected according to environmental factors after discharge. International Classification of Functioning, Disability and Health–based goals have been reported to increase rehabilitation efficiency [ 11 ]. With information from the family, personalized goals can be set for each patient.…”