PTCohortPM & R : the journal of injury, function, and rehabilitation2023

Feasibility of an intensive interprofessional lifestyle medicine program for patients with musculoskeletal conditions in the setting of lifestyle-related chronic disease.

Heidi Prather, Alexandra E Fogarty, Abby L Cheng and 3 others

PMID 34713577

WHAT IT FOUND

21 of 26 patients finished the program, and 13 of 21 who finished met their personal goal.

Anxiety scores fell by 3.5 points, but physical function, weight and other measures did not show clear change. This shows feasibility, not that the program works.

Key findings

01Twenty-one patients completed the program, and 13 of the 21 completers met their personal end-of-program goal.

02PROMIS Anxiety scores fell by 3.5 points; the PROMIS Physical Function change of 2.4 points and changes in Depression and Pain Interference were not statistically significant.

03The program combined physiatrist-led care with psychology, nutrition, physical therapy, acupuncture, massage and smoking-cessation support, so the contribution of any single component cannot be separated.

STILL TO COME

How it was doneWhat they foundWhat it means for PTs

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What it does not show

This was a small single-site feasibility study, not a test of whether the program works. Outcomes were compared within the same patients over time, so the program cannot be separated from usual care or other factors. Patients received several services at once, so the contribution of any one discipline cannot be isolated. Some patients left early, and missing data were omitted, which can distort the results. Repeat laboratory tests were often not completed because of insurance coverage, cost or inconvenience. The program was offered to patients who had already completed standard musculoskeletal care and were interested in lifestyle change. The satisfaction measure did not capture what patients found most helpful. Initial sleep apnea screening and interim blood pressure collection were not reliably performed.

Declared interests

The supplied publication type lists non-U.S. government research support. No author conflict-of-interest declaration is included in the supplied text.

The easy way to misread this

Do not read this as proof that lifestyle medicine reduces pain or improves function. It was a small single-site feasibility study that compared patients with themselves over time, not with a control group. Patients received physiatrist-led care, psychology, nutrition, physical therapy, acupuncture, massage and smoking-cessation support together, and most secondary outcome changes were not statistically significant.

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