The Impact of Executive Function on Retention and Compliance in Physical Therapy in Veterans.
Elisa F Ogawa, Rebekah Harris, Rachel E Ward and 5 others
PMID 39822209WHAT IT FOUND
In Veterans doing physical therapy, executive function problems did not predict whether they stayed in the study or attended treatment sessions.
Those with executive function problems started with worse mobility, and more dropped out, but the study was too small to confirm that.
Key findings
01At baseline, 22% of the 72 Veterans analyzed had executive function deficits, and those Veterans had worse performance-based and patient-reported mobility.
02Executive function deficit status did not predict dropout, and it did not predict treatment attendance or posttreatment exercise compliance among completers.
03Dropout was associated with higher pain interference, greater patient-reported mobility limitation, more depressive symptoms, and living alone; Veterans who lived alone had increased odds of dropping out by more than 6 times.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The analysis used 72 Veterans with complete data, and only 16 had executive function deficits, so the study was too small to reliably test differences in retention or compliance. This was a secondary analysis of a trial with a fixed protocol, not a study designed to prove that executive function causes dropout or poor attendance. Study operations were interrupted by the COVID-19 pandemic, and cognitive testing was done both virtually and in person, which may have affected enrollment, dropout, and measurement. Six of 78 enrolled Veterans were excluded for missing measures, and those excluded Veterans were older and had worse mobility. The authors state they were unable to conclude whether retention and compliance differed by executive function status.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not conclude that executive function deficits cause Veterans to drop out or miss physical therapy sessions. The deficit group had a higher dropout rate, but executive function did not predict dropout in the statistical models, and the study was too small to confirm that difference.