Comorbidity and physical therapy

Abstract

Outpatient physical therapy and rehabilitation provides services for a a diversity of musculoskeletal conditions such as spinal, joint, and soft tissue pains, as well as wide range of injuries, medical ailments, and post-surgical conditions. Having a baseline information about these patients referred for physical therapy and their associated comorbidities, to start their rehabilitation programs, help in guiding the treating physiatrist / therapist to set the most appropriate management plan for the patient, avoid strenuous exercises which might have negative impact on his/her medical condition, and assist in monitoring the patient's response to therapy. Considering a full profile for the patient helps also in setting the appropriate patient education program tailored to the patient needs and organizing the appropriate patients' group therapy services. On the research level, such data helps researchers in reclassifying the outpatient subpopulations, and evaluating the outcomes of physical therapy professional programs. It also helps in considering what to emphasize in musculoskeletal and orthopedic rehabilitation courses. Therefore, assessment of patients, for their associated comorbidities became a vital part of the patients' pre-physiotherapy evaluation. Musculoskeletal conditions booked its place as the most prevalent referral cause for physiotherapy management. This might explain why majority of the studies carried out to assess comorbidity in patients referred for physiotherapy included patients referred mainly for specific musculoskeletal conditions such as low back pain and arthritis. This chapter will discuss the prevalence of comorbid conditions in physical therapy population as well as the association between physical therapy and comorbidity. It will also review the impact of comorbidities on physiotherapy courses, and how to set up targeted rehabilitation programs tailored for patients living with comorbidity(ies). It will also discuss the barriers to comprehensive patient management and inclusion of comorbidity assessment in standard clinical practice.