The American Physical Therapy Association's Annual Combined Sections Meeting Conference & Exposition (APTA CSM) was held from February 13-15, 2025, at the George R. Brown Convention Center in Houston, Texas. This event stands as the premier physical therapy conference of the year, offering attendees the chance to partake in expert-led sessions organized by APTA's 18 specialty sections and academies. Moreover, participants have the opportunity to engage in exclusive networking events, fostering connections within a community dedicated to advancing the field of physical therapy.
The following are succinct summaries of studies presented at the APTA CSM that specifically showcase advancements in back pain research.
Association between Psychologic Factors and Chronic Low Back Pain in Parkinson Disease
- More than half of individuals diagnosed with Parkinson's disease (PD) experience low back pain (LBP), a symptom that is more prevalent in comparison to their age-matched counterparts without PD. It remains uncertain whether individuals with PD who also suffer from LBP exhibit more pronounced levels of anxiety and depression when compared to those with PD but without LBP, as well as older adults experiencing LBP.
- The hypothesis posits that individuals with PD who have chronic LBP will display more severe symptoms of anxiety and depression in contrast to individuals with PD who do not experience LBP, as well as older adults with LBP. Anxiety, and potentially depression, are linked to chronic LBP in individuals with PD, suggesting that those with PD and chronic LBP may experience heightened levels of anxiety compared to those without LBP. However, there appears to be no significant difference in the severity of anxiety or depressive symptoms when comparing individuals with PD and LBP to older adults with LBP of similar age.
- Individuals suffering from chronic low back pain (LBP) incur significant healthcare expenses. Physical therapy (PT) is often recommended for the treatment of chronic LBP, yet there is a lack of research on the cost implications of PT. Our study aimed to evaluate the difference in total healthcare costs over a 2-year period for individuals who received PT for chronic LBP compared to those who did not.
- The results showed that overall total costs were higher for patients in the PT group who utilized commercial insurance and Medicaid, while costs remained relatively unchanged for those with Medicare coverage. Younger individuals with commercial insurance had notably higher total costs, indicating a potential need for more cost-effective treatment options. Interestingly, older adults utilized less PT, despite the potential benefits of maintaining function and quality of life.
- The availability of clinical practice guidelines (CPGs) for physical therapists (PTs) has seen a significant increase in recent years. Despite this, studies have shown low adherence rates among PTs in the United States to CPGs for low back pain (LBP). Surprisingly, there is a lack of research exploring the potential barriers hindering the utilization of the latest LBP CPG from the Academy of Orthopaedic Physical Therapy of the American Physical Therapy Association (APTA).
- The primary objective of this study is to investigate the obstacles faced by PTs when trying to implement the most up-to-date APTA CPG for LBP. Additionally, we aim to examine any potential relationships between demographic factors, usage patterns, and reported barriers. The findings of this study have the potential to enhance the adoption and integration of CPGs in real-world clinical settings, ultimately leading to improved patient outcomes. It is recommended that future research delve further into the barriers hindering the implementation of CPGs to ensure their effective use in clinical practice.
- Guidelines for treating low back pain (LBP) consistently recommend non-pharmacologic treatments such as spinal manipulation and exercise as the first line of defense. However, the utilization of physical therapy (PT) as an initial treatment strategy remains significantly underutilized, potentially leading to an increased risk of chronic pain and unnecessary interventions. To address this issue, the researchers conducted an explanatory, sequential mixed-methods study to assess the variation in the use of physical therapy for acute low back pain (LBP) and to identify the determinants that may explain this variation.
- This study revealed significant disparities in the guideline-concordant use of PT among physicians and advanced practice providers at emergency departments (EDs) and urgent care (UC) sites. This variability appears to be influenced by various factors, including how individual providers assess the benefits and risks of PT, the cost to patients, the time required to refer patients to PT, the availability of resources, anticipated patient outcomes, and the impact on provider performance outcomes such as patient satisfaction.
- Globally, low back pain (LBP) is a prevalent musculoskeletal condition that significantly impacts the quality of life for older adults. Despite current efforts in geriatric LBP management, the disability crisis persists. However, there is a growing body of evidence pointing to two key factors that contribute to this issue: hip strength and movement-evoked pain (MEP).
- In this preliminary analysis, we sought to explore the intercorrelation between hip strength, MEP, and leg pain presence - a common yet poorly understood factor in geriatric LBP. Additionally, the researchers aimed to assess the unique impact of these factors on both reported and performance-based physical function outcomes. The findings revealed a significant relationship between hip strength and MEP in older adults with chronic LBP. Furthermore, hip strength, MEP, and leg pain presence were all found to be associated with various physical function outcomes, even after controlling for age and gender differences.
Impact of Exercise Quantity on Low Back Pain Outcomes in Physical Therapy: A Retrospective Analysis
- Low back pain (LBP) is a prevalent issue in outpatient physical therapy, with therapeutic exercise being a key component of treatment. Despite exercise being a primary intervention, the ideal number of prescribed exercises for LBP remains uncertain. This study aimed to investigate whether the quantity of prescribed exercises (≤4 exercises vs >4 exercises) had a significant impact on LBP outcomes at discharge, as assessed by the Focus on Therapeutic Outcomes (FOTO) tool. The hypothesis was that patients given fewer exercises (≤4) would exhibit better FOTO outcomes at discharge compared to those given more than 4 exercises.
- The results of the study revealed that exercise quantity alone did not predict LBP outcomes, highlighting the limited impact of controlling for the number of prescribed exercises as a variable. Further research is necessary to determine the optimal exercise prescription (type, specificity, progression) and dosing (frequency, duration, volume, intensity) for different LBP conditions.
Utilizing Improvement Kata to Improve Patient Outcomes for Low Back Pain
- Continuous improvement principles have been utilized in the manufacturing industry for several decades, and more recently, these principles have been integrated into the healthcare sector. One such approach, known as the improvement kata, consists of four main steps aimed at guiding the thought process of the improver(s): 1) defining a target or goal, 2) assessing the current state to gain a better understanding of the background, 3) establishing the target state, which represents what the process will look like when the goal is achieved, and 4) experimenting towards the target state.
- In the 6-therapist outpatient orthopedic clinic, which operates within a not-for-profit health system, the researchers had failed to meet the system quality goal for low back pain (LBP) over the past two years. Their goal is based on the metric known as failure to progress (FTP), which measures the percentage of patients who do not achieve a 30% improvement on the MDQ (or another outcome measure). By applying the improvement kata, the clinic hypothesized that by enhancing our adherence to the LBP care process, they could surpass our system FTP goal of 45.66% by June 24, 2024. The improvement kata proves to be an effective approach for leading quality improvement initiatives in an outpatient physical therapy setting. This framework offers a structured approach to problem-solving, enabling a standardized method for experimenting towards a target state and goal.
Thank you for joining us for this recap of the 2025 APTA CSM. We recommend visiting this link to explore all the posters presented at the event.
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