Month: March 2021

Objective
The objective of this study was to xamine primary factors which may predict patients’ failure to show at initial physical therapist evaluation in an orthopedic and sports outpatient setting.
Methods
A retrospective analysis of patients’ demographic data for physical therapist evaluations between January 2013 and April 2015 was performed. A binary logistic regression model was used to evaluate the odds of a no-show at evaluation. Demographic variables of age, employment status, days waited for the appointment, payer source, and distance traveled to clinic were analyzed. Independent variables were considered significant if the 95% Cis of the odds ratios did not include 1.0.
Results
A total of 6971 patients were included in the final analysis with 10% (n = 698) of the scheduled patients having a no-show event for their initial evaluation. The following factors increased the odds of patients having a no-show event: days to appointment (OR = 1.058; 95% CI = 1.042 to 1.074), unemployment status (OR = 1.96; 95% CI = 1.41 to 2.73), unknown employment status (OR = 3.22; 95% CI = 1.12 to 8.69), Medicaid insurance (OR = 4.87; 95% CI = 3.43 to 6.93), Medicare insurance (OR = 2.22; 95% CI = 1.10 to 4.49), unknown payer source (OR = 262.84; 95% CI = 188.72 to 366.08), and distance traveled ≥5 miles (OR = 1.31; 95% CI = 1.01 to 1.70). Female sex [OR = 0.73; 95% CI = 0.57 to 0.95) and age ≥ 40 years (OR = 0.44; 95% CI = 0.33 to 0.60) decreased the odds of a no-show event.
Conclusion
Results from this study indicate there may be some demographic factors that are predictive of patients failing to attend their first physical therapist visit.
Impact
Understanding the predictive factors and identifying potential opportunities for improvements in scheduling processes might help decrease the number of patients failing to show for their initial physical therapy appointment, with the ultimate goal of positively influencing patient outcomes.

Background
The lifetime prevalence of low back pain (LBP) is high and recurrence is common. Graded motor imagery is a treatment method used in patients with chronic pain that has 3 stages: left/right discrimination or laterality recognition, explicit motor imagery, and mirror therapy.
Case Presentation
A 33-year-old man self-referred to physical therapy for chronic LBP. He demonstrated misconstrued beliefs regarding his LBP, impaired laterality recognition, and fear-avoidance behaviors.
Outcome and Follow-Up
This “monkey see, monkey do” approach, in conjunction with other interventions, resulted in a 10% improvement of modified Oswestry Disability Index score, greater than 90% laterality accuracy, and a reduction in pain levels.
Discussion
Graded motor imagery can facilitate sensory cortex reorganization. A unique approach to improving laterality recognition was demonstrated in this case: the patient could not improve his laterality scores to acceptable levels until he watched his wife successfully complete the task. JOSPT Cases 2021;1(1):61–67. doi:10.2519/josptcases.2021.9875

Dr. Cody Mansfield PT, DPT, OCS, AT, FAAOMPT
Dr. Matt Briggs PT, DPT, AT, PhD