Health Services Research in Physical Therapy On The Rise

In just seven short years, researchers funded through the Center on Health Services Training and Research have published over 200 publications.

The Center on Health Services Training and Research (CoHSTAR) was first established with a five-year Foundation for Physical Therapy Research (FPTR) grant of $2.5 million in 2015. One of its primary goals was to increase the quantity and quality of physical therapy health services/health policy research. CoHSTAR-funded researchers have since published countless studies that provide data that better informs the efficacy of physical therapy practices and defines the value of physical therapy among payers, other health care professions, and patients.

In 2019, FPTR extended funding for the program for years 6 and 7. Seeing the continued growth, FPTR elected to extend the program once more for years 8, 9, and 10 – doubling the original scope of the grant to an investment of $1.25 million.

Funding of this one-of-a-kind institution would not have been possible without the support of our donors. Through your support, CoHSTAR has expanded the number of health services research studies, totaling 200 publications in less than 7 years in various areas. Below you will find some examples of published research studies.

Acute Care and Hospital Readmission

• A Person-Centered Approach to Poststroke Care: The COMprehensive Post-Acute Stroke Services Model.
  Bushnell, C. D., Duncan, P. W., Lycan, S. L., Condon, C. N., Pastva, A. M., Lutz, B. J., Rosamond, W. D. (2018). J Am Geriatr Soc, 66(5), 1025-1030. doi:10.1111/jgs.15322
• Patients With Greater Stroke Severity and Premorbid Disability Are Less Likely to Receive Therapist Consultations and Intervention During Acute Care Hospitalization.
  Capo-Lugo, C. E., Askew, R. L., Naidech, A., & Prabhakaran, S. (2019). Phys Ther, 99(11), 1431-1442. doi:10.1093/ptj/pzz116.
• Positive Beliefs the Likelihood of Successful Com-munity Discharge from Skilled Nursing Facilities.
  Evans, E., Kosar, C. M., & Thomas, K. S. (2020). Arch Phys Med Rehabil. doi:10.1016/j.apmr.2020.09.375
• Risk Predic-Tion For Unplanned Readmissions From Home Health Using Machine Learning.
  Falvey, J., Jones, C., Hess, E., Nuccio, E., Baron, A., & Stevens-Lapsley, J. (2018). Innovation in Aging, 2(Suppl 1), 989-989. doi:10.1093/geroni/igy031.3658.
• Preoperative Ac-tivities of Daily Living Dependency is Associated With Higher 30-Day Readmission Risk for Older Adults After Total Joint Arthroplasty.
  Falvey, J. R., Bade, M. J., Hogan, C., Forster, J. E., & Stevens-Lapsley, J. E. (2020). Clinical Orthopaedics and Related Research®, 478(2), 231-237. doi:10.1097/corr.0000000000001040

Arthroplasty or Total Joint Replacement

• Incremental clinical effectiveness and cost effectiveness of providing supervised physiotherapy in addition to usual medical care in patients with osteoarthritis of the hip or knee: 2-year results of the MOA randomized controlled trial.
  Abbott, J. H., Wilson, R., Pinto, D., Chapple, C. M., & Wright, A. A. (2019). Osteoarthritis Cartilage, 27(3), 424-434. doi:10.1016/j.joca.2018.12.004
• Physical therapy vs internet-based exercise training for patients with knee osteoarthritis: results of a randomized controlled trial.
  Allen, K. D., Arbeeva, L., Callahan, L. F., Golightly, Y. M., Goode, A. P., Heiderscheit, B. C., Schwartz, T. A. (2018). Osteoarthritis Cartilage, 26(3), 383-396. doi:10.1016/j.joca.2017.12.008.
• Home-Health-Care Physical Therapy Improves Early Functional Recovery of Medicare Beneficiaries After Total Knee Arthroplasty.
  Falvey, J. R., Bade, M. J., Forster, J. E., Burke, R. E., Jennings, J. M., Nuccio, E., & Stevens-Lapsley, J. E. (2018). J Bone Joint Surg Am, 100(20), 1728-1734. doi:10.2106/jbjs.17.01667
• A randomized trial of a motivational interviewing intervention to increase lifestyle physical activity and improve self-reported function in adults with arthritis.
  Gilbert, A. L., Lee, J., Ehrlich-Jones, L., Semanik, P. A., Song, J., Pellegrini, C. A., Chang, R. W. (2018). Semin Arthritis Rheum, 47(5), 732-740. doi:10.1016/j.semarthrit.2017.10.003.
• Development and Evaluation of the Boston University Osteoarthritis Functional Pain Short Form (BU-OA-FPS).
  Goode, A. P., Ni, P., Jette, A., & Fitzgerald, G. K. (2018). Phys Ther, 98(8), 715-724. doi:10.1093/ptj/pzy049.

Economic Evaluation or Clinical Effectiveness

• Incremental clinical effectiveness and cost effectiveness of providing supervised physiotherapy in addition to usual medical care in patients with osteoarthritis of the hip or knee: 2-year results of the MOA randomized controlled trial.
  Abbott, J. H., Wilson, R., Pinto, D., Chapple, C. M., & Wright, A. A. (2019). Osteoarthritis Cartilage, 27(3), 424-434. doi:10.1016/j.joca.2018.12.004.
• Cost-Effectiveness of Primary Care Management With or Without Early Physical Therapy for Acute Low Back Pain: Economic Evaluation of a Randomized Clinical Trial.
  Fritz, J. M., Kim, M., Magel, J. S., & Asche, C. V. (2017). Spine (Phila Pa 1976), 42(5), 285-290. doi:10.1097/brs.0000000000001729.
• Recommendations for the conduct of economic evaluations in osteoporosis: outcomes of an experts’ consensus meeting organized by the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) and the US branch of the International Osteoporosis Foundation.
  Hiligsmann, M., Reginster, J. Y., Tosteson, A. N. A., Bukata, S. V., Saag, K. G., Gold, D. T., Silver-man, S. (2019). Osteoporos Int, 30(1), 45-57. doi:10.1007/s00198-018-4744-x.
• High-Need Phenotypes in Medicare Beneficiaries: Drivers of Variation in Utilization and Outcomes.
  Keeney, T., Belanger, E., Jones, R. N., Joyce, N. R., Meyers, D. J., & Mor, V. (2020). J Am Geriatr Soc, 68(1), 70-77. doi:10.1111/jgs.16146.
• Time Between an Emergency Department Visit and Initiation of Physical Therapist Intervention: Health Care Utilization and Costs.
  Magel, J., Kim, J., Fritz, J. M., & Freburger, J. K. (2020). Physical Therapy, 100(10), 1782-1792. doi:10.1093/ptj/pzaa100

Diversity, Race and Racial Disparities

• Improvement During Inpatient Rehabilitation Among Older Adults With Guillain-Barré Syndrome, Multiple Sclerosis, Parkinson Disease, and Stroke.
  Andrews, A. W., & Middleton, A. (2018). Am J Phys Med Rehabil, 97(12), 879-884. doi:10.1097/phm.0000000000000991.
• Longer Time Before Acute Rehabilitation Therapy Worsens Disability After Intracerebral Hemorrhage.
  Capo-Lugo, C. E., Askew, R. L., Muldoon, K., Maas, M., Liotta, E., Prabhakaran, S., & Naidech, A. (2020). Arch Phys Med Rehabil, 101(5), 870-876. doi:10.1016/j.apmr.2019.11.006.
• Patients With Greater Stroke Severity and Premorbid Disability Are Less Likely to Receive Therapist Consultations and Intervention During Acute Care Hospitalization.
  Capo-Lugo, C. E., Askew, R. L., Naidech, A., & Prabhakaran, S. (2019). Phys Ther, 99(11), 1431-1442. doi:10.1093/ptj/pzz116.
• Association between general joint hypermobility and knee, hip, and lumbar spine osteoarthritis by race: a cross-sectional study.
  Flowers, P. P. E., Cleveland, R. J., Schwartz, T. A., Nelson, A. E., Kraus, V. B., Hillstrom, H. J., Golightly, Y. M. (2018). Arthritis Research & Therapy, 20(1), 76. doi:10.1186/s13075-018-1570-7.
• Biomarkers reflect differences in osteoarthritis phenotypes of the lumbar spine: the Johnston County Osteoarthritis Project.
  Goode, A. P., Nelson, A. E., Kraus, V. B., Renner, J. B., & Jordan, J. M. (2017). Osteoarthritis Cartilage, 25(10), 1672-1679. doi:10.1016/j.joca.2017.07.007.

Exercise or Physical Activity or Mobility

• Incremental clinical effectiveness and cost effectiveness of providing supervised physiotherapy in addition to usual medical care in patients with osteoarthritis of the hip or knee: 2-year results of the MOA randomized controlled trial.
  Abbott, J. H., Wilson, R., Pinto, D., Chapple, C. M., & Wright, A. A. (2019). Osteoarthritis Cartilage, 27(3), 424-434. doi:10.1016/j.joca.2018.12.004.
• Physical therapy vs internet-based exercise training for patients with knee osteoarthritis: results of a randomized controlled trial.
  Allen, K. D., Arbeeva, L., Callahan, L. F., Golightly, Y. M., Goode, A. P., Heiderscheit, B. C., Schwartz, T. A. (2018). Osteoarthritis Cartilage, 26(3), 383-396. doi:10.1016/j.joca.2017.12.008.
• Lessons Learned: The Difficulties of Incorporating Intensity Principles Into Inpatient Stroke Rehabilitation.
  Bowden, M. G., Monsch, E. D., Middleton, A., Daughtry, C., Powell, T., & Kraft, S. V. (2020). Archives of Rehabilitation Research and Clinical Translation, 2(2), 100052. doi:https://doi.org/10.1016/j.arrct.2020.100052.
• Physical Activity Minimum Threshold Predicting Improved Function in Adults With Lower-Extremity Symptoms.
  Dunlop, D. D., Song, J., Lee, J., Gilbert, A. L., Semanik, P. A., Ehrlich-Jones, L., Chang, R. W. (2017). Arthritis Care Res (Hoboken), 69(4), 475-483. doi:10.1002/acr.23181.
• A randomized trial of a motivational interviewing intervention to increase lifestyle physical activity and improve self-reported function in adults with arthritis.
  Gilbert, A. L., Lee, J., Ehrlich-Jones, L., Semanik, P. A., Song, J., Pellegrini, C. A., Chang, R. W. (2018). Semin Arthritis Rheum, 47(5), 732-740. doi:10.1016/j.semarthrit.2017.10.003.

Geriatrics or Older Adults

• Potential long-term impact of “On The Move” group-exercise program on falls and healthcare utilization in older adults: an exploratory analysis of a randomized controlled trial.
  Coyle, P. C., Perera, S., Albert, S. M., Freburger, J. K., VanSwearingen, J. M., & Brach, J. S. (2020). BMC Geriatr, 20(1), 105. doi:10.1186/s12877-020-1506-3.
• Development and Vali-dation of Person-Centered Cut-Points for the Figure-of-8-Walk Test of Mobility in Community-Dwelling Older Adults.
  Coyle, P. C., Perera, S., Shuman, V., VanSwearingen, J., & Brach, J. S. (2020). J Gerontol A Biol Sci Med Sci, 75(12), 2404-2411. doi:10.1093/gerona/glaa035.
• Home-Health-Care Physical Therapy Improves Early Functional Recovery of Medicare Beneficiaries After Total Knee Arthroplasty.
  Falvey, J. R., Bade, M. J., Forster, J. E., Burke, R. E., Jennings, J. M., Nuccio, E., & Stevens-Lapsley, J. E. (2018). J Bone Joint Surg Am, 100(20), 1728-1734. doi:10.2106/jbjs.17.01667.
• Same But Different: FIM Summary Scores May Mask Variability in Physical Functioning Profiles.
  Fisher, S. R., Middleton, A., Graham, J. E., & Ottenbacher, K. J. (2018). Arch Phys Med Rehabil, 99(8), 1479-1482.e1471. doi:10.1016/j.apmr.2018.01.016.
• Effects of a Home-Based Telephone-Supported Physical Activity Program for Older Adult Veterans With Chronic Low Back Pain.
  Goode, A. P., Taylor, S. S., Hastings, S. N., Stanwyck, C., Coffman, C. J., & Allen, K. D. (2018). Phys Ther, 98(5), 369-380. doi:10.1093/ptj/pzy026.

Home Health, Skilled Nursing Facilities or Inpatient Rehabilitation

• Improvement During Inpatient Rehabilitation Among Older Adults With Guillain-Barré Syndrome, Multiple Sclerosis, Parkinson Disease, and Stroke.
  Andrews, A. W., & Middleton, A. (2018). Am J Phys Med Rehabil, 97(12), 879-884. doi:10.1097/phm.0000000000000991
• Lessons Learned: The Difficulties of Incorporating Intensity Principles Into Inpatient Stroke Rehabilitation.
  Bowden, M. G., Monsch, E. D., Middleton, A., Daughtry, C., Powell, T., & Kraft, S. V. (2020). Archives of Rehabilitation Research and Clinical Translation, 2(2), 100052. doi:https://doi.org/10.1016/j.arrct.2020.100052.
• Positive Beliefs the Likelihood of Successful Com-munity Discharge from Skilled Nursing Facilities.
  Evans, E., Kosar, C. M., & Thomas, K. S. (2020). Arch Phys Med Rehabil. doi:10.1016/j.apmr.2020.09.375
• Risk Prediction For Unplanned Readmissions From Home Health Using Machine Learning.
  Falvey, J., Jones, C., Hess, E., Nuccio, E., Baron, A., & Stevens-Lapsley, J. (2018). Innovation in Aging, 2(Suppl 1), 989-989. doi:10.1093/geroni/igy031.3658
• Home-Health-Care Physical Therapy Improves Early Functional Recovery of Medicare Beneficiaries After Total Knee Arthroplasty.
  Falvey, J. R., Bade, M. J., Forster, J. E., Burke, R. E., Jennings, J. M., Nuccio, E., & Stevens-Lapsley, J. E. (2018). J Bone Joint Surg Am, 100(20), 1728-1734. doi:10.2106/jbjs.17.01667.

Osteoarthritis or Low Back Pain

• Incremental clinical effectiveness and cost effectiveness of providing supervised physiotherapy in addition to usual medical care in patients with osteoarthritis of the hip or knee: 2-year results of the MOA randomized controlled trial.
  Abbott, J. H., Wilson, R., Pinto, D., Chapple, C. M., & Wright, A. A. (2019). Osteoarthritis Cartilage, 27(3), 424-434. doi:10.1016/j.joca.2018.12.004
• Physical therapy vs internet-based exercise training for patients with knee osteoarthritis: results of a randomized controlled trial.
  Allen, K. D., Arbeeva, L., Callahan, L. F., Golightly, Y. M., Goode, A. P., Heiderscheit, B. C., Schwartz, T. A. (2018). Osteoarthritis Cartilage, 26(3), 383-396. doi:10.1016/j.joca.2017.12.008
• Physical Activity Minimum Threshold Predicting Improved Function in Adults With Lower-Extremity Symptoms.
  Dunlop, D. D., Song, J., Lee, J., Gilbert, A. L., Semanik, P. A., Ehrlich-Jones, L., Chang, R. W. (2017). Arthritis Care Res (Hoboken), 69(4), 475-483. doi:10.1002/acr.23181
• Association between general joint hypermobility and knee, hip, and lumbar spine osteoarthritis by race: a cross-sectional study.
  Flowers, P. P. E., Cleveland, R. J., Schwartz, T. A., Nelson, A. E., Kraus, V. B., Hillstrom, H. J., Golightly, Y. M. (2018). Arthritis Research & Therapy, 20(1), 76. doi:10.1186/s13075-018-1570-7.
• A randomized trial of a motivational interviewing intervention to increase lifestyle physical activity and improve self-reported function in adults with arthritis.
  Gilbert, A. L., Lee, J., Ehrlich-Jones, L., Semanik, P. A., Song, J., Pellegrini, C. A., Chang, R. W. (2018). Semin Arthritis Rheum, 47(5), 732-740. doi:10.1016/j.semarthrit.2017.10.003.

Stroke

• Potential long-term impact of “On The Move” group-exercise program on falls and healthcare utilization in older adults: an exploratory analysis of a randomized controlled trial.
  Coyle, P. C., Perera, S., Albert, S. M., Freburger, J. K., VanSwearingen, J. M., & Brach, J. S. (2020). BMC Geriatr, 20(1), 105. doi:10.1186/s12877-020-1506-3
• Home-Health-Care Physical Therapy Improves Early Functional Recovery of Medicare Beneficiaries After Total Knee Arthroplasty.
  Falvey, J. R., Bade, M. J., Forster, J. E., Burke, R. E., Jennings, J. M., Nuccio, E., & Stevens-Lapsley, J. E. (2018). J Bone Joint Surg Am, 100(20), 1728-1734. doi:10.2106/jbjs.17.01667
• Preoperative Activities of Daily Living Dependency is Associated With Higher 30-Day Readmission Risk for Older Adults After Total Joint Arthroplasty.
  Falvey, J. R., Bade, M. J., Hogan, C., Forster, J. E., & Stevens-Lapsley, J. E. (2020). Clinical Orthopaedics and Related Research®, 478(2), 231-237. doi:10.1097/corr.0000000000001040
• Cost-Effectiveness of Primary Care Management With or Without Early Physical Therapy for Acute Low Back Pain: Economic Evaluation of a Randomized Clinical Trial.
  Fritz, J. M., Kim, M., Magel, J. S., & Asche, C. V. (2017). Spine (Phila Pa 1976), 42(5), 285-290. doi:10.1097/brs.0000000000001729.

Timing and Utilization Of Care

Potential long-term impact of “On The Move” group-exercise program on falls and healthcare utilization in older adults: an exploratory analysis of a randomized controlled trial.
Coyle, P. C., Perera, S., Albert, S. M., Freburger, J. K., VanSwearingen, J. M., & Brach, J. S. (2020). BMC Geriatr, 20(1), 105. doi:10.1186/s12877-020-1506-3