This study was completed as a partial fulfillment toward Dr. Li's PhD degree, which was supported through the Canadian Institutes of Health Research (CIHR) Doctoral Research Award and the Canadian Arthritis Network Graduate Student Award.
Effectiveness of the primary therapist model for rheumatoid arthritis rehabilitation: A randomized controlled trial
Article first published online: 6 FEB 2006
Copyright © 2006 by the American College of Rheumatology
Arthritis Care & Research
Volume 55, Issue 1, pages 42–52, 15 February 2006
How to Cite
Li, L. C., Davis, A. M., Lineker, S. C., Coyte, P. C. and Bombardier, C. (2006), Effectiveness of the primary therapist model for rheumatoid arthritis rehabilitation: A randomized controlled trial. Arthritis & Rheumatism, 55: 42–52. doi: 10.1002/art.21692
- Issue published online: 6 FEB 2006
- Article first published online: 6 FEB 2006
- Manuscript Accepted: 4 AUG 2005
- Manuscript Received: 27 MAR 2005
- CIHR Fellowship Award
- Canadian Health Services Research Foundation/CIHR Health Services Chair
- Rheumatoid arthritis;
- Primary therapist model;
- Physical therapy;
- Occupational therapy;
- Randomized controlled trial
To compare the primary therapist model (PTM), provided by a single rheumatology-trained primary therapist, with the traditional treatment model (TTM), provided by a physical therapy (PT) and/or occupational therapy (OT) generalist, for treating patients with rheumatoid arthritis (RA).
Eligible patients were adults requiring rehabilitation treatment who had not received PT/OT in the past 2 years. Participants were randomized to the PTM or TTM group. The primary outcome was defined as the proportion of clinical responders who experienced a ≥20% improvement in 2 of the following measures from baseline to 6 months: Health Assessment Questionnaire, pain visual analog scale, and Arthritis Community Research and Evaluation Unit RA Knowledge Questionnaire.
Of 144 consenting patients, 33 (10 PTM participants, 23 TTM participants) dropped out without completing any followup assessment, leaving 111 for analysis (63 PTM participants, 48 TTM participants). The majority were women (PTM 87.3%, TTM 79.2%), with a mean age of 54.2 years and 56.8 years for the PTM and TTM groups, respectively. Average disease duration was 10.6 years and 13.2 years for each group, respectively. At 6 months, 44.4% of patients in the PTM group were clinical responders versus 18.8% in the TTM group (χ2 = 8.09, P = 0.004).
Compared with the TTM, the PTM was associated with better outcomes in patients with RA. The results, however, should be interpreted with caution due to the high dropout rate in the TTM group.