Physical therapy services for older adults with at least moderately severe hip or knee arthritis in 2 Ontario counties.

Objective: Physical therapy (PT) is a recommended treatment for the management of arthritis. We investigated factors related to referral to PT services in people with hip or knee arthritis and describe characteristics of treatment received.

Methods: As part of a longitudinal study of the population aged > or = 55 years with at least moderately severe hip or knee arthritis in 2 Ontario counties (n = 1350), participants were surveyed in the third year of followup about use of PT. Participants were categorized as to whether they had total joint replacement surgery in the past year (TJR group, n = 52) or did not (non-TJR group, n = 1298). Multivariate logistic regression was used to identify determinants of referral to PT considering sociodemographic characteristics, comorbidity, use of prescribed arthritis medication, and arthritis severity (WOMAC summary score).

Results: Overall, 18.7% of the cohort was referred to PT in the past year: 65.4% of the TJR group and 16.8% of the non-TJR group. The only significant predictor of PT in the TJR group was current use of prescribed arthritis medication. Greater arthritis severity, current use of prescribed arthritis medication, and greater comorbidity were significant independent predictors of referral to PT for the non-TJR group in multivariate logistic regression. The Ontario Health Insurance Plan paid for the majority of PT received.

Conclusion: Low rates of referral to PT in the previous year suggest possible underutilization. Further research is needed to examine patterns of use of PT throughout the course of the arthritis disease process and to examine barriers to PT access.