FOTO Rehab Outcomes Blog

Utilization of Physical Therapists for Plantar Fasciitis

Written by Selena Horner | Mar 6, 2017 11:00:00 AM

 I'm sure many physical therapists have a different perspective than myself with regard to the utilization of physical therapists for this condition.

What this claims data does not capture is at what point in time did the person seek services for foot pain. During the time period in which this study occurred, direct access for physical therapy services wasn't as predominant across the United States.  During this time period, it would be highly unlikely that a person with foot pain would even think about seeing a physical therapist.

Another aspect to consider: if a person is seeking services in the early stage, it is quite probable that the self-management recommendations may have been successful. 

I know 7% seems quite low. What we don't know is if there was a cost difference between no physical therapist involved or a physical therapist involved. What we don't know is if there is a difference in the outcomes of the care.

Please note: my thoughts are based on the abstract.

Here's a quick view of the abstract. 

Utilization of Physical Therapy Intervention Among Patients With Plantar Fasciitis in the United States.

Abstract

Study Design: Retrospective observational study.

Background: Plantar fasciitis is responsible for 1 million ambulatory patient care visits annually in the United States. Few studies have investigated practice patterns in the treatment of patients with plantar fasciitis.

Objective: To assess physical therapist utilization and employment of manual therapy and supervised rehabilitation in the treatment of patients with plantar fasciitis.

Methods: A retrospective review of the PearlDiver patient record database was used to evaluate physical therapist utilization and use of manual therapy and supervised rehabilitation in patients with plantar fasciitis between 2007 and 2011. An International Classification of Diseases code (728.71) was used to identify plantar fasciitis, and Current Procedural Terminology codes were used to identify evaluations (97001), manual therapy (97140), and rehabilitation services (97110, 97530, 97112).

Results: A total of 819 963 unique patients diagnosed with plantar fasciitis accounted for 5 739 737 visits from 2007 to 2011, comprising 2.7% of all patients in the database. Only 7.1% (95% confidence interval: 7.0%, 7.1%) of patients received a physical therapist evaluation. Of the 57 800 patients evaluated by a physical therapist (59.8% female), 50 382 (87.2% ± 0.4%) received manual therapy, with significant increases in utilization per annum. A large proportion (89.5% ± 0.4%) received rehabilitation following physical therapist evaluation.

Conclusion: Despite plantar fasciitis being a frequently occurring musculoskeletal condition, a small proportion of patients with plantar fasciitis were seen by physical therapists. Most patients who were evaluated by a physical therapist received manual therapy and a course of supervised rehabilitation as part of their plan of care. Level of Evidence Treatment, level 2a. 

J Orthop Sports Phys Ther. 2017 Feb;47(2):49-55. doi: 10.2519/jospt.2017.6999.