title: Taking a new course in research on the effectiveness of interventions. A study of physiotherapy interventions for people with musculoskeletal complaints.
abstract: Physiotherapy is a commonly employed intervention for people with musculoskeletal complaints. However, due to (methodological) limitations in previous research, the effectiveness of physiotherapy interventions has not yet been proven. The aim of the present study is twofold. First we try to solve some of the methodological problems, of which the most important are selection and endogeneity biases and state dependence. Secondly, the effect of a physiotherapy intervention on recovery from musculoskeletal complaints is investigated. The probability of receiving a physiotherapy intervention is estimated, as well as the probability of recovery as a result of this intervention. A longitudinal design is used. Analyses are performed using secondary data on a populational level. The analytical framework is provided by a Markov model. We use a logit model to estimate transition probabilities of this Markov model. Results show that experience with physiotherapy in the past is an important predictor for receiving physiotherapy in the future. Other predictors of the chance of receiving an intervention are also identified. Furthermore, results indicate that the effect of a physiotherapy intervention on recovery is negative. It is concluded that both the latter effect and the effect of intervention experience can partly be explained by medicalization, in spite of a presence of "severe" cases in the intervention group.
authors.affiliation: The Maastricht Health Research Institute for Prevention and Care, Department of Health Organisation, Policy and Economics, Faculty of Health Sciences, Maastricht University, PO Box 616, 6200 MD Maastricht, The Netherlands. C.Joling@beoz.unimaas.nl
authors.forename: Catelijne
authors.initials: C
authors.lastname: Joling
authors.forename: Wim
authors.initials: W
authors.lastname: Groot
authors.forename: Peter P M
authors.initials: PP
authors.lastname: Janssen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015984:Causality; D005260:Female; D006801:Humans; D016013:Likelihood Functions; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008390:Markov Chains; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000534:rehabilitation*; D026741:Physical Therapy Modalities / Q000706:statistics & numerical data; D020127:Recovery of Function; D012008:Recurrence; D015983:Selection Bias; D016896:Treatment Outcome; D006113:United Kingdom