title: Patient age is related to the types of physical therapy interventions provided for chronic low back pain: an observational study.
abstract: METHODS
  Retrospective analysis of a longitudinal cohort of patients treated for chronic low back pain (CLBP).
  
  
  OBJECTIVE
  To determine whether patient age is associated with types of physical therapy interventions received for CLBP.
  
  
  BACKGROUND
  Advancing age is associated with less positive treatment outcomes in patients with CLBP. If patient age influences a therapist's choice of interventions, it may partially explain the difference in treatment outcomes.
  
  
  METHODS
  Data were examined in a sample of 7392 patients (62% women, 38% men; mean ± SD age, 56.7 ± 16.5 years) with CLBP. We used a generalized estimating equation to examine the probability of each subject receiving each of the individual intervention categories in the presence of the other intervention categories.
  
  
  RESULTS
  A significant interaction between intervention category and age existed after controlling for gender, duration of symptoms, comorbidities, payer source, and functional status at initial intake (χ(2) = 130.27, df = 8, P<.0001). The changes in probability of receiving an intervention category averaged 10% as patient age increased. The probability of receiving exercise or task-specific training did not change with advancing age. The probability of receiving postural exercises, pain modalities, joint mobility techniques, ice, or McKenzie exercises decreased with advancing age. The probability of receiving augmented soft tissue mobilization and balance/mobility training increased as age increased.
  
  
  CONCLUSIONS
  The impact of age on physical therapist treatment choices varies depending on the type of intervention. Other variables in addition to age may have an impact on treatment choice. Further research is needed to determine how therapists incorporate age into their clinical decision making.
authors.affiliation: Associate Professor, Department of Physical Therapy, Ithaca College, Ithaca, NY.
authors.forename: Hilary B
authors.initials: HB
authors.lastname: Greenberger
authors.forename: Katherine
authors.initials: K
authors.lastname: Beissner
authors.forename: Dianne V
authors.initials: DV
authors.lastname: Jewell
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D002908:Chronic Disease; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D026741:Physical Therapy Modalities / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D016896:Treatment Outcome