title: An early intervention program for subacute physical disability related to musculoskeletal diseases in the elderly: a pilot study.
abstract: To evaluate the efficacy of a program for subacute physical disability due to musculoskeletal disorders (MSD) in the elderly. We carried out a randomized controlled evaluator-blinded intervention study in a health district (October 2005 to April 2008). Subjects older than 64, starting a subacute MSD episode of physical disability-defined as moderate disability or higher in the Rosser classification-and identified by general practitioners, were randomized into standard care or an early specific program. The program was carried out by rheumatologists following detailed proceedings. Efficacy was defined as the difference between groups in the duration of episodes-time from onset until an improvement larger than a point in the Rosser classification). Hazard ratios (HR) to recovery of the program over standard care were obtained from Cox regression analyses. One hundred and twenty-three patients were included, generating 244 episodes of subacute MSD. Mean duration of episodes was 5 months; 14.5 % of them were chronically disabled throughout follow-up. The program was associated with shorter duration of episodes compared with CG analyzing just the ended ones (p = 0.004). The HR to recovery between groups did not achieve statistical differences. Nevertheless, recovery rate at 12 months and HR from those with moderate physical disability at the inclusion period (Rosser disability level 4, n = 84) were superior in the IG (HR 1.9, p = 0.03; HR 1.93; p = 0.03 respectively). An early intervention program for subacute MSD-related disability in elderly has partial efficacy; the program benefited patients with moderate physical disability and after a year of follow-up.
authors: Servicio de Reumatologia, Rheumatology Department, IdISSC, Hospital Clínico San Carlos, Calle Martín Lagos s/n, 28040, Madrid, Spain.
authors: Lydia
authors: L
authors: Abasolo
authors: Leticia
authors: L
authors: Leon
authors: Cristina
authors: C
authors: Lajas
authors: Loreto
authors: L
authors: Carmona
authors: Jose Antonio
authors: JA
authors: Serra
authors: Agustín
authors: A
authors: Reoyo
authors: Luis
authors: L
authors: Rodriguez-Rodriguez
authors: Juan Ángel
authors: JÁ
authors: Jover
mesh_terms: D000367:Age Factors; D000368:Aged; D004185:Disability Evaluation; D061345:Early Medical Intervention; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D009140:Musculoskeletal Diseases / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D010865:Pilot Projects; D015397:Program Evaluation; D016016:Proportional Hazards Models; D020127:Recovery of Function; D012720:Severity of Illness Index; D013030:Spain; D013997:Time Factors; D016896:Treatment Outcome
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