Feasibility and acceptability of telephone-delivered cognitive-behavioral-based physical therapy for patients with traumatic lower extremity injury

Abstract

Purpose To determine feasibility and acceptability of a telephone-based Cognitive-Behavioral-Based Physical Therapy program for patients following traumatic lower extremity injury (CBPT-Trauma). Methods Patients were screened for high psychosocial risk factors and then completed the 6-week CBPT-Trauma program. Physical function, pain, and psychosocial outcomes were assessed at baseline and 6-months follow-up. Descriptive statistics assessed change in outcomes. Results Recruitment rate was 59%. Twenty-seven patients (73%) had a high psychosocial risk profile. Twelve patients completed the program and the follow-up assessment at 6 months and found the program to be very or extremely helpful to their overall recovery. All demonstrated a clinically meaningful increase in physical function. Six patients demonstrated a clinically relevant decrease in pain intensity, pain catastrophizing, and fear of movement. Seven patients reported a clinically meaningful increase in pain self-efficacy. Discussion Findings suggest that recruitment is feasible for CBPT-Trauma program. However, engagement in the CBPT-Trauma study was low. For those that completed the program, patients were satisfied with the CBPT-Trauma program and experienced meaningful improvement in psychosocial factors and patient-reported outcomes. This open pilot study highlights the importance of targeted treatment for patients at high-risk for poor outcomes and the potential for increased access to services through telephone-delivery.