Evaluating the Feasibility of an Emergency Department Physical Therapy Intervention for Acute Low Back Pain

Abstract

Purpose: Integration of physical therapists into the emergency department (ED) setting is a relatively new practice in the United States. It is currently unknown whether patients are able to retain the skills and knowledge delivered during a brief ED physical therapy (PT) intervention, and whether patients participate in recommended home exercises or follow-up for a return visit. Methods: This is a prospective feasibility study of 30 ED patients with acute low back pain who were evaluated by an ED physical therapist, given individualized instruction in 3 prescribed home exercises, and discharged home with both printed and online instructions of the 3 prescribed exercises. Enrolled patients returned 1 week after their initial ED visit for an in-person demonstrated performance evaluation of the prescribed home exercises; patients also self-reported the frequency of home exercise performance in the week after ED discharge. Results: Thirty patients were enrolled, and 27 patients (90.0%) returned for the in-person evaluation at a median of 7.5 days. The most frequently prescribed exercises were prone positioning to press up on elbows (70.4% of participants), transverse abdominal contraction with posterior pelvic tilt (70.4%), and supine lower trunk rotation (44.4%). Twenty of 27 patients (74.0%) were able to successfully demonstrate performance of all 3 prescribed exercises. Participants reported performing any home exercise a median of 3 times (interquartile range 2-5) in the week following their index ED visit. Conclusions: A brief PT intervention delivered in the ED for acute low back pain is feasible with respect to patient follow-up, demonstrated performance of prescribed home exercises, and participation in home exercise therapy.