Number of physical therapy visits and patient satisfaction in individuals with temporomandibular disorder: a cohort study.  

AUTHORS: Prodoehl, J.,1 Kraus, S.2, Buros Stein, A.3

AFFILIATIONS:

1 Physical Therapy Program, Midwestern University, 555 31st Street, Downers Grove, IL 60515, USA

2 Horizon Physical Therapy LLC, 3661 North Stratford Road NE, Atlanta, GA 30342, USA

3 Office of Research and Sponsored Programs, Midwestern University, 19555 N 59th Ave. Glendale, AZ 85308, USA

AIM OF INVESTIGATION:
To examine intake factors collected during a physical therapy (PT) evaluation in a cohort of individuals with temporomandibular disorder (TMD) to determine which factors were inversely associated with number of PT visits and patient satisfaction.

METHODS:
Data from 511 patients referred over 18 months were reviewed to extract 29variables from the history and physical exam to develop a predictive model.  Outcomes were patient satisfaction and the number of PT visits. Linear and negative binomial regression assessed the relationship between variables and the outcomes of interest.  A multivariate regression model was built for both outcomes.

RESULTS:
Two factors were associated with lower satisfaction and with an increased number of PT visits: higher initial patient rated neck disability and a greater number of healthcare professionals seen before starting PT. Other factors associated with satisfaction were duration of symptoms, subluxation, and referral from an oral surgeon.  Only neck disability was a significant predictive factor in the multivariate model. Factors associated with number of PT visits were gender, educational level, time between initial visit and discharge, number of pain areas, bruxism, biopsychosocial factors, dizziness, resting pain, and neck pain. In the overall multivariate model, gender, the number of healthcare professionals seen, and resting pain rating were significant predictors of the number of visits.

CONCLUSIONS:
Results will inform all members of the interdisciplinary team about expectations from a PT episode of care for TMD by identifying factors that are likely to impact the length of treatment as well as patient satisfaction.

ACKNOWLEDGEMENTS AND/OR FUNDING SOURCE: None