An Educational Intervention for Physical Therapists to Promote Dietary Counseling in Patients with Osteoarthritis

Abstract

Objective: To assess the feasibility of an educational intervention on influencing physical therapist (PT) practice behaviors to include nutrition counseling or dietician referrals for the management of patients with osteoarthritis (OA). Background: Over 30 million Americans suffer from OA, which is an insidious disease, representing one of the leading causes of physical disability. Symptoms are due to the deterioration of articular cartilage and alterations of extracellular matrix. Obesity and poor nutrition are the greatest modifiable risk factors. Obesity induces the production of pro-inflammatory cytokines, which are associated with pathological processes of OA. Special attention has been given to the Mediterranean Diet (MD) for its anti-inflammatory properties. Nutritional counseling and dietary modification can supplement PT treatments in the management of OA. PTs are in an ideal position to encourage health promoting behaviors and self-management by addressing nutritional concerns in OA patients. Methods: A one-group pre-test post-test quantitative design was employed to evaluate improvements in PTs’ knowledge and attitudes. Provider education involved a brief educational intervention utilizing “It’s Your MOVE” brochure. A convenience sample of six participants were recruited at CORE Physical Therapy in Orange County, CA. Results: Six participants completed the pre-test and post-test questionnaires. Descriptive statistics demonstrated a significant improvement in post-intervention knowledge. A 76.7% change was observed. Effectiveness of the intervention on provider knowledge was likely due to the educational seminar. Limitations in PT practice was the main barrier for lack of nutrition counseling. Likelihood for practice change demonstrated variable results ranging from unlikely to absolutely. Conclusion: There is a need to improve PT involvement in health promotion efforts for OA patients. Reducing barriers in PT practice will allow providers to integrate nutrition counseling and improve interprofessional collaborations with dietitians in OA care plans. Despite the effectiveness of the education intervention, reservations regarding state practice laws heavily influenced PTs’ practice behaviors.