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An early intervention program for subacute physical disability related to musculoskeletal diseases in the elderly: a pilot study

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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.

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Acknowledgments

The authors are grateful to the staff at the department of Rheumatology of Hospital Clinico, especially to Angeles López de Benito, for their support and help during the study, as well as to all the coordinators of the primary care teams in centers where the study could be carried out. This work was supported by the Fondo de Investigaciones Sanitarias of the Spanish Ministry of Health (Grant FIS PI/041582); Fundación Mapfre 2005–2006; Obra Social Fundación La Caixa; Fundación Mutua Madrileña; and by the RETICS Program, RD08/0075 (RIER), from Instituto de Salud Carlos III (ISCIII), within the VI Plan Nacional de I+D+I 2008–2011 (FEDER).

Conflict of interest

All authors declare no conflicts of interest.

Author information

Authors and Affiliations

  1. Servicio de Reumatologia, Rheumatology Department, IdISSC, Hospital Clínico San Carlos, Calle Martín Lagos s/n, 28040, Madrid, Spain

    Lydia Abasolo, Leticia Leon, Cristina Lajas, Luis Rodriguez-Rodriguez & Juan Ángel Jover

  2. Instituto de Salud Musculoesqueletica, Madrid, Spain

    Loreto Carmona

  3. Geriatric Department, Hospital Gregorio Marañón, Madrid, Spain

    Jose Antonio Serra

  4. GAP Madrid Area, Madrid, Spain

    Agustín Reoyo

Authors
  1. Lydia Abasolo
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  2. Leticia Leon
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  3. Cristina Lajas
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  4. Loreto Carmona
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  5. Jose Antonio Serra
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  6. Agustín Reoyo
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  7. Luis Rodriguez-Rodriguez
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  8. Juan Ángel Jover
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The APDE Group

Corresponding author

Correspondence to Leticia Leon.

Additional information

The authors present in APDE Group are listed in “Appendix.”

Appendix: APDE Group (in alphabetical order)

Appendix: APDE Group (in alphabetical order)

Abásolo Alcázar L, Aguilera Reijas P, Arnalte Barrera M, Barrios Rueda E, Béjar Pérez J.M, Bermejo Viñedo J, Cabrera Velez R, Carmona L, Carravilla Parra J.R, Carreño Freire P, Cóndor Cubero M.L, Del Castillo Alemany M, Del Valle de Joz I, Estevez Muñoz J.C, Gil Alós I, Heras Salvat M.G, Jover Jover J.A, Lajas Petisco C.J, León Mateos L, Linares López L, Martín Hernández R, Melendro Estefanía I, Muñoz González R, Pérez Cea S, Polo Egido E, Pujol Bengochea P, Reoyo Jiménez A, Seijas Martínez-Echevarría M.J, Serra Rexach J.A.

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Abasolo, L., Leon, L., Lajas, C. et al. An early intervention program for subacute physical disability related to musculoskeletal diseases in the elderly: a pilot study. Rheumatol Int 35, 1183–1191 (2015). https://doi.org/10.1007/s00296-015-3223-3

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