COVID-19 has rightfully become the focus of much of the discussion around health care, but interesting findings in other areas continued to emerge during the pandemic. Here's the third installment in our roundup series of notable research released over the past few months.

1. Early Startup of Pulmonary Rehab Reduces Mortality Risk After One Year for Individuals with COPD
A large retrospective study of nearly 200,000 Medicare beneficiaries with chronic obstructive pulmonary disease has revealed that risk of mortality after one year drops significantly if pulmonary rehab is begun 30 or fewer days after hospital discharge, and that pulmonary rehab started between 61 and 90 days also lowers risk, albeit at a lower rate. Authors found that every three sessions of pulmonary rehab were associated with lower risk of death. (JAMA, May 12, 2020)

2. Frequent Physical Therapy Sessions Make a Big Difference in Patients With Lumbar Spinal Stenosis
While most researchers agree that patients with LSS benefit from physical therapy to help reduce disability and leg pain, authors of this study wanted to find out the relationship between the number of physical therapy sessions attended and the related therapeutic effects. The study focused on three groups over six weeks: LSS patients receiving supervised physical therapy twice a week, those receiving physical therapy once a week, and a third group that received only instructions on home exercise. After six weeks, the 2X group showed significant improvements in function and in back and leg pain compared with both the 1X group and home exercise group. Researchers also found no significant differences in change after six weeks between the 1X and home exercise groups. (Spine, June 2020)

3. Adding Low-Dose Strength Training Doesn't Seem to Improve Outcomes for Knee OA
A study of 90 patients with knee OA tracked exercise interventions during twice-weekly physical therapy sessions conducted over 12 weeks that, for one group, consisted of neuromuscular exercise and education only and, for the other, included additional low-dose strength training — a single, fatiguing knee extension set and four sets of leg-press exercises. Researchers found that the addition of strength training did not result in improvements in self-reported physical function compared with the group that received neuromuscular exercise and education only. (Osteoarthritis and Cartilage, June 2020)

4. Physical Therapy Referrals for Vertigo and Other Vestibular Disorders Remain Low
Researchers who reviewed 5.6 million adult visits for benign paroxysmal positional vertigo and 6.6 million visits for peripheral vestibular disorders in ambulatory care clinics in the U.S. found that referral for physical therapy remain relatively low. Referrals for BPPV doubled from 6.2% during 2004-2006 to 12.9% during 2013-2015. Referrals for PVDs decreased, from 3.8% between 2004 and 2006 to 0.5% in the 2013-2015 study period. Compared with otolaryngologists, primary care physicians were less likely to make a physical therapy referral for other PVDs. (Archives of Physical Medicine and Rehabilitation, May 2020)

5. Physical Therapy Post-THA Works, but Questions Remain About Cost-Effectiveness
This systematic review and meta-analysis looked at 20 studies from a variety of countries and found that physical therapy interventions increased functional performance, hip muscle strength, and range of motion while decreasing pain following total hip arthroplasty. And while findings from the UK's National Health Service determined that an accelerated physical therapy program post-THA was cost-effective, other studies questioned cost-effectiveness. The studies reviewed spanned observation periods ranging from two weeks to 12 months. (Rheumatology International, May 2020)

6. Adding PTs to the Emergency Department Reduces Imaging, Opioid Administration, and Length-of-Stay for Patients Reporting MSK Pain
Over an 18-month study period, researchers tracked data from an urban academic emergency department in Salt Lake City, Utah, that included a PT on-site three days a week. Authors of the study compared patients presenting with musculoskeletal pain who received treatment from a PT in the ED with those who didn't. They found that the PT-treated patients received less imaging (38.3% compared with 51%) and less opioid administration (17.5% compared with 32.9%). The patients treated by a PT also reported a lower average length-of-stay — four hours versus 6.2 hours for the non-PT group. (PLOS One, April 2020)