{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T09:00:05Z","timestamp":1791622805472,"version":"4.3.4"},"reference-count":52,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2020,12,22]],"date-time":"2020-12-22T00:00:00Z","timestamp":1608595200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"US Department of Health and Human Services, Agency for Healthcare Research and Quality","award":["K12HS023011"],"award-info":[{"award-number":["K12HS023011"]}]},{"DOI":"10.13039\/100012663","name":"Davee Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100012663","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000016","name":"US Department of Health and Human Services","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100000016","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","award":["P50DA044121"],"award-info":[{"award-number":["P50DA044121"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,3,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>Low back pain accounts for nearly 4 million emergency department (ED) visits annually and is a significant source of disability. Physical therapy has been suggested as a potentially effective nonopioid treatment for low back pain; however, no studies to our knowledge have yet evaluated the emerging resource of ED-initiated physical therapy. The study objective was to compare patient-reported outcomes in patients receiving ED-initiated physical therapy and patients receiving usual care for acute low back pain.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This was a prospective observational study of ED patients receiving either physical therapy or usual care for acute low back pain from May 1, 2018, to May 24, 2019, at a single academic ED (&amp;gt;91,000 annual visits). The primary outcome was pain-related functioning, assessed with Oswestry Disability Index (ODI) and Patient-Reported Outcomes Measurement Information System pain interference (PROMIS-PI) scores. The secondary outcome was use of high-risk medications (opioids, benzodiazepines, and skeletal muscle relaxants). Outcomes were compared over 3\u00a0months using adjusted linear mixed and generalized estimating equation models.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>For 101 participants (43 receiving ED-initiated physical therapy and 58 receiving usual care), the median age was 40.5\u00a0years and 59% were women. Baseline outcome scores in the ED-initiated physical therapy group were higher than those in the usual care group (ODI\u00a0=\u00a051.1 vs 36.0; PROMIS-PI\u00a0=\u00a067.6 vs 62.7). Patients receiving ED-initiated physical therapy had greater improvements in both ODI and PROMIS-PI scores at the 3-month follow-up (ODI\u00a0=\u00a0\u221214.4 [95% CI\u00a0=\u00a0\u221223.0 to \u22125.7]; PROMIS-PI\u00a0=\u00a0\u22125.1 [95% CI\u00a0=\u00a0\u22129.9 to \u22120.4]) and lower use of high-risk medications (odds ratio\u00a0=\u00a00.05 [95% CI\u00a0=\u00a00.01 to 0.58]).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>In this single-center observational study, ED-initiated physical therapy for acute low back pain was associated with improvements in functioning and lower use of high-risk medications compared with usual care; the causality of these relationships remains to be explored.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Impact<\/jats:title>\n                  <jats:p>ED-initiated physical therapy is a promising therapy for acute low back pain that may reduce reliance on high-risk medications while improving patient-reported outcomes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Lay Summary<\/jats:title>\n                  <jats:p>Emergency department\u2013initiated physical therapy for low back pain was associated with greater improvement in functioning and lower use of high-risk medications over 3\u00a0months.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ptj\/pzaa219","type":"journal-article","created":{"date-parts":[[2020,12,18]],"date-time":"2020-12-18T17:23:42Z","timestamp":1608312222000},"source":"Crossref","is-referenced-by-count":26,"title":["A Prospective Observational Study of Emergency Department\u2013Initiated Physical Therapy for Acute Low Back Pain"],"prefix":"10.1093","volume":"101","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1934-4829","authenticated-orcid":false,"given":"Howard S","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine , Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA"},{"name":"Center for Health Services and Outcomes Research , Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jody D","family":"Ciolino","sequence":"additional","affiliation":[{"name":"Division of Biostatistics , Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"Lancki","sequence":"additional","affiliation":[{"name":"Division of Biostatistics , Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyle J","family":"Strickland","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Services , Northwestern Memorial Hospital, Chicago, Illinois, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Pinto","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy , Marquette University College of Health Sciences, Milwaukee, Wisconsin, USA"},{"name":"Department of Medical Social Sciences , Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Stankiewicz","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Services , Northwestern Memorial Hospital, Chicago, Illinois, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D Mark","family":"Courtney","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine , University of Texas Southwestern Medical 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