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Chronic Disease

Approximately 50% of all Canadians are living with at least one chronic health condition. Many of these patients are receiving team-based primary health care, where they can benefit from accessing a wide range of providers, including physiotherapists, for management and prevention of future health problems.

 

Role of Physiotherapy in Chronic Disease

Research strongly supports the role of physiotherapists in the prevention, treatment and
management of chronic diseases, including hypertension, emphysema, Type 2 diabetes,
Parkinson’s, arthritis and obesity. Physiotherapy interventions, including exercise prescription,
facilitate patient participation in programs that enhance and maintain physical well-being which
has a significant impact on quality of life (QOL) and future use of health care services.

Impact on Patient Experience

Physiotherapy interventions for chronic disease prevention and management, including exercise
prescription and education, take into account the individual’s medical condition and needs.

Patients report that physiotherapy management of their chronic conditions results in:

• Decreased pain and shortness of breath, or dyspnea.
• Increased confidence and commitment to exercise, which positively impacts
health-related QOL.
• Enhanced social interaction, also improving QOL.

Impact on Population Health
Exercise is essential in the prevention, management and treatment of chronic diseases.
• Physiotherapy interventions target mobility and improve QOL for individuals with chronic
diseases and conditions such as multiple sclerosis, chronic heart failure and lymphedema
related to breast cancer.
• Physiotherapist- supervised inpatient exercise rehabilitation reduces physical impairment
and improves functional ability and exercise capacity in individuals with Type 2 diabetes.
• Physiotherapy programs enhance and maintain physical well-being for those with
chronic conditions.

The Value of Physiotherapy

Chronic disease prevention programs that focus on exercise, education and self-management
strategies reduce future use of health care resources.
• Physiotherapy assessment and individualized exercise program strategies with telephone
follow-up reduces the number of emergency visits, and hospital emergency and health
service utilization.
• Physiotherapy management of chronic diseases, such as osteoarthritis, alleviates wait times
for physician services by addressing pain and functional issues and reduces the need for
more costly surgical interventions.
• Patient self-management of chronic conditions is an efficient, effective, and sustainable use
of health care resources.

Summary
There is strong evidence that physiotherapy interventions, including exercise prescription and
self-management support, are effective in the prevention and management of chronic conditions.

 

© 2012 Canadian Physiotherapy Association. All rights reserved.

 

Key References:
1. Health Council of Canada. (2012). Self-management support for Canadians with chronic health conditions: a focus on primary health care. Toronto.
Health Council of Canada.
2. Valuation of Physiotherapy Services in Canada; CPA report using MCDA analysis for determining value of physiotherapy services; Mitton G;
Dionne F. 2012.
3. Clemens KE, Jaspers B, Klaschik E, Nieland P. Evaluation of the clinical effectiveness of physiotherapeutic management of lymphedema in
palliative care patients. Jpn J Clin Oncol. 2010;40(11):1068-72.
4. Park YH, Song M, Cho BL, Lim JY, Song W, Kim SH. The effects of an integrated health education and exercise program in community-dwelling
older adults with hypertension: a randomized controlled trial. Patient Educ Couns. 2011;82(1):133-7.
5. Adami PE, Negro A, Lala N, Martelletti P. The role of physical activity in the prevention and treatment of chronic diseases. Clin Ter. 2010;161(6):537-41.
6. Buraga I, Davidescu I, Nica S, Mihailescu G. Physical rehabilitation and quality of life in multiple sclerosis. Romanian Journal of Neurology.
2009;8(4):157-9.
7. Miche E, Roelleke E, Zoller B, Wirtz U, Schneider M, Huerst M, Amelang M, Radzewitz A. A longitudinal study of quality of life in patients with
chronic heart failure following an exercise training program. European Journal of Cardiovascular Nursing. 2009;8(4): 281-7.
8. Kim do S, Sim YJ, Jeong HJ, Kim GC. Effects of active resistive exercise on breast cancer-related lymphedema: a randomized controlled trial.
Archives of Physical Medicine and Rehabilitation. 2010;91(12):1844-8.
9. Ozdirenc M, Kocak G, Guntekin R. The acute effects of in-patient physiotherapy program on functional capacity in type II diabetes mellitus.
Diabetes Research and Clinical Practice. 2004;64(3):167-72.
10. Courtney M, Edwards H, Chang A. Parker, Finlayson K, Hamilton K. Fewer emergency readmissions and better quality of life for older adults
at risk of hospital re-admission: a randomized controlled trial to determine effectiveness of a 24 week exercise and telephone follow-up program.
Journal of the American Geriatric Society. 2009;57(3):395-402.
11. Lamb SE, Toye F, Barker KL. Chronic disease management programme in people with severe knee osteoarthritis: efficacy and moderators of
response. Clinical Rehabilitation. 2008;22(2):169-78.
The Value of Physiotherapy
The value of a health care service is more than its proven cost-effectiveness.
Quality of life, access, and continuity of care and integration of services are
equally important criteria when looking at the broader concept of value.