ATI Evidence-based Guide Investigating Clinical Services

NCT02285868 | Active Not Recruiting DMC

• 1 other identifier: ATI EGIS01012015
• Study Type: observational
• Target: 4,000,000
• Locations: 1 country
• Sites: 1

Brief Summary

The goal of this study is to evaluate how standard-of-care outpatient rehabilitation is delivered and how variation in care delivery mechanisms relates to clinical outcomes, service utilization, and value in patients receiving physical or occupational therapy. The study will focus on patients with musculoskeletal (MSK) conditions receiving physical or occupational therapy. The focus is to use existing standard-of-care documentation in a physical therapy (PT) electronic medical record (EMR) to evaluate patient characteristics, interventions delivered, utilization management, and clinical outcomes in routine outpatient PT care, in order to generate evidence to improve clinical effectiveness and quality of care. Researchers will compare different care delivery mechanisms to see if variations lead to significant differences in outcomes. Participants will have their standard-of-care documentation analyzed, including routine clinical measures, objective/functional measures, and patient-reported outcomes. They will not be directly involved in research interventions or randomization. This study does not involve a research intervention, randomization, or alteration of clinical care. It is a retrospective cohort study analyzing existing standard-of-care documentation from ATI's physical therapy EMR. Data are collected via the investigators proprietary electronic medical record system and are synthetic to the clinical process that is, the data are collected in real-time with patients and the scores are immediately provided to the treating therapist as well as archived for later Registry and scientific use.

Conditions

Primary Body Region (Arranged Most Common to Least); Lumbar/SI; Knee; Shoulder; Cervical/Thoracic; Foot/Ankle; Hip; Elbow; Neurological; Vestibular; Pelvic Floor; TMJ; Fibromyalgia; Headaches; Lymphedema

Keywords

Orthopedic rehabilitation; Rehabilitation outcomes; Physical therapy; Physical therapy outcomes; occupational therapy; Standard of care

Outcome Measures

Primary Outcomes (1)

• Change in functional status

  60 days

Secondary Outcomes (1)

• Change in global health status

  60 days

Study Arms (6)

Arm, Shoulder and Hand injuries

Pre- and post-treatment outcomes of care as measured by the DASH (Disabilities of the Arm, Shoulder and Hand) via physical therapy

Lumbar spine injuries

Pre- and post-treatment outcomes of care as measured by the Modified Oswestry (lumbar spine) via physical therapy

Knee injuries

Pre- and post-treatment outcomes of care as measured by the Knee Outcome Survey via physical therapy

Foot and ankle injuries

Pre- and post-treatment outcomes of care as measured by the Foot \& Ankle Ability Measure via physical therapy

Hip and lower extremity injuries

Pre- and post-treatment outcomes of care as measured by the Lower Extremity Functional Scale via physical therapy

Neck injuries

Pre- and post-treatment outcomes of care as measured by the Neck Disability Index Questionnaire via physical therapy

Eligibility Criteria

• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

All patients presenting ith orthopedic rehabilitation needs

Sponsors & Collaborators

• ATI Holdings, LLC: lead

Study Sites (1)

ATI Physical Therapy and Institute for Musculoskeletal Advancement

Downers Grove, Illinois, 60515, United States

Location

Related Publications (12)

• Denninger TR, Cook CE, Chapman CG, McHenry T, Thigpen CA. The Influence of Patient Choice of First Provider on Costs and Outcomes: Analysis From a Physical Therapy Patient Registry. J Orthop Sports Phys Ther. 2018 Feb;48(2):63-71. doi: 10.2519/jospt.2018.7423. Epub 2017 Oct 26.

  PMID: 29073842 BACKGROUND

• Lutz AD, Brooks JM, Chapman CG, Shanley E, Stout CE, Thigpen CA. Risk Adjustment of the Modified Low Back Pain Disability Questionnaire and Neck Disability Index to Benchmark Physical Therapist Performance: Analysis From an Outcomes Registry. Phys Ther. 2020 Apr 17;100(4):609-620. doi: 10.1093/ptj/pzaa019.

  PMID: 32285130 BACKGROUND

• Lutz AD, Rodriguez S, DeBuck KF, Denninger TR, Myers LM, Myers NL. Work Conditioning: The Appropriate Stepped Physical Therapy Care for Injured Workers in Physically Demanding Roles: A Retrospective Cohort Study. J Occup Environ Med. 2025 Nov 11. doi: 10.1097/JOM.0000000000003611. Online ahead of print.

  PMID: 41214483 BACKGROUND

• Lutz AD, Windsor BA, Shanley E, Denninger TR, Harrington SE, Thigpen CA. A comparison of treatment signatures of high and low performing physical therapists for patients with lower back pain: analysis of spine care from a physical therapy outcomes registry. Spine J. 2022 May;22(5):847-856. doi: 10.1016/j.spinee.2021.11.008. Epub 2021 Nov 20.

  PMID: 34813956 BACKGROUND

• Hawley-Hague H, Lasrado R, Martinez E, Stanmore E, Tyson S. A scoping review of the feasibility, acceptability, and effects of physiotherapy delivered remotely. Disabil Rehabil. 2023 Nov;45(23):3961-3977. doi: 10.1080/09638288.2022.2138574. Epub 2022 Nov 2.

  PMID: 36325612 BACKGROUND

• Domingues B, Pereira AP, Pradhan A, Zidde C, Janela D, Marramaque C, Bento V, Yanamadala V, Cohen SP, Belz L, Wang K, Correia FD, Costa F. Digital Versus In-Person Physical Therapy in Adults With Musculoskeletal Conditions: Retrospective Matched-Cohort Analysis of Surgery and Low-Value Surgical Rates. J Med Internet Res. 2025 Dec 17;27:e82573. doi: 10.2196/82573.

  PMID: 41288021 BACKGROUND

• Hinman RS, Campbell PK, Kimp AJ, Russell T, Foster NE, Kasza J, Harris A, Bennell KL. Telerehabilitation consultations with a physiotherapist for chronic knee pain versus in-person consultations in Australia: the PEAK non-inferiority randomised controlled trial. Lancet. 2024 Mar 30;403(10433):1267-1278. doi: 10.1016/S0140-6736(23)02630-2. Epub 2024 Mar 7.

  PMID: 38461844 BACKGROUND

• Demont A, Bourmaud A, Kechichian A, Desmeules F. The impact of direct access physiotherapy compared to primary care physician led usual care for patients with musculoskeletal disorders: a systematic review of the literature. Disabil Rehabil. 2021 Jun;43(12):1637-1648. doi: 10.1080/09638288.2019.1674388. Epub 2019 Oct 11.

  PMID: 31603709 BACKGROUND

• Burge E, Monnin D, Berchtold A, Allet L. Cost-Effectiveness of Physical Therapy Only and of Usual Care for Various Health Conditions: Systematic Review. Phys Ther. 2016 Jun;96(6):774-86. doi: 10.2522/ptj.20140333. Epub 2015 Dec 17.

  PMID: 26678447 BACKGROUND

• Lentz TA, Ikeaba U, Alhanti B, Lutz A, George SZ, Cook C, Thigpen C. Self-reported disability trajectories and their predictors among patients receiving care by physical therapists for musculoskeletal conditions: a retrospective analysis of registry data. BMJ Open. 2025 Jun 20;15(6):e099315. doi: 10.1136/bmjopen-2025-099315.

  PMID: 40541444 BACKGROUND

• Dieleman JL, Cao J, Chapin A, Chen C, Li Z, Liu A, Horst C, Kaldjian A, Matyasz T, Scott KW, Bui AL, Campbell M, Duber HC, Dunn AC, Flaxman AD, Fitzmaurice C, Naghavi M, Sadat N, Shieh P, Squires E, Yeung K, Murray CJL. US Health Care Spending by Payer and Health Condition, 1996-2016. JAMA. 2020 Mar 3;323(9):863-884. doi: 10.1001/jama.2020.0734.

  PMID: 32125402 BACKGROUND

• McConaghy K, Klika AK, Apte SS, Erdemir A, Derwin K, Piuzzi NS. A Call to Action for Musculoskeletal Research Funding: The Growing Economic and Disease Burden of Musculoskeletal Conditions in the United States Is Not Reflected in Musculoskeletal Research Funding. J Bone Joint Surg Am. 2023 Mar 15;105(6):492-498. doi: 10.2106/JBJS.22.00693. Epub 2022 Nov 9.

  PMID: 36574617 BACKGROUND

MeSH Terms

Conditions

Neurologic Manifestations; Fibromyalgia; Headache; Lymphedema

Condition Hierarchy (Ancestors)

Nervous System Diseases; Signs and Symptoms; Pathological Conditions, Signs and Symptoms; Muscular Diseases; Musculoskeletal Diseases; Rheumatic Diseases; Neuromuscular Diseases; Pain; Lymphatic Diseases; Hemic and Lymphatic Diseases

Study Officials

• Natalie Myers, PhD, ATC

  ATI Physical Therapy and Institute for Musculoskeletal Advancement

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: OTHER
• Time Perspective: OTHER
• Target Duration: 1 Year
• Sponsor Type: INDUSTRY
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Director of Research

Study Record Dates

• First Submitted: November 4, 2014
• First Posted: November 7, 2014
• Study Start: February 24, 2026
• Primary Completion (Estimated): February 24, 2029
• Study Completion (Estimated): February 24, 2029
• Last Updated: March 5, 2026

Record last verified: 2026-03

Locations

US (1)