OBJECTIVE: To conduct a cost-utility analysis of a group physiotherapy intervention, compared to usual care, for musculoskeletal disorders in Canadian military personnel. DESIGN: Economic evaluation alongside a pragmatic randomized clinical trial. METHODS: One hundred and twenty military members presenting with shoulder, knee, ankle, or low back pain were randomized to receive either usual one-on-one physiotherapy care or a group intervention. Cumulative health care costs were prospectively collected over 26 weeks from the perspective of the Canadian Armed Forces. The clinical outcome of the cost-utility analysis was the quality-adjusted life-year (QALY) estimated by the ED-5Q-5L (European Quality of Life 5 Dimensions 5 Level Version) at baseline, 6, 12, and 26 weeks. The incremental cost-effectiveness ratio (ICER) was estimated by the cost difference between interventions (in 2023 Canadian dollars [CAD$]) divided by the effect difference. RESULTS: The mean QALY gain was 0.011 in the group intervention, and 0.010 in the usual care. The average cost for a patient was CAD $532 in the group intervention and CAD $599 in the usual care. The ICER (-$67 000/QALY) indicated that the group intervention was cost-effective, as it costs less than usual care while providing comparable effectiveness. CONCLUSION: Group interventions were cost-effective compared to usual care for treating musculoskeletal disorders in military personnel. J Orthop Sports Phys Ther 2025;55(4):1-10. Epub 26 Feb 2025. doi: 10.2519/jospt.2025.12888.
| Discipline Area | Score |
|---|---|
| Rehab Clinician (OT/PT) |  |
Rehab Clinician (OT/PT) rater
Group physiotherapy was found to be cost-effective compared with usual one-on-one care; it was cheaper and as effective, even with group size of 3 participants with 1 therapist. Therefore, group interventions are a reasonable strategy to improve access to rehabilitation for people living with musculoskeletal disorders when financial resources and the number of available professionals are limited and when clients will accept it.
Rehab Clinician (OT/PT) rater
THis is a very clear health economic analysis with a clear clinical message and utility.
Rehab Clinician (OT/PT) rater
This intriguing study provides an economic perspective on the efficacy of group exercise versus individualized physical therapy. The unexpected findings highlight the impressive outcomes of group therapy, offering valuable insights for clinicians to consider in their practice.
, McMaster University