» Table of Contents

National Implementation of Health Systems Research (HSR)-Developed Practices: Group PT

Knee osteoarthritis (OA) is a common and often disabling health condition in the U.S., and Veterans are at an increased risk due in part to high rates of joint injuries and stresses. The prevalence of knee OA is expected to rise dramatically in the coming decades, placing increased demand on VA to provide knee OA care, including physical therapy (PT). With support from the VA Physical Medicine & Rehabilitation Service and Diffusion of Excellence, the Function QUERI Program center is guiding the uptake and sustainment of Group Physical Therapy (Group PT) for Veterans with Knee Osteoarthritis, a 2024 VHA Shark Tank finalist, across the U.S.

Group PT includes six 1-hour sessions delivered in a group format with strengthening and stretching exercises plus a didactic component to teach Veterans about knee OA management. Group PT originated as an HSR-funded randomized clinical trial that showed group-based physical therapy yields equivalent or greater improvements in pain and functional outcomes for Veterans with knee OA compared with individual PT, while requiring fewer clinician hours per patient to deliver. Based on these results, the Durham VA Health Care System implemented Group PT for knee OA as a clinical service, resulting in clinically relevant improvements in Veterans’ pain and function. With funding from QUERI, Group PT has been implemented in an additional 18 VA sites (plus 1 site not enrolled in Function QUERI).

Function QUERI’s goal is to implement and evaluate effective practices to maximize function and independence in Veterans. To date, Function QUERI practices have been implemented in 142 VA Medical Centers across the U.S.

A unique facet of Group PT is its customizability to fit the needs of each facility, including the facility’s staff and patient population. Sites vary in the personnel (physical therapists, PT assistants, kinesiotherapists), models (virtual, in-person, hybrid), and settings (community-based outpatient clinics, medical centers, clinics) for Group PT. Two clinical resource hubs (CRHs) are also delivering Group PT as a means of providing gap coverage for PT services across their VISNs (VISN 4 and 22). In 2023, Group PT was nominated and selected as a CRH strong practice.

Group PT has reached more than 300 Veterans, including women Veterans and Veterans residing in rural areas, helping to improve access to care for one of the most common, function-limiting health conditions among Veterans. Going forward, Function QUERI is evaluating implementation strategies to support widespread delivery of Group PT in response to VA’s priority to connect Veterans to the soonest and best care.

For more information on Group PT, check out its innovation page on the Diffusion of Excellence Marketplace. The Function QUERI team can also provide access to resources (e.g., delivery toolkit, patient handbook, CPRS templates) if your site is interested in implementing Group PT.

^[1] Implementation of a group physical therapy program for Veterans with knee osteoarthritis - PubMed (nih.gov)