Ab1689-Pare the Role of Physical Therapy in Adult Chronic Nonbacterial Osteitis (Cno): Patients’ and Therapists’ Perspective

Background: Chronic nonbacterial osteitis (CNO) is a rare musculoskeletal disease causing bone pain and functional impairment. The disease has historically been labelled as synovitis, acne, pustulosis, hyperostosis, osteitis (SAPHO)-syndrome due to its wider spectrum of inflammatory features. Objectives: We map the use and perceived effects of physical therapy (PT) for CNO, and preferences and needs regarding the provision of PT from the patients' and first-line therapists' perspectives. Methods: Cross-sectional study among the unique Dutch adult CNO cohort (patients enrolled between 1992–present). A survey on PT use that was previously employed in patients with axial spondylarthritis was adapted to align with CNO, covering the current PT-use and/or use in the past 24 months and reasons for non-use if applicable. PT-users were asked about the treatment modalities, and perceived health-related effects, satisfaction (numeric rating scale, 1-10) along with preferences for future use; their physical therapists were invited to complete a self-developed survey covering therapy details and preferences regarding information on CNO. Results: 80/195 and 14/16 patients and therapists completed the survey respectively. 41(51%) patients had used PT for CNO in the preceding 2 years. Reasons for not using PT included ineffectiveness of PT prior to this period (n=14/39, 36%), lack of physician recommendation (n=12/39, 31%), and cost concerns (n=6/39, 15%) (multiple answers possible). PT-users reported diverse methods of PT for CNO, most commonly involving passive therapy like massage (n=25/41, 61%) and joint mobilizations (n=18/41, 44%), and active therapy such as muscle strengthening and breathing exercises (n=17/41, 42% and n=20/41, 49%). PT-users were mostly, but variably satisfied (median satisfaction score 8/10, range 1-10). 51/80 (64%) patients (users and non-users combined) desired greater emphasis from their clinicians regarding the value of PT. Therapists reported to appreciate referral letters with disease and patient-specific information (n=13/14, 93%), and the opportunity to consult a therapist situated at the expert center given the rarity of the condition (n=12/14, 86%). Conclusion: Half of adult CNO patients currently use or recently used PT, which involves variable therapeutic methods. The majority of patients desire more clinical emphasis on PT, and the majority of therapists indicated a preference for more disease-specific information from the expert center to support their care. Future studies should investigate the effectiveness of CNO-tailored exercise programs to better define the role of PT in CNO management. REFERENCES: NIL. Acknowledgements: NIL. Disclosure of Interests: None declared.