PHYSIOTHERAPIST – SUPERVISED PHYSICAL CONDITIONING PROGRAMS SAVE MONEY

Physiotherapists across Australia work closely with workers compensation authorities to help people return to work after an accident or injury.

A recent systematic review of research findings show that:

Workers with chronic back pain who participate in a physical conditioning program take an average of 45 less sick days per episode, compared to workers who receive usual medical care.

A systematic review of 23 randomised controlled trials has shown the benefits of properly structured physiotherapist (or multidisciplinary team) led physical conditioning programs for workers with chronic low back pain.

Physical conditioning programs are also known as work conditioning, work hardening or functional restoration programs. The evidence shows that these programs can reduce the number of sick days lost per episode by an average of 45 days, when compared to usual general practitioner care or advice, for workers with chronic back pain. These results measured a year after the physical conditioning program was completed.

To achieve this remarkable outcome the programs need to have a number of features.

Programs should:

• Be work related.
• Be supervised by a physiotherapist (or a multidisciplinary team).
• Combine a cognitive behavioural approach with intensive physical training,which aims to improve aerobic capacity, muscle strength, endurance and coordination. ‘Cognitive behavioural approach’ means reassuring people that it is beneficial to stay active and not be afraid of moving, and to return to normal activity (including work) as soon as possible after an episode of back pain.

Medical practitioners, return to work coordinators, insurers, employers and workers alike should take note of the results of this important review. Applying the results of this systematic review will save money and reduce the disability and inconvenience workers experience as a result of low back pain.

Reference: Schonstein E, Kenny DT, Keating J, Koes BW (2003) Work conditioning, work hardening and functional restoration for workers with back and neck pain. In: The Cochrane Library, Issue 3, 2003. Oxford: Update Software.

Researchers: Mrs Eva Schonstein, Associate Professor Dianna Kenny, Dr Jenny Keating, Professor Bart Koes

Further information: e-mail: E.Schonstein@fhs.usyd.edu.au