Proper treatment can significantly impact an injured person’s timely return to life and work.
Our clients often go to seemingly endless physiotherapy treatments that do not put a focus on returning to life or work.
Without that focus, these clients often become dependent on the treatment and the provider, which causes negative behaviours. This type of treatment is known as passive physiotherapy.
The difference between passive and active treatment
Passive physiotherapy is therapy that is performed on the client rather than by the client.
It can include techniques like massage, acupressure, heat packs, and mobilisation and machines like ultrasounds, interferential, TENS, laser, and traction.
Active physiotherapy, on the other hand, involves treatments where the client is physically involved.
This includes things like exercise programs, stretching, strengthening, and work conditioning.
The goal of active physiotherapy is to increase the client’s strength, functioning level, and stabilisation to help prevent injuries and aid in returning to work and life.
Active treatment is associated with substantially better clinical outcomes than passive treatment.
Patients with acute lower back pain who were treated with active physiotherapy, for example, incurred fewer treatments, spent less on treatment, and had less pain and disability.
The overall success rate of those adhering to active treatment recommendations was 64.7 percent, as opposed to 36.5 percent for passive treatment.
Guidelines for treatment
Official Disability Guidelines (ODGs) exist to guide treatment and expectations.
The ODGs include injury-specific treatment pathways, return-to-work prescriptions based on evidence for specific injuries, patient information resources, and co-morbidity calculations (diabetes, use of opioids, surgery, anxiety, etc.)
These guidelines have existed for 22 years and are accepted by more than 100,000 users worldwide including federal, state, and local governments and icare™ of New South Wales.
The widespread adoption of these guidelines has led to medical cost savings of 25-60 percent, a 30 percent decrease in average disability duration, a 77 percent decrease in treatment delays, and an average 45 percent decrease in insurance premiums because of improved health outcomes.
However, having these ODGs to reference is not enough.
Often, outside experiences and circumstances impact a client’s recovery and return to work.
Identifying any issues that may derail a positive outcome for the client is essential.
These issues should be identified and addressed early with the party responsible for treatment.
How APM facilitates returning to work
At APM, we use a combination of the ODGs, the biopsychosocial approach, and the APMIQ to guide the client toward returning to work.
We work with the client to set S.M.A.R.T. goals for returning to life and work, and we continuously discuss these goals throughout the claim.
Additionally, our consultants engage the employer to actively encourage contact with the workplace and provide suitable duties, so the worker returns in a positive mindset and timely manner.
They are in constant communication with treatment providers to communicate the client’s functional requirements and any potential psychological factors that may impact treatment.
These efforts help ensure the treatment is active and facilitate an evidence-based, timely return to work.
If treatment is determined to be passive, APM discusses the issue openly with all parties and implements a plan to move the client to a work conditioning program using a cognitive behavioural approach (if appropriate and agreed to by the treatment providers).
This plan includes mapping the functional requirements of the client’s role, identifying which treatment methods are being employed to actively increase function in the mapped areas, and measuring progress against functional goals.
Proper treatment plans and procedures are imperative for returning those who have been injured to their work and their lives.
APM is dedicated to ensuring each client has the resources and support needed to facilitate speedy, effective recovery and return to work.
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