Complimentary Webinar: Using Not-for-Profit Organizations as a RTW option

Are you or your clients interested in learning about a new and innovative RTW solution?  Sign up for a complimentary webinar being offered by Eastern Alliance Insurance Group's Return to Wellness Specialist, Sarah Tayts. 

WHO:     This presentation is open to all EAIG agency partners and EAIG clients.  Please feel free to forward this post via email to anyone you believe would benefit from attending this presentation.  You can do this by clicking on the envelope icon located at the bottom of this post, or simply copy/paste the URL to this post into a separate email.


WHAT:     The presentation will highlight how to strategically use NFPs to solve even your most challenging RTW situations, as well as address the most common questions regarding the process. 

WHEN:     Wednesday, December 4, 2013 @ 10 am EST

HOW:     Register for the webinar by clicking here and completing a basic registration form.  For more information on how to get the most out of the GoTo Webinar session, you can click here to view a brief PowerPoint tutorial.               

In the past, this presentation has been very well attended, so be sure to register now to reserve your spot!

Guest post! Physical Therapy may assist in recovery from a musculoskeletal injury, and depression, in the injured worker by Dr. Joseph Brence, DPT

As you know, we’re always interested in hearing others’ perspectives regarding the rehabilitation of an injured worker. We’re excited to share this guest post written by Joseph Brence, DPT, COMT, DAC.  Dr. Joseph Brence is a physical therapist practicing in Pittsburgh, Pennsylvania.  When he is not busy treating patients, he is involved in several, large clinical research projects.  He has a large interest in the brain's involvement in the pain experience as well as the neurophysiological effects of manual therapy techniques. You can read more from Dr. Brence at www.forwardthinkingpt.com

Physical Therapy may assist in recovery from a musculoskeletal injury, and depression, in the injured worker
Joseph Brence, DPT, COMT, DAC

Work-related injuries affect almost 500,000 individuals annually in the United States.  Over half of these cases are related to sprains, strains and other musculoskeletal pathology.  In addition, musculoskeletal injuries are the leading cause for work-related disability and lost productivity, and estimated direct and indirect costs range from 45 – 215 billion dollars.

Work-related injuries can lead to the development of chronic pain as well as changes in societal status and psychological variables such as depression. Research has suggested that one out of every three individuals who suffer from chronic pain also suffer from depression.  Research has also suggested that elevated levels of depression are associated with an increased risk for a poor response to Physical Therapy and are associated with elevated levels of pain and disability.  A recently published article examined the effects of Physical Therapy on depressive symptoms in individuals with work-related musculoskeletal injuries.

The authors in this prospective cohort study recruited patients who were between the ages of 18 and 65; had sustained a work-related, musculoskeletal neck or back injury (3-12 weeks since onset); were not currently working; and were receiving benefits from Worker’s Compensation.   The participants also had to have clinically relevant levels of depression (measured on a Beck Depression Inventory of 14 or higher) and had to state that they were not being treated for depression throughout their course of Physical Therapy (often the case in Workers Compensation).  The participants completed a course of seven weeks of Physical Therapy treatment interventions.

The outcomes of this study demonstrated that depressive symptoms resolved in 40% of patients who entered into a Physical Therapy program, following a work-related accident. This outcome is not unusual because of the neurological and hormonal changes that we know to occur with exercise.  The authors further reported that a reduction in depressive symptoms was related to a decrease in pain and disability at the one-year follow-up, which improved the likelihood for return to work.   For those who did not get better, it appears that combined elevated levels of depression and pain catastrophizing thoughts (ex. The pain is killing me) pre-treatment, predicted persistence of depressive symptoms post-treatment.  

So what does this mean?

These findings indicate that Physical Therapy can have a profound effect in decreasing depressive symptoms in a subgroup of individuals.  The authors go as far as suggesting that in certain instances, we may want to include a reduction in depression as a realistic and important goal of treatment.  Psychosocial variables, such as this, have been correlated to long-term disability and can often restrict an individuals ability to recover from a musculoskeletal injury (thus decreasing the likelihood for return to work).  Despite the notion that many in Workers Compensation field want to steer away from the assessment of these variables, I suspect they are important prognostic indicators for recovery and we should encourage early screening, detection and intervention.  In the end, we interact with the complex "human" and acknowledging the influence of biological, psychological and social variables, will only better enhance recovery and return to work. 
 

Dunning KK, Davis KG, et al. Costs by industry and diagnosis among musculoskeletal claims in state workers compensation system: 1999-2004. Am J of Indust Med. 2010: 53; 276-284.

Wideman TH, Scott W, et al. Recovery from depressive symptoms over the course of physical therapy: a prospective cohort study of individuals with work-related orthopaedic injuries and symptoms of depression. JOSPT 2012: 42; 957-968.

Kroenke K, Spitzer RL, et al. The Patient Health Questionnaire-2: Validity of a 2 item depression screener. Medical Care. 2003: 41; 1284-1294.