Improving Patient Outcomes With Exercise Physiology

Facilitating an early referral can improve patient outcomes

A few months back I attended a professional development workshop facilitated by our industry body, Exercise & Sport Science Australia (ESSA) and listened to a presentation given by Mary Hawkins representing Work Cover NSW.

During this presentation I was horrified to hear the statistic that 83% of all referrals made for Exercise Physiology treatment occurred six months post injury or later within the Worker’s Compensation scheme.

However this did make a lot of sense, as the majority of our patients are often a year or more post injury by the time we get to treat them.

It is my opinion and I’m sure the opinion of many other Exercise Physiologists, that this should occur a lot sooner than six months in order to have a positive impact on an injured worker’s ability to return to work in a timely and durable manner.

Work Cover NSW has previously published in The Soft Tissue Injury Guidelines that work related activity is a recommended progression of treatment for workers with soft tissue injuries following the sub acute period (usually 4 – 12 weeks post injury). Particularly when a soft tissue injury continues beyong the expected recovery time and / or psychosocial risk factors are identified.

Given these recommendations and based upon my previous experience in the insurance industry, I believe that it would be of greater benefit to the patient and the overall claim outcome if the insurance company case manager was able to flag these patients as potential suitable candidates for exercise physiology treatment at the eight and twelve week review points; and make an early proactive referral.

Some of the things that should be considered at these review points for the appropriateness of referring for exercise physiology treatment services include:

• Acute treatment methods are no longer resulting in significant functional improvement
• The  injury has been appropriately assessed and managed during the acute period, now requiring a suitable progression of treatment
• The injury is now in the sub acute period and the worker is not performing pre-injury duties (usually >12 weeks post injury)
• The injury is not yet chronic and disabling
• There is evidence of psychosocial risk factors and / or delayed recovery
• Activity levels are not progressing and / or fluctuate widely
• Insufficient suitable duties exist in the workplace to meet medical restrictions
• The injured worker requires a high level of supervision, instruction and reinforcement.

If you are unsure whether you are suitable for an exercise physiology treatment program and would like our assistance, please get in touch with us and we can discuss further with your case manager about organising a referral.