Why do some patients need more physical therapy than others?

Joe Paduda

Why does a therapist’s treatment duration vary for patients with the same diagnosis?

What conditions have the most impact on patient recovery?

Thanks to Vennela Thumula, Randall Lea and Te-Chun Liu of the Workers Compensation Research Institute, there are answers.

WCRI’s latest research, based on data from focus on therapeutic outcomes (FOTO), digs into just how big an impact mental and physical health comorbidities — and other factors — have on improvements in functional status.

The methodology is robust indeed, the data as solid as it gets, and the insights provided by the researchers quite valuable.

Using FOTO’s 100-point scale, their research indicates that patients with physical and mental health comorbidities see about 20% less improvement in functional status than patients with no comorbidities.

Comorbidities — aka health conditions a patient has in addition to the one you’re focused on — may be physical (think obesity, hypertension, arthritis) or mental (depression, anxiety/panic attacks, sleep dysfunction).

Some quick takeaways:

• About two-thirds of patients have a physical or mental health comorbidity, and they definitely affect the patient’s ability to recover.
• The more comorbidities a patient has, the greater the impact on recovery.
• More troubling still, the more likely these patients would have “very limited” function at the end of therapy.

The researchers also looked at the same metrics for non-work comp patients and found comorbidities had similar, if not more, impact on recovery.

And it isn’t just comorbidities.

Quicker access to PT had an even greater impact on recovery than physical or mental health complications. The details are on page 43 of the study. If you’re not a WCRI member, become one to get access to all its great work at no charge. Nonmembers will have to pony up a few bucks to learn more.

What does this mean for you?

Great research is really useful. Use this to help injured workers get better faster. 

Joseph Paduda is co-owner of CompPharma, a consulting firm focused on improving pharmacy programs in workers’ compensation. This column is republished with his permission from his Managed Care Matters blog.