Functional restoration– Evidence-based practice?
Jenny Ralls
Rehabworks Ltd., UK
: Analg Resusc: Curr Res
Abstract
Chronic and episodic pain disorders are inherently difficult to deal with and often the people living with them get spat out at the end of a system having watched their levels of function at work, home, and socially drop through the floor. Problems which start as relatively simple musculoskeletal disorders can quickly spiral into long term disability, reduced participation and breakdown of family life, and associated mental health disorders. Functional Restoration Programmes are designed to tackle these multi-faceted issues in a practical way, through the inclusion of Cognitive Behavioural techniques, education, general fitness and work hardening. However, they have become a contentious intervention; whilst thousands of people and businesses find them beneficial in restoring fitness for work and life a recent systematic review questioned its efficacy. They are, after all, relatively costly and time intensive, so require a substantial investment from the fee payer. This review will look at what Functional Restoration Programmes are (and what they aren’t), where the discrepancies arise, and where these interventions fit into the clinical picture. It will address issues of expected outcomes and return on investment (based on an occupational health model), and argue that they have an important role in the clinical pathway. The practical elements of inclusion and exclusion criteria will be covered as crucial factors to success, plus an overview of separate components. The importance of outcome measures and options for these will be covered briefly and outcome measure options will be presented. Lastly we will discuss what the future of these programmes might hold
Biography
