EXERCISE PHYSIOLOGIST-LED PAIN SCIENCE COACHING VIA TELEHEALTH IMPROVED PAIN AND FUNCTION IN LIFE INSURANCE CLAIMANTS: A PRAGMATIC COHORT STUDY

Abstract

Personal injury and illness compensation claimants are more likely to experience persistent pain and poorer clinical/vocational outcomes than non-compensated clients. Evidence supports the effectiveness of pain science coaching to help people understand and re-train their pain system. This consequently reduces pain intensity, improves function and quality of life. However, the effectiveness of telehealth-delivered, exercise physiologist-led pain science coaching is yet to be evaluated. This study aimed to determine the effectiveness of an accredited exercise physiologist-led pain science coaching intervention via telehealth in Australian life insurance claimants. This pragmatic cohort study included 1,275 claimants receiving a pain science coaching intervention supported by life insurance compensation. Ethics was approved via Deakin University Human Research Ethics Committee (2023-347). Outcome measures were pain intensity (11 item numerical pain rating scale, range: 0-10 points) and function (two 11-item patient-specific functional scale, range: 0-20 points). Linear mixed models determined within-group change over time. Clients (female: 75%, male: 25%) had a mean (SD) age of 50 (10) years (range: 20-69 years) and claim duration of 2 (2) years (range: 0-20 years). Mean (SD) intervention duration was 10 (6) weeks (range: 3-41 weeks), financial cost was A$1,149 (A$202; range: A$510-A$2,040) and included 5 (1) hours (range: 2-11 hours) of pain science coaching. Following the intervention, pain intensity decreased 25% (estimated marginal mean change [95%CI]: -1.49 [-1.59, -1.40] points, P<0.001) and function increased 76% (4.41 [4.21, 4.62] points, P<0.001). Changes surpassed established clinically meaningful effect thresholds for pain intensity (1.17 points) and function (2.6 points). Client Net Promotor Score was +60 (Australian Healthcare Index benchmark ≥ +30) and 91% were satisfied with the intervention. An exercise physiologist-led pain science coaching intervention resulted in clinically meaningful improvements in pain intensity and function in compensation claimants. Clients reported high satisfaction rates.