Abstract

CASE SETTING 52-year-old male client referred for post-operative cervical-spine two-level fusion rehabilitation, two-years following a motor accident. History of prior motor accident five-years earlier with cervical-spine discectomy resolving symptoms. Referred under compensable insurance policy with 13-years claim benefit remaining. Referral objective to restore health and function for return-to-work (RTW). Experiencing intolerable neck pain with reduced left arm function, pain medication side effects, and low mood. Loss of hope resulting from significant pain post-operatively, whereas prior surgery resolved similar symptoms. Not working at referral. Pre-disability work was full-time self-employed barista. TREATMENT/REHABILITATION PROVIDED Six hours of EXPHYS BETTER Pain VR program, consisting of virtual-reality (VR) pain science coached by an exercise physiologist (AEP) over 10-weeks, face-to-face, within the pain mechanism and bio-psycho-social models. Learning consisted of VR modules and workbook with practical application of six key target pain concepts: pain is always real, doesn’t accurately measure tissue health, relies on context, is a protector, has a buffer zone, and can be retrained. Two functional goals of self-care and cooking were established, and RTW. RESULTS Validated inventories demonstrated self-reported improvements in; pain intensity: 11 item numerical pain rating scale, range: 0-10 points [8 referral; 1 closure]; and function; two 11-item patient-specific functional scale [self-care, cooking], range: 0-20 points) [2 referral; 16 closure]. Work mindset improved from pre-contemplation [referral] to maintenance [closure]. Work capacity improved from no capacity to full capacity. Work status improved from not working to working pre-disability hours and duties. Insurance claim closed. Direct return-on-investment of $300 for every $1 spent on the EXPHYS BETTER Pain VR Program. Client net promotor score (NPS) was promoter (10/10), and customer satisfaction (CSAT) was very satisfied (5/5). REFLECTIONS/LEARNINGS Virtual-reality pain science, delivered by an AEP within the pain mechanisms model, positively impacts pain and function, RTW, and customer experience, with demonstrated return-on-investment.

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