 |
|
 |
 |
| |
|
|
| |
| Depression Affects Physical Therapy |
 |
by Lisa B. Minn, PT - May 5, 2011
|
 Last month an article in the Physical Therapy Journal caught my eye. The title was, “Depressive Symptoms, Anatomical Region, and Clinical Outcomes for Patients Seeking Outpatient Physical Therapy for Musculoskeletal Pain.” The study analyzed questionnaire data (FOTO) of 8,304 patients from 86 clinics in the U.S who were seeking therapy for pain of the neck, back, arm or leg. The association of depression and low back pain has previously been documented in a number of studies. In fact, up to 46% of patients who see a physical therapist for low back pain have signs and symptoms of depression. The bottom line of this recent study is that depression effects therapy, regardless of the body part that hurts.
This study showed that depression contributes to greater intensity of pain and to more impairment of function. This was true at both intake and discharge. Higher depression scores are also related to a greater number of PT visits. Patients with normal scores averaged 8.9 sessions while those with severe depressive symptoms had 11.5 sessions. However higher scores did not have any effect on the rate of improvement of pain and function. Those with higher scores improved at the same rate as those with lower scores. It is not know whether the depressive symptoms preceded the onset of musculoskeletal pain or if the pain was the reason for depression.
This study confirms what most PTs have always suspected; that mental health is an important determinant of physical outcomes. But the more important question is, what can we do about it? We may, on occasion, refer our patients to a mental health professional but what is the criteria for doing so? Should we use a screening tool for every patient? If so, which one? Can we integrate mind-body strategies into PT intervention to improve mild depressive symptoms? How can we teach mindfulness or other cognitive skills in a busy clinic setting?
There is some evidence that Yoga may be effective in reducing symptoms of depression. A 2010 review of evidence reported that although the methodology of existing studies is flawed, "there are several reasons to consider constructing careful research on yoga for depression. First, current strategies for treating depression are not sufficient for many individuals, and patients have several concerns about existing treatments. Yoga may be an attractive alternative to or a good way to augment current depression treatment strategies. Second, aspects of yoga—including mindfulness promotion and exercise—are thought to be “active ingredients” of other successful treatments for depression. Third, there are plausible biological, psychological, and behavioral mechanisms by which yoga may have an impact on depression."
Here is a link from Yoga Journal that explains how yoga can improve symptoms of depression:Yoga For Depression, Part I by Timothy McCall, M.D. For more information on yoga and depression, including recommended resources, see Yoga Therapy Web.com.
Opening image from Depressionam.com
Related PY posts:
Pushing Pills for Pain
It Hurts to be Sad and Angry
 Lisa Minn is a licensed physical therapist and yoga enthusiast. She has been incorporating aspects of Yoga and Pilates into her physical therapy practice since 2001 and became a certified yoga instructor in 2004. Her experience ranges from working with athletes at West Point and Georgetown to instructing elderly and wheelchair-bound clients in the fundamentals of Hatha Yoga. Lisa has conducted several lectures and workshops across the US, as well as in Honduras and Peru, where she volunteered her services. She currently resides and practices in Northern California. This and other articles by Lisa can be found at The Pragmatic Yogi.
The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.
RECOMMEND THIS ARTICLE
You must be logged in
to recommend articles
|
|
|
|
| |
|
|
 |
 |
|
 |
 |
 |
|
