L'objectif général de cette étude consistait à décrire les pratiques des personnes impliquées dans la coordination du retour au travail dans de grandes organisations privées et publiques au Québec. Le premier objectif spécifique était de décrire les personnes impliquées dans la coordination du retour au travail, ainsi que les organisations pour lesquelles elles travaillent. Le deuxième objectif spécifique était de décrire les tâches et activités réalisées par ces personnes, identifier les acteurs avec lesquels elles sont appelées à collaborer, ainsi qu'établir les qualités et aptitudes requises pour effectuer la coordination du retour au travail. Enfin, le troisième objectif spécifique était d'explorer les leviers et les obstacles à l'accomplissement des tâches et activités, de même que ceux associés au retour au travail.
Corrélation entre des paramètres morphoanthropométriques et d'imagerie diagnostique et la fonction de l'épaule
L'objectif général du présent projet est de faire des analyses de corrélation entre différents paramètres d'imagerie diagnostique, morphologiques, posturaux et de pseudo-cinématique et la fonction de l'épaule chez deux groupes de travailleurs avec et sans rupture de la coiffe pour tenter d'établir les déterminants de la fonction de l'épaule.
L'objectif de cette étude prospective visait la validation de l'outil intitulé « Obstacles au Retour au Travail Et Sentiment d'Efficacité pour les Surmonter » (ORTESES) auprès d'employés en processus de RAT suite à un trouble mental courant (TMC) ou un trouble musculosquelettique (TMS). Plus précisément, il s'agissait de valider les propriétés psychométriques relatives à l'ORTESES : (1) validité de contenu, (2) validité apparente, (3) validité de construit, (4) stabilité temporelle (fidélité) et (5) validité prédictive.
Les exercices physiques permettent de réduire la douleur et les incapacités chez les gens souffrant d'une lombalgie non aiguë (> 3-4 semaines), mais ces effets sont relativement limités. Pour rehausser l'efficacité de ce type d'intervention, nous devons déterminer pour quels patients chaque modalité d'exercice est la plus efficace (arrimage patient/intervention) et pour quelles raisons (mécanismes sous-jacents). Dans la présente recherche, nous nous intéressons aux exercices de stabilisation lombaire, une modalité active d'exercice gagnant en crédibilité et en popularité. Trois objectifs spécifiques ont été poursuivis : (1) initier le développement de règles de prédiction clinique (RPC) de succès et d'échec pour dépister, lors de l'examen clinique, les patients qui répondront bien ou pas du tout à ces exercices; (2) étudier les mécanismes (d'origines neuromusculaire et psychologique) mis en action par ces exercices à l'aide de mesures plus spécifiques permettant de décrire les effets du traitement; (3) évaluer la fidélité test-retest de moyenne durée (8 semaines) des mesures neuromusculaires chez des sujets sains.
A One-Year Follow-Up of 54 026 Employees
Introduction: The diagnoses of workers being unfit to work may be a relevant health indicator. Therefore, the aim of this study was to analyze the one-year incidence of an unfit to work diagnosis.
Method: This one-year prospective study included all workers undergoing annual work medical examination from occupational health services in Troyes, France.
Results: Twenty-one occupational physicians followed 54,026 employees. The all-cause incidence of being unfit to return to work was 0.772%. The two main causes of being unfit to work were musculoskeletal disorders (61%) and psychopathologies (24%). The relative risk (RR) of being unfit to work, independent of the cause, was higher when employees were aged over 50 years (RR?=?2.51), and female (RR?=?1.51).
Conclusions: Prospective results from occupational physicians' medical records may provide significant and cost-effective directions to prioritize actions and target health promotion in the workplace.
Source: Dutheil, Frédéric; Naughton, Geraldine; Sindyga, Patricia; Lesage, François-Xavier. Journal of Occupational & Environmental Medicine: September 2016, volume 58, Issue 9, p. 918-923.
Background: The Quebec Back Pain Disability Scale (QBPDS) has been translated into different languages, and several studies on its measurement properties have been done.
Purpose: The purpose of this review was to critically appraise and compare the measurement properties, when possible, of all language versions of the QBPDS by systematically reviewing the methodological quality and results of the available studies.
Method: Bibliographic databases (PubMed, Embase, CINAHL, and PsycINFO) were searched for articles with the key words “Quebec,” “back,” “pain,” and “disability” in combination with a methodological search filter for finding studies on measurement properties concerning the development or evaluation of the measurement properties of the QBPDS in patients with nonspecific low back pain. Assessment of the methodological quality was carried out by the reviewers using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist for both the original language version of the QBPDS in English and French and all translated versions. The results of the measurement properties were rated based on criteria proposed by Terwee et al.
Results: The search strategy resulted in identification of 1,436 publications, and 27 articles were included in the systematic review. There was limited-to-moderate evidence of good reliability, validity, and responsiveness of the QBPDS for the different language versions, but for no language version was evidence available for all measurement properties.
Conclusion: For research and clinical practice, caution is advised when using the QBPDS to measure disability in patients with nonspecific low back pain. Strong evidence is lacking on all measurement properties for each language version of the QBPDS.
Source: Speksnijder, C. M., Koppenaal, T., Knottnerus, J. A., Spigt, M., Staal, J. B., & Terwee, C. B. (2016). Physical Therapy, 2016. http://dx.doi.org/10.2522/ptj.20140478.
Background: Chronic low back pain is one of the most common presenting complaints to a physician's office. Treatment is often challenging and recovery depends on various factors, often resulting in significant investments of time and resources.
Objective: The aim of this review is to determine which Web-based interventions aimed at chronic low back pain are of benefit to patients.
Methods: Randomized controlled trials (RCTs) studying Web-based interventions directed at adults with chronic low back pain were included. Retrospective studies, narrative reviews, nonrandomized trials, and observational studies were excluded. Electronic databases and bibliographies were searched.
Results: In total, nine unique RCTs were identified (total participants=1796). The number of patients randomized in each trial ranged from 51 to 580. Four trials studied online cognitive behavioral therapy (CBT) and five trials studied other Web-based interventions with interactive features. Empowerment/control was improved in six studies. Use of CBT was associated with reduced catastrophization among patients. Mixed results were reported with regards to reduction in pain levels and disability, although some studies showed promise in reducing disability in the short term. One study that measured health care utilization reported reduced utilization with the use of moderated email discussion.
Conclusions: Limited data are available regarding effective Web-based interventions to improve outcomes for patients with chronic low back pain. Nine RCTs with small sample sizes were identified in this review. Online CBT appears to show some promise in terms of reducing catastrophization and improving patient attitudes. Further research in this area with larger-scale studies focusing on appropriate outcomes appears to be a priority.
Source: Shashank Garg, Divya Garg, Tanvir C Turin, M Faruq U Chowdhury. J Med Internet Res, 2016; 18 (7), p. e139.
Background: Symptoms that persist subsequent to a work-related traumatic brain injury (wrTBI) influence the ability to return to work (RTW) and indicate areas of functional disability, as classified in the International Classification of Functioning, Disability and Health (ICF) framework.
Objective: The purpose of this study was to describe the relationship between RTW status and ICF framework domains in men and women with a wrTBI.
Methods: A retrospective chart review of 209 consecutive workers with TBI (mild TBI: 71.8%; mean age: 40.2 ± 11.1, men: 71.3%) was conducted. Workers were assessed during the chronic post-injury phase, at the neurology service of a large rehabilitation hospital in Ontario, Canada in 2003. Frequency distributions were calculated and chi-square tests performed.
Results: At the point of assessment, 78.0% of workers were in receipt of disability benefits, while the remainder had returned to work on a full- or part-time basis. Significant differences were observed in the Body Functions and Structures domain of the ICF model, specifically clinical diagnoses of depression, anxiety, pain disorders; self-perceived cognitive disturbance, and certain psychosocial factors (p < 0.05), between workers who had returned to work and those who had not. When stratified according to sex, these associations remained significant only in men.
Conclusions: The factors outlined above should be subject to further TBI research, as indicators for RTW. The lack of significant findings in women warrants further exploration of variables within the physical and social environmental domains of the ICF.
Source: Chen Xiong, Tickalyn Martin, Aneesha Sravanapudi, Angela Colantonio, Tatyana Mollayeva. Disability and Health Journal, Volume 9, Issue 3, July 2016, p. 439-448.
A participatory supportive return-to-work (RTW) program did not result in a significant shorter duration until sustainable RTW of workers without an employment contract, sick-listed due to a common mental disorder, compared to usual occupational healthcare. Further research is needed to consider how vocational needs of these vulnerable workers could be better addressed.
Source: Lammerts L, Schaafsma FG, Bonefaas-Groenewoud K, van Mechelen W, Anema JR. Scand J Work Environ Health, 2016.
Results From a Cohort Study
Objective: The aim of this study is to validate the use of the Framingham Risk Score (FRS) as clinical tool to predict the risk of diagnosis of unsuitability for work in a cohort of Italian workers.
Methods: A cohort of workers has been observed from January 2006 to March 2014. FRS was calculated at each visit. Health surveillance diagnosis of unsuitability for work was selected as outcome.
Results: Two thousand eight hundred fifty seven workers were observed, 58.9% were men, mean age was 51.6 (±6.7), the mean FRS was 15.1% (±10.7%). Increased values of FRS at baseline were associated with increased rate of diagnosis of unsuitability for work (Hazard ratio [HR], 11.2, 95%CI, 3.3 to 37.8).
Conclusions: FRS is a strong predictor of diagnosis of unsuitability for work and should be used as a clinical tool for the assessment of fitness for work in health surveillance.
Source: Palladino, Raffaele; Caporale, Oreste; Nardone, Antonio; Fiorentino, Denise; Torre, Ida; Triassi, Maria. Journal of Occupational & Environmental Medicine: August 2016, Volume 58, Issue 8, p. 805-809.
A Finnish cohort study of public sector employees
Work-related psychosocial factors that are measured once may not provide an accurate estimate of long-term exposure. Thus, we used repeated measures of organizational justice to evaluate its association with disability pension in a cohort of 24 895 Finnish public sector employees. High organizational justice was associated with lower risk of disability pension due to depression and musculoskeletal diseases.
Source: Juvani A, Oksanen T, Virtanen M, Elovainio M, Salo P, Pentti J, Kivimäki M, Vahtera J. Scand J Work Environ Health, 2016.
BACKGROUND: Multiple somatic symptoms are common and may cause prolonged sickness absence (SA) and unsuccessful return to work (RTW). AIMS: To compare three instruments and their predictive and discriminative abilities regarding RTW. METHODS: A longitudinal cohort study of participants recruited from two municipal job centres, with at least 8 weeks of SA. The instruments used were the Symptom Check List of somatic distress (SCL-SOM) (score 0-48 points), the Bodily Distress Syndrome Questionnaire (BDSQ) (0-120 points) and the one-item self-rated health (SRH) (1-5 points). The instruments' predictive value was explored in a time-to-event analysis. Different cut-points were analysed to find the highest number of correctly classified RTW cases, identified in a register on public transfer payments. RESULTS: The study involved 305 subjects. The adjusted relative risk regarding prediction of RTW was 0.89 [95% confidence interval (CI) 0.83-0.95], 0.89 (95% CI 0.83-0.95) and 0.78 (95% CI 0.70-0.86) per 5-, 10- and 1-point increase in the SCL-SOM, BDSQ and SRH, respectively. After mutual adjustment for the three instruments, only the prediction of RTW from SRH remained statistically significant 0.81 (95% CI 0.72-0.92). The highest sensitivity (86%) was found by SRH at the cut-point.
Source: Momsen AH, Stapelfeldt CM, Nielsen CV, et al. Occupational Médicine, 2016.
This review is part of a project of the European Agency for Safety and Health at Work (EU-OSHA), initiated by the European Parliament, on the safety and health of older workers. The objective of the review is to provide an up-to-date summary of knowledge regarding vocational rehabilitation and return-to-work systems, programmes and interventions and their different components.
In 2012 a working group consisting of representatives of Australian and New Zealand workers' compensation authorities, unions and employer groups developed a survey instrument and sampling methodology to be used to measure return to work outcomes of injured workers receiving workers' compensation and to better understand the experience of those injured workers and the factors that may have an effect on their return to work. In June 2012 Safe Work Australia's Strategic Issues Group for Workers' Compensation agreed to the survey instrument and methodology developed by the working group and the Social Research Centre was contracted to run the survey. In 2014, Safe Work Australia agreed that the survey should be run biennially. This is the third time the revised Return to Work Survey has been run.
A systematic review of the literature and meta-analysis
This systematic review identified a lack of evidence to support the effectiveness of "very early" (less than 15 days after the start of sickness absence) workplace intervention to reduce sick leave compared to usual care. Lack of consensus on definition of "very early/early" interventions, methodological design of studies, the extent, and timing of usual care provided and variable compliance between groups might explain the absence of demonstrated benefit.
Source: Vargas-Prada S, Demou E, Lalloo D, Avila-Palencia I, Sanati KA, Sampere M, Freer K, Serra C, Macdonald EB. Scand J Work Environ Health, 2016.
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