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Models of care for the management of persistent musculoskeletal pain and/or depression
Musculoskeletal pain can occur following damage to the muscles, ligaments, tendons, and bones. The three main causes of musculoskeletal pain are unusual or repetitive strain on the system, trauma to a specific area from a fall, sprain or blow, and certain musculoskeletal diseases.1 Many Australians experience musculoskeletal pain, however for a few, this becomes chronic or persistent. 2 Persistent musculoskeletal pain is often associated with depression and anxiety.3 Persistent musculoskeletal pain is a major cause of disability in older age and a major cause of work absence in the working age...
Long-Term Outcomes of Multidisciplinary Rehabilitation for Chronic Musculoskeletal Pain
Objectives: Evidence for the effectiveness of multidisciplinary rehabilitation for chronic musculoskeletal pain (CMP) has been reported but its outcomes in the longer term and in mixed groups of chronic pain patients are largely unknown. The aim of the present study was to describe the two-year outcomes of a 15-week multidisciplinary pain rehabilitation programme in patients with mixed CMP in terms of pain, activities, participation and healthcare usage. Methods: Data were recorded routinely at admission, discharge, and at three, 12 and 24 months' follow-up for all consecutive patients...
Return to Work in Patients with Chronic Musculoskeletal Pain: Multidisciplinary Intervention Versus Brief Intervention
A Randomized Clinical Trial Objective: This randomized clinical trial was performed to compare the effect of a new multidisciplinary intervention (MI) programme to a brief intervention (BI) programme on return to work (RTW), fully and partly, at a 12-month and 24-month follow-up in patients on long-term sick leave due to musculoskeletal pain. Methods: Patients (n = 284, mean age 41.3 years, 53.9 % women) who were sick-listed with musculoskeletal pain and referred to a specialist clinic in physical rehabilitation were randomized to MI (n = 141) or BI (n = 143). The MI included the use of a visual...
Web-Based Interventions for Chronic Back Pain: A Systematic Review
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...
Chronic low back pain among French healthcare workers and prognostic factors of return to work (RTW)
A non-randomized controlled trial Background: Many factors influence the return to work of workers with chronic low back pain (CLBP). They have been said to vary according to socio-professional group. This study first aimed to compare prognostic factors influencing the return to work of CLBP healthcare workers (HCWs) and other workers (non-HCWs) after rehabilitation coupled with an occupational intervention. The second objective was to improve the evolution of indicators such as clinical examination, psychosocial impact and pain impact. Methods: Between 2007 and 2012, a cohort of 217 CLBP workers...
Workplace strength training prevents deterioration of work ability among workers with chronic pain and work disability
A randomized controlled trial Objective Imbalance between work demands and individual resources can lead to musculoskeletal disorders and reduced work ability. The aim of this study was to evaluate the effect of two contrasting interventions on work ability among slaughterhouse workers with chronic pain and work disability. Methods Sixty-six slaughterhouse workers with upper-limb chronic pain and work disability were randomly allocated to 10 weeks of either strength training for the shoulder, arm, and hand muscles (3 times per week, 10 minutes per session) or ergonomic training (usual care control...
Occupational and genetic risk factors for osteoarthritis: A review
BACKGROUND : Osteoarthritis (OA) is a multifactorial disease with strong genetic and occupational components. Although published studies have described several risk factors for OA, very few studies have investigated the occupational and genetic factors that contribute to this debilitating condition. OBJECTIVE : To describe occupational and genetic factors that may contribute to the risk of developing (OA). METHODS : A literature search was conducted in PubMed using the search terms osteoarthritis, occupation, work, and genetics. RESULTS : Heavy physical work load was the most common occupational...
Introduction to the Special Section: Sustainability of Work with Chronic Health Conditions
Background The increasing prevalence of older workers and chronic health conditions represents a growing occupational health concern. More research is needed to understand risk factors, apply and adapt theories, and test workplace-focused interventions that might prevent work disability and disengagement among chronically ill workers. Methods A 2-h roundtable symposium involving 28 participants was held at an international conference (Second Scientific Conference on Work Disability Prevention & Integration, Groningen, The Netherlands) in October 2012. In that symposium, small groups of participants...
Predicting return to work following treatment of chronic pain disorder
Background : The care of injured workers with chronic pain remains an important public health issue given its increasing prevalence. The consequences often include loss of self-esteem and stress in family relationships. Aims: To report our interdisciplinary approach to the care of chronic pain disorder (CPD) and describe the predictors associated with a successful return to work (RTW). Methods : Relevant covariates, including demographic data, time from injury, and functional scores were recorded for clients injured at work in Ontario, Canada. Our primary outcome, RTW, was assessed at 3 months...
Prognostic Factors for Recovery in Chronic Nonspecific Low Back Pain: A Systematic Review
Verkerk, Karin (2012). Prognostic Factors for Recovery in Chronic Nonspecific Low Back Pain: A Systematic Review . Physical Therapy (sous presse, version électronique) Background Few data are available on predictors for a favorable outcome in patients with chronic non-specific low back pain (CNLBP). Purpose To assess prognostic factors for pain intensity, disability, return to work, quality of life, or global perceived effect in patients with CNLBP at short-term (≤ 6 months) and long-term (> 6 months) follow-up. Data Sources Relevant studies evaluating the prognosis of CNLBP were searched...
Pain coping in injured workers with chronic pain
What's unique about workers? Purpose: Pain caused by a work injury is a complex phenomenon comprising multiple factors, e.g. age, gender, prior health status, occupation, job demands, and severity of injury. Little research has focused on injured workers with chronic pain. This study investigates injured workers' pain coping. Methods: A descriptive cross-sectional study design was used to measure coping strategies of injured workers in a work rehabilitation program. Differences in coping strategies by demographics, injury-related variables, pain, disability, and depression were measured...
Transitions between sickness absence, work, unemployment, and disability in Denmark 2004-2008
Pedersen, J. et coll. (2012). Transitions between sickness absence, work, unemployment, and disability in Denmark 2004-2008. Scandinavian Journal of Work, Environment, and Health (sous presse). OBJECTIVES: Studies of labor market outcomes like sickness absence are usually restricted to a single outcome. This paper investigates the use of multi-state models for studying multiple transitions between sick-listing, work, unemployment, and disability pension by analyzing longitudinal register data. Every person sick-listed in Denmark during 2004 was followed until the spring of 2008. METHODS: A multi...
How well do observed functional limitations explain the variance in Roland Morris scores in patients with chronic non-specific low back pain undergoing physiotherapy?
Caporaso, F. et coll. How well do observed functional limitations explain the variance in Roland Morris scores in patients with chronic non-specific low back pain undergoing physiotherapy? European Spine Journal . Self-rated activity limitations in patients with non-specific chronic low back pain (cLBP) do not correlate well with performance in traditional tests of impairment (e.g. back strength, ROM, etc.). Tests using more “functional activities” have therefore been recommended as alternative “objective” outcome measures. We examined the relationship between a battery...
Identifying factors relevant in the assessment of return-to-work efforts in employees on long-term sickness absence due to chronic low back pain: a focus group study
Muijzer, Anne et coll. (2012, sous presse). Identifying factors relevant in the assessment of return-to-work efforts in employees on long-term sickness absence due to chronic low back pain: a focus group study. BMC Public Health , 12. (version provisoire en libre accès) Background: Efforts undertaken during the return to work (RTW) process need to be sufficient to prevent unnecessary applications for disability benefits. The purpose of this study was to identify factors relevant to RTW Effort Sufficiency (RTW-ES) in cases of sick-listed employees with chronic low back pain (CLBP). Methods...
Hommage au Docteur Ronald Melzack
Voici une série d'articles portant sur les processus neurosensoriels de la douleur en hommage au pionnier de la recherche dans ce domaine, le Docteur Ronald Melzack, professeur émérite au Département de psychologie de l'Université McGill et à qui nous devons le McGill Pain Questionnaire . Des collaborateurs des cinq continants ont participé à ce numéro spécial. http://www.neuropain.ch/sites/default/files/e-news/e-news_91.pdf
Evaluating Common Outcomes for Measuring Treatment Success for Chronic Low Back Pain
Chapman, J. R. et coll. (2011). Evaluating Common Outcomes for Measuring Treatment Success for Chronic Low Back Pain. Spine , 36 (21 Suppl): S54-S68. STUDY DESIGN.: Systematic review. OBJECTIVE.: To identify, describe, and evaluate common outcome measures in patients with chronic low back pain (CLBP). SUMMARY OF BACKGROUND DATA.: The treatment of CLBP has been associated with multiple clinical challenges. Further complicating this is the myriad of outcome scores used to assess treatment of CLBP. These scores have been used to examine different domains of patient satisfaction and quality of life...
Motor performance in chronic low back pain: is there an influence of pain-related cognitions? A pilot study
Kusters, Dymphy et coll. (2011). Motor performance in chronic low back pain: is there an influence of pain-related cognitions? A pilot study. BMC Musculoskeletal Disorders 2011, 12:211. (article en libre accès) Backgroundf: Chronic low back pain (CLBP) is often accompanied by an abnormal motor performance. However, it has not been clarified yet whether these deviations also occur during motor tasks not involving the back and whether the performance is influenced by pain and pain-related cognitions. Therefore, the aim of the present study is to get insight in the contribution of both pain...
Factors Influencing Work Interference in Patients With Chronic Low Back Pain: A Residency Research Network of Texas (RRNeT) Study
Young, Richard A. et coll. (2011). Factors Influencing Work Interference in Patients With Chronic Low Back Pain: A Residency Research Network of Texas (RRNeT) Study. The Journal of the American Board of Family Medicine, 24 (5): 503-510. (article en libre accès) Introduction: Chronic low back pain (CLBP) is a disabling and expensive condition commonly seen in family physicians' offices. A complete understanding of factors contributing to patients' return to work remains elusive. Objective: To describe patients with CLBP seen in family physicians' offices and to explore factors...
Troubles musculo-squelettiques : anxiété chez des travailleurs en réadaptation
Le rapport de recherche : Présence et évolution des facteurs de maintien du trouble de l’anxiété généralisée chez des travailleurs en réadaptation pour une douleur persistante d’origine musculo-squelettique porte sur cette problématique : La prévalence du trouble d’anxiété généralisée (TAG) est plus élevée chez les personnes ayant une lombalgie, comparativement à la population en générale. En présence d’un TAG, l’intolérance...
Barriers to and possibilities of returning to work after a multidisciplinary rehabilitation programme. A qualitative interview study
Sjöström, Rita et al. (2011). Barriers to and possibilities of returning to work after a multidisciplinary rehabilitation programme. A qualitative interview study. Work 39(3): 243-250. Objective: The aim of this qualitative study was to explore experiences of sick-listed persons of not returning to work during a six-year period after participation in an extensive multidisciplinary rehabilitation programme. Participants: The study comprised ten participants with musculoskeletal disorders, mainly neck and back pain. Methods: Semi-structured interviews were conducted and analysed by manifest...
Promoting Culturally Competent Chronic Pain Management Using the Clinically Relevant Continuum Model
Monsivais, Diane B. (2011). Promoting Culturally Competent Chronic Pain Management Using the Clinically Relevant Continuum Model. Nursing Clinics of North America , 46(2): 163-169. This article reviews the culture of biomedicine and current practices in pain management education, which often merge to create a hostile environment for effective chronic pain care. Areas of cultural tensions in chronic pain frequently involve the struggle to achieve credibility regarding one's complaints of pain (or being believed that the pain is real) and complying with pain medication protocols. The clinically...
Knee and low back complaints in professional hospital nurses: Occurrence, chronicity, care seeking and absenteeism
Alexopoulos, Evangelos C. et al. (2011). Knee and low back complaints in professional hospital nurses: Occurrence, chronicity, care seeking and absenteeism. Work 38 (4): 329-335. Objective: To investigate the relationships between physical, psychosocial, and individual characteristics and occurrence, chronicity, care seeking and absenteeism due to musculoskeletal complaints of the lower back and knee. Methods and Participants: This was a cross-sectional study among 350 nursing personnel in six hospitals in South-West Greece. Data related to physical and psychosocial workload, need for recovery...
Correlations between pain and function in a longitudinal low back pain cohort
McGorry, R.W. et al. (2011). Correlations between pain and function in a longitudinal low back pain cohort. Disability & Rehabilitation , 33 (11): 945-952. Purpose .   Most studies of low back pain (LBP) and functional limitation have been cross-sectional, and show only modest correlations between pain and function. Though functional limitation may be superior for predicting disability outcomes, there is a need to understand better the gap between pain and function. This study analysed changes in intra-individual correlations between pain and function over time. Method .   Seventeen...
Douleur, dépression, incapacité et résultats de la réadaptation
Cette étude avait pour objectif principal d'évaluer le lien entre les symptômes de dépression et les résultats de la réadaptation chez des personnes ayant subi des lésions musculo-squelettiques au travail. Les résultats de cette étude indiquent que la dépression agit négativement sur la réponse d’un patient à la réadaptation et sur son retour au travail. Dans ce document, les auteurs de l’étude discutent des processus à travers lesquels la dépression pourrait influencer...
A Multidimensional Measure of Pain Interference: Reliability and Validity of the Pain Disability Assessment Scale
Koji, Yamashiro et al. (2011). A Multidimensional Measure of Pain Interference: Reliability and Validity of the Pain Disability Assessment Scale. Clinical Journal of Pain 27 (4): 338–343. Measuring outcomes across multiple domains is essential for an adequate understanding of chronic pain and the effects of pain treatment. Pain interference reflects the negative effects of pain on functioning, and is recognized as a critical outcome domain. The Pain Disability Assessment Scale (PDAS) contains items that assess the negative effects of pain on broad spectrum pain interference domains. The purpose...
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