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Physiotherapy for injured workers in Canada: are insurers’ and clinics’ policies threatening good quality and equity of care?
Results of a qualitative study In recent years, significant efforts have been made to improve the provision of care for compensated injured workers internationally. However, despite increasing efforts at implementing best practices in this field, some studies show that policies overseeing the organisation of care for injured workers can have perverse influences on healthcare providers' practices and can prevent workers from receiving the best care possible. The influence of these policies on physiotherapists' practices has yet to be investigated. Our objectives were thus to explore the...
Return to Work in Employees on Sick Leave due to Neck or Shoulder Pain
A Randomized Clinical Trial Comparing Multidisciplinary and Brief Intervention with One-Year Register-Based Follow-Up Purpose: The aim of this study was to evaluate the effect of a multidisciplinary intervention (MDI) compared to a brief intervention (BI) with respect to return to work (RTW), pain and disability in workers on sick leave because of neck or shoulder pain. Methods: 168 study participants with sickness absence for 4–16 weeks due to neck or shoulder pain were enrolled in a hospital-based clinical study and randomized to either MDI or BI. The primary outcome was RTW obtained by...
Rehabilitation and return to work after cancer - Instruments and practices
Being diagnosed with cancer has immediate and long-lasting effects, even after the completion of treatment. This project explores the occupational safety and health challenges that employers and employees face when workers return to work after a diagnosis of cancer. The report provides national examples of successful instruments and practices that help prevent long-term sickness absence and unemployment. Source:
Return to work after work-related stress
A randomized controlled trial of a work-focused cognitive behavioral intervention In this randomized controlled trial (RCT) study, a work-focused cognitive behavioral therapy (CBT) treatment combined with an optional workplace intervention was associated with faster lasting return to work compared to a control group that received clinical assessment among patients on sick leave due to work-related stress. The intervention group returned to work four weeks faster, which could have substantial financial impact on both the employee and related societal costs. Source: Dalgaard, V. L., Aschbacher, K...
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...
Effects of a randomized controlled intervention trial on return to work and health care utilization after long-term sickness absence
BACKGROUND: The aim of the RCT study was to investigate if the effect of a multidisciplinary intervention on return to work (RTW) and health care utilization differed by participants' self-reported health status at baseline, defined by a) level of somatic symptoms, b) health anxiety and c) self-reported general health. METHODS: A total of 443 individuals were randomized to the intervention (n = 301) or the control group (n = 142) and responded to a questionnaire measuring health status at baseline. Participants were followed in registries measuring RTW and health care utilization. Relative...
Research review on rehabilitation and return to work
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. Source:
Estimating the Net Benefit of a Specialized Return-to-Work Program for Workers on Short-Term Disability Related to a Mental Disorder
An Example Exploring Investment in Collaborative Care Objective: This article estimates the net benefit for a company incorporating a collaborative care model into its return-to-work program for workers on short-term disability related to a mental disorder. Methods: Employing a simple decision model, the net benefit and uncertainty were explored. Results: The breakeven point occurs when the average short-term disability episode is reduced by at least 7 days. In addition, 85% of the time, benefits could outweigh costs. Conclusions: Model results and sensitivity analyses indicate that organizational...
Santé mentale au travail
Projet-pilote pour passer d'une approche individuelle de réadaptation à une approche organisationnelle de prévention Les problèmes de santé mentale au travail représentent actuellement l'une des plus importantes causes d'absence du travail, et ce phénomène a connu une croissance marquée au cours des dernières années. Nos travaux antérieurs ont révélé que la majorité des travailleurs qui se sont absentés en raison d'un problème de santé mentale font...
Are work disability prevention interventions effective for the management of neck pain or upper extremity disorders?
A systematic review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration Purpose We conducted a systematic review to critically appraise and synthesize literature on the effectiveness of work disability prevention (WDP) interventions in workers with neck pain, whiplash-associated disorders (WAD), or upper extremity disorders. Methods We searched electronic databases from 1990 to 2012. Random pairs of independent reviewers critically appraised eligible studies using the Scottish Intercollegiate Guidelines Network criteria. Scientifically admissible studies were summarized...
Evaluation of Functional Restoration Outcomes for Chronic Disabling Occupational Lower Extremity Disorders
Objective: To compare patients with chronic low back pain (LBP) with those with chronic lower extremity (LE) disorders. Methods: Participants were 2164 consecutive patients with either LE or LBP disorders, admitted to a functional restoration program (FRP). Analyses compared demographic, psychosocial, and work-related factors and 1-year post-FRP socioeconomic outcomes. Results: Patients with LE disorders initially reported lower symptom levels of depression, pain, and disability and were also less likely to have a substance use or opioid dependence disorder, relative to LBP patients. Both groups...
IWH research helps shape new work integration initiative
In November 2010, Ontario's Workplace Safety and Insurance Board introduced the new Work Reintegration Program. Many of its features address problems with the old vocational rehabilitation program that were described by Institute for Work & Health research. By 2009, Ontario's Workplace Safety and Insurance Board (WSIB) was certainly getting the message that its vocational rehabilitation program for injured workers, called Labour Market Re-entry (LMR), was not working as intended. Although bad press and a value-for-money audit drove the point home, evidence from a research project started...
Return-to-Work Activities in a Chinese Cultural Context
Cheng, A. S., Loisel, P., Feuerstein, M. (2011). Return-to-Work Activities in a Chinese Cultural Context. Journal of Occupational Rehabilitation , 21 (supplement 1): 44-54. (Accès limité) Introduction Several studies have been conducted in the West showing that return to work (RTW) coordination is a key element to facilitate RTW of injured workers and to prevent work disabilities. However, no study has been carried out to investigate the scope of RTW activities in China. The purpose of this study was to explore the views of key RTW stakeholders on necessary activities for RTW coordination...
Health Maintenance Care in Work-Related Low Back Pain and Its Association With Disability Recurrence
Cifuentes, Manuel et al. (2011). Health Maintenance Care in Work-Related Low Back Pain and Its Association With Disability Recurrence. Journal of Occupational & Environmental Medicine , 53 (4): 396–404. Objectives: To compare occurrence of repeated disability episodes across types of health care providers who treat claimants with new episodes of work-related low back pain (LBP). Method: A total of 894 cases followed 1 year using workers’ compensation claims data. Provider types were defined for the initial episode of disability and subsequent episode of health maintenance care....
Community occupational therapists' clinical reasoning: Identifying tacit knowledge
Occupational therapy interventions in the community, a fast expanding practice setting, are central to an important social priority, the ability to live at home. These interventions generally involve only a small number of home visits, which aim at maximising the safety and autonomy of community-dwelling clients. Knowing how community occupational therapists determine their interventions, i.e. their clinical reasoning, can improve intervention efficacy. However, occupational therapists are often uninformed about and neglect the importance of clinical reasoning, which could underoptimise their interventions...
Development of a Unique Triage System for Acute Care Physical Therapy and Occupational Therapy Services
An Administrative Case Report This administrative case report documents the development of a mechanism by which systematic triage was used to assign patients to therapists in acute care settings. The primary objective was to develop a triage tool to improve patient access to medically necessary therapy services. Physical Therapy , October 2010, Volume 90, Issue 10. Source :
Work-Anxiety and Sickness Absence After a Short Inpatient Cognitive Behavioral Group Intervention in Comparison to a Recreational Group Meeting
Objective: The aim of this study was to study the effects of a short-term cognitive behavior therapy on work-anxiety and sickness-absence in patients with work-anxiety. Methods: Three-hundred forty-five inpatients who suffered from cardiologic, neurological, or orthopedic problems and additionally work-anxiety were randomly assigned into two different group interventions. Patients got four sessions of a group intervention, which either focused on cognitive behavior–therapy anxiety–management (work-anxiety coping group, WAG) or unspecific recreational activities (RG). Results: No differences...
Vulnerable workers more likely to receive no income for work-related absence
This study aimed to find out the percentage of employees in Canada who receive workers' compensation benefits or other replacement wages after a work-related injury or illness lasting one week or longer. In particular, the researchers wanted to determine if some groups of workers were more or less likely to receive income-replacement payments following a work injury. Source:
Red Flags/Green Lights
A Guide to Identifying and Solving Return-to-Work Problems Most injured workers return to their jobs successfully. For a few, however, problems may arise that complicate their recovery and return to work. This guide, based on IWH research, is designed for such situations. It presents warning signs (or red lights) and helpful practices (or green lights) for those involved in the return-to-work, health-care, vocational rehabilitation or claims process.

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