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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...
Étude des qualités psychométriques de l’Outil d’identification de la situation de handicap au travail (OISHT) utilisé auprès de travailleurs ayant un trouble musculosquelettique ou un trouble mental courant
L'outil d'identification de la situation de handicap au travail (OISHT) consiste en une entrevue structurée qui a été développée pour aider les cliniciens à identifier de façon systématique les facteurs liés à l'incapacité au travail. L'OISHT est un des rares outils disponibles en réadaptation pour la clientèle en phase chronique d'incapacité au travail. Il tient compte de l'influence de différents systèmes (personnel, santé, travail, indemnisation) et a...
Sickness absence after carpal tunnel release
A systematic review of the literature Objectives: The aim of this systematic review was to provide an overview of time to return to work (RTW) after carpal tunnel release (CTR), including return to different occupations and working patterns. Methods: A systematic search from inception to 2016 was conducted using nine electronic databases, trial registries and grey literature repositories. Randomized controlled trials and observational studies reporting RTW times after CTR were included. Study risk of bias was assessed using Cochrane risk of bias assessment tools. Time to RTW was summarized using...
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...
Validation of the Readiness for Return-To-Work Scale in outpatient occupational rehabilitation in Canada
Purpose: To examine construct and concurrent validity of the Readiness for Return-To-Work (RRTW) Scale with injured workers participating in an outpatient occupational rehabilitation program. Methods: Lost-time claimants (n = 389) with sub-acute or chronic musculoskeletal disorders completed the RRTW Scale on their first day of their occupational rehabilitation program. Statistical analysis included exploratory and confirmatory factor analyses of the readiness items, reliability analyses, and correlation with related scales and questionnaires. Results: For claimants in the non-job...
Effets psychologiques et biomécaniques immédiats de deux catégories de ceintures lombaires chez des travailleurs en santé et des travailleurs avec maux de dos
Bien que les ceintures lombaires (CL) soient inefficaces pour prévenir un premier épisode de lombalgie, l'avancement des connaissances soutient leur utilisation chez les travailleurs souffrant déjà de ce mal. Dans la perspective où un retour au travail tardif risque de nuire à la condition de santé des travailleurs, l'option du port de la CL peut potentiellement être avantageuse, car elle pourrait permettre, lors du retour progressif au travail, d'apporter un soutien psychologique afin de rassurer le patient. Cela pourrait donc...
Identifying return-to-work trajectories using sequence analysis in a cohort of workers with work-related musculoskeletal disorders
Objectives: This study aimed to identify return-to-work (RTW) trajectories among workers with work-related musculoskeletal disorders (MSD) and examine the associations between different MSD and these RTW trajectories. Methods: We used administrative workers' compensation data to identify accepted MSD lost-time claims with an injury date between 2010–2012 in British Columbia, Canada. Cox regression analyses were used to investigate differences in time to RTW between MSD. Validated day-to-day calendar measures of four RTW states (sickness absence, modified RTW, RTW, and non-RTW) were grouped...
Pratiques des milieux de travail pour assurer un retour en emploi sain et durable
Au Québec, la Loi sur les accidents du travail et des maladies professionnelles (LATMP) établit que tout travailleur ayant subi une lésion professionnelle qui porte atteinte à son intégrité physique ou psychique a droit à la réadaptation que requiert son état en vue de sa réinsertion sociale et professionnelle. La LATMP prévoit aussi un droit de retour au travail lorsque le travailleur redevient capable d’exercer son métier. Les organisations et les travailleurs sont donc directement concernés par la...
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...
Length of sickness absence and sustained return-to-work in mental disorders and musculoskeletal diseases
A cohort study of public sector employees This study adds to the scientific evidence on the length of sickness absence until sustained return to work (SRTW) in depression, anxiety disorders, intervertebral disc disorders, and back pain among Finnish public sector employees. Timescales are provided for returning to work in different occupational groups also taking into consideration the persistence of the health problem and comorbid conditions. Source: Kausto, J., Pentti, J., Oksanen, T., Virta, L. J., Virtanen, M., Kivimäki, M., & Vahtera, J. (2017). Scandinavian Journal of Work, Environment...
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...
Effectiveness of Workplace Interventions in Return-to-Work for Musculoskeletal, Pain-Related and Mental Health Conditions
An Update of the Evidence and Messages for Practitioners Purpose: The objective of this systematic review was to synthesize evidence on the effectiveness of workplace-based return-to-work (RTW) interventions and work disability management (DM) interventions that assist workers with musculoskeletal (MSK) and pain-related conditions and mental health (MH) conditions with RTW. Methods: We followed a systematic review process developed by the Institute for Work & Health and an adapted best evidence synthesis that ranked evidence as strong, moderate, limited, or insufficient. Results: Seven electronic...
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...
Effectiveness of Workplace Interventions in Return-to-Work for Musculoskeletal, Pain-Related and Mental Health Conditions
An Update of the Evidence and Messages for Practitioners Purpose: The objective of this systematic review was to synthesize evidence on the effectiveness of workplace-based return-to-work (RTW) interventions and work disability management (DM) interventions that assist workers with musculoskeletal (MSK) and pain-related conditions and mental health (MH) conditions with RTW. Methods: We followed a systematic review process developed by the Institute for Work & Health and an adapted best evidence synthesis that ranked evidence as strong, moderate, limited, or insufficient. Results: Seven electronic...
Effectiveness of Occupational Therapy Interventions for Lower-Extremity Musculoskeletal Disorders
A Systematic Review Lower-extremity (LE) musculoskeletal disorders (MSDs) can have a major impact on the ability to carry out daily activities. The effectiveness of interventions must be examined to enable occupational therapy practitioners to deliver the most appropriate services. This systematic review examined the literature published between 1995 and July 2014 that investigated the effectiveness of occupational therapy interventions for LE MSDs. Forty-three articles met the criteria and were reviewed. Occupational therapy interventions varied on the basis of population subgroup: hip fracture...
Troubles musculosquelettiques
Revue réaliste sur les bases théoriques des programmes de réadaptation incluant le milieu de travail Une revue réaliste portant sur un ensemble de programmes de réadaptation au travail incluant une intervention en milieu de travail a été réalisée. Selon cette méthode, les programmes se caractérisent par trois éléments principaux : le contexte (C), qui représente les caractéristiques des conditions dans lesquelles les programmes sont mis en place et les composantes de ces derniers; les mécanismes...
Effectiveness of Occupational Therapy Interventions for Adults With Musculoskeletal Conditions of the Forearm, Wrist, and Hand
A Systematic Review Occupational therapy practitioners are key health care providers for people with musculoskeletal disorders of the distal upper extremity. It is imperative that practitioners understand the most effective and efficient means for remediating impairments and supporting clients in progressing to independence in purposeful occupations. This systematic review provides an update to a previous review by summarizing articles published between 2006 and July 2014 related to the focused question, What is the evidence for the effect of occupational therapy interventions on functional outcomes...
Factors Associated With Success in an Occupational Rehabilitation Program for Work-Related Musculoskeletal Disorders
Work-related musculoskeletal disorders are a significant burden; however, no consensus has been reached on how to maximize occupational rehabilitation programs for people with these disorders, and the impact of simulating work tasks as a mode of intervention has not been well examined. In this retrospective cohort study, the authors used logistic regression to identify client and program factors predicting success for 95 clients in a general occupational rehabilitation program and 71 clients in a comprehensive occupational rehabilitation program. The final predictive model for general rehabilitation...
Return to work after vocational rehabilitation for sick-listed workers with long-term back, neck and shoulder problems
A follow-up study of factors involved BACKGROUND: Absence from work due to musculoskeletal disorders is a significant problem from a number of perspectives, and there is a great need to identify factors that facilitate return to work (RTW). OBJECTIVE: To identify factors related to RTW after vocational rehabilitation for sick-listed workers with long-term back, neck and/or shoulder problems, and to compare the results with those from a previous literature review based on studies from 1980 to 2000. METHODS: A literature review based on studies published 2001–2014 in PubMed, CINAHL, EMBASE...
Travailleurs avec déchirure de la coiffe des rotateurs et asymptomatiques
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. Source: http...
Validation du questionnaire Obstacles au Retour au Travail Et Sentiment d’Efficacité pour les Surmonter (ORTESES) auprès de travailleurs avec un trouble mental courant ou un trouble musculosquelettique
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...
Développement préliminaire d’une règle de prédiction clinique pour dépister les patients ayant une lombalgie non aiguë répondant favorablement à un programme d’exercice de stabilisation lombaire
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...
Ill Health–Related Job Loss
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...
Measurement Properties of the Quebec Back Pain Disability Scale in Patients With Nonspecific Low Back Pain
Systematic Review 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...
Organizational justice and disability pension from all-causes, depression and musculoskeletal diseases
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. http...
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