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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...
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...
Length of Disability and Medical Costs in Low Back Pain
Do State Workers' Compensation Policies Make a Difference? Objective: The aim of the study was to examine the impact of state workers' compensation (WC) policies regarding wage replacement and medical benefits on medical costs and length of disability (LOD) in workers with low back pain (LBP). Methods: Retrospective cohort analysis of LBP claims from 49 states (n?=?59,360) filed between 2002 and 2008, extracted from a large WC administrative database. Results: Longer retroactive periods and state WC laws allowing treating provider choice were associated with higher medical costs and longer...
Results of a feasibility study: barriers and facilitators in implementing the Sherbrooke model in France
Objectives: Return-to-work interventions associated with the workplace environment are often more effective than conventional care. The Sherbrooke model is an integrated intervention that has proved successful in preventing work disability due to low-back pain. Implementation, however, runs up against many obstacles, and failure has been reported in many countries. The present study sought to identify barriers to and facilitators of the implementation of the Sherbrooke model within the French health system. Methods: A multiple case study with nested levels of analysis was performed in two regions...
How can a brief intervention contribute to coping with back pain?
A focus group study about participants' expériences Background: Our aim was to explore how individuals who had participated in a brief back and neck pain intervention perceived connections between the intervention and their subsequent coping. Methods: Three focus group discussions were conducted with a sample of ten employees aged 20–67 years, who had participated in a brief intervention for back and neck pain, perceived the intervention as helpful and had returned or remained at work subsequent to the intervention. Participants were invited to share stories of how the intervention...
Multidisciplinary biopsychosocial rehabilitation for chronic low back pain
Low back pain (LBP) is responsible for considerable personal suffering worldwide. Those with persistent disabling symptoms also contribute to substantial costs to society via healthcare expenditure and reduced work productivity. While there are many treatment options, none are universally endorsed. The idea that chronic LBP is a condition best understood with reference to an interaction of physical, psychological and social influences, the 'biopsychosocial model', has received increasing acceptance. This has led to the development of multidisciplinary biopsychosocial rehabilitation (MBR...
Evaluation of Functional Restoration Outcomes for Chronic Disabling Occupational Cervical Disorders
Objective: To systematically evaluate the effectiveness of an interdisciplinary functional restoration program (FRP) for treating chronic cervical disorders. Methods: Consecutive chronic occupational lumbar disorder patients (n = 898) and chronic occupational cervical disorder patients (n = 215) were admitted to an FRP from 2001 to 2011. Patients were compared on demographics, work-related and psychosocial factors, and socioeconomic outcomes 1 year after discharge. Results: Compared with lumbar patients, cervical patients were more likely to be female, have preadmission surgery, perform white-collar...
Exploring factors facilitating adults with spinal cord injury rejoining the workforce
A pilot study BACKGROUND: Return-to-work (RTW) rates after spinal cord injury (SCI) in the USA are very low and are continuing to decline. Previous research has attempted to identify factors facilitating RTW; however, the phenomenon of RTW involves many personal factors and predicting RTW success remains difficult. PURPOSE: The purpose of this pilot study was to explore the factors facilitating adults with SCI rejoining the workforce in an urban area in order to identify items that may be emphasized in the rehabilitation process. METHODS: The study was completed using qualitative methods. Four...
Absence from work and return to work in people with back pain
A systematic review and meta-analysis Background: A considerable proportion of work absence is attributed to back pain, however prospective studies in working populations with back pain are variable in setting and design, and a quantitative summary of current evidence is lacking.Objective: To investigate the extent to which differences in setting, country, sampling procedures and methods for data collection are responsible for variation in estimates of work absence and return to work.Methods: Systematic searches of seven bibliographic databases. Inclusion criteria were: adults in paid employment...
Barriers to change in depressive symptoms following multidisciplinary rehabilitation for whiplash
The role of perceived injustice OBJECTIVE: Depressive symptoms complicate patients' recovery following musculoskeletal injury. There is strong evidence to support the utility of multidisciplinary approaches for treating comorbid pain and depressive symptoms. Despite this, a significant proportion of patients may not experience meaningful reductions in depressive symptoms following intervention. The purpose of this study was to identify barriers to change in depressive symptom during multidisciplinary rehabilitation for patients with whiplash injuries. METHODS: 53 patients with clinically meaningful...
Outcomes of the introduction of a standardized fitness-for-duty evaluation of commercial truck drivers on the incidence of low back injuries and workers' compensation costs
OBJECTIVE: To determine the incidence of low back injuries and associated workers' compensation costs before and after the introduction of a standardized fitness-for-duty evaluation of commercial truck drivers who present for their comprehensive Department of Transportation (DOT) physical examination. METHODS: Trained physical therapists administered questionnaires and performed functional testing of commercial truck drivers scheduled for their DOT examination. The results were communicated to providers performing DOT examinations. Incidence rates of low back injury and associated workers'...
The return-to-work process of individuals sick-listed because of whiplash-associated disorder
A three-year follow-up study in a Danish cohort of long-term sickness absentees BACKGROUND: The chronic course of whiplash-associated disorder (WAD) has implications for both the individual and society. It has been shown that up to 50% of patients have not yet returned to work six months after a whiplash injury. We wanted to study the return-to-work (RTW) process in individuals sick-listed for more than eight weeks in six Danish municipalities. RTW in individuals sick-listed due to WAD was compared to that in those sick-listed for other musculoskeletal disorders (MSD). METHODS: Information about...
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...
Return to work and productive activities following a spinal cord injury
The role of income and insurance Study design:We analyzed longitudinal data on secondary outcomes from participants in a telerehabilitation study.Objectives:To examine the factors affecting return to productive activities and employment and the time to these events following a spinal cord injury (SCI).Setting:A large southeastern rehabilitation hospital in the United States.Methods:We used hazard regression models to analyze data from newly injured people (n=111) participating in an educational intervention post discharge who were followed for up to 2 years. Outcomes were time to return to productive...
Prediction of postinjury employment and percentage of time worked after spinal cord injury
OBJECTIVE: To use a 2-part model to identify biographic, injury, educational, and vocational predictors of postinjury employment and the percentage of time employed after spinal cord injury (SCI) onset. DESIGN: Survey. SETTING: Data were collected at 3 hospitals in the Southeastern and Midwestern United States. PARTICIPANTS: Participants were adults with traumatic SCI of at least 1 year duration, all under 65 years at the time of SCI onset. A total of 1329 observations were used in the analysis. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Postinjury employment, defined by whether the...

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