Journal of occupational rehabilitation
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Randomized Controlled Trial Clinical Trial
Changes in cognitive-behavioral factors and muscle activation patterns after interventions for work-related neck-shoulder complaints: relations with discomfort and disability.
Knowledge regarding the working mechanism of an intervention is essential for obtaining a better understanding of the intervention and contributes to optimize its outcome. This study aimed at investigating whether changes in cognitive-behavioral factors and muscle activation patterns after myofeedback training and ergonomic counseling were associated with outcome, in subjects with work-related musculoskeletal neck-shoulder complaints. ⋯ Intervention effects were generally non-specific and findings suggested that cognitive-behavioral factors underlie the outcome of these interventions rather than changes in muscle activation patterns. Emphasizing these factors during therapy may increase the beneficial outcome of occupational interventions.
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Every year many workers are excluded from work because of a work disability attributable to a musculoskeletal disorder (MSD). Factors associated with the development and persistence of the work disability can be related to the worker, work environment, compensation policies, healthcare system and insurance system. Workers' understanding/representations of their disability are associated with coping behaviors aimed at helping them adapt to or solve their health problem. A representation is a complex, organized entity incorporating thoughts, beliefs, and attitudes regarding a particular subject. Representations have been studied in anthropology, sociology and psychology since the 1960s, but often in a compartmentalized way. These representations provide an important key to understanding what motivates workers during rehabilitation and the return-to-work process. To build upon disciplinary knowledge and better understand workers' efforts to cope with their persistent disability, this article therefore aims to pool the different knowledge available on the illness representation concept, from the fields of anthropology, sociology and psychology in order to gain a better understanding of its application in the MSD context. ⋯ Bridging the gap between these disciplines will help us achieve a new level of knowledge that will, by taking social interactions into account, enhance understanding of workers' representations, and the behaviors they adopt to manage their MSD-related disability.
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Successful management of workers on sick leave due to low back pain by the general physician and physiotherapist depends on reliable prognostic information on the course of low back pain and work resumption. ⋯ Knowledge of the predictive value of these indicators by physicians and physiotherapists will help to identify subgroups of patients and will thus enhance clinical decision-making.
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Work related upper extremity musculoskeletal disorders (MSD) result in substantial disability, and expense. Identifying workers or jobs with high risk can trigger intervention before workers are injured or the condition worsens. ⋯ The QuickDASH may be useful for identifying jobs or workers with increased risk for upper extremity MSDs. It may provide an efficient health surveillance screening tool useful for targeting early workplace intervention for prevention of upper extremity MSD problems.
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The present study examined the effects of pain chronicity on the responsiveness of psychosocial variables to intervention for whiplash injuries. ⋯ The findings suggest that self-reported disability is particularly resistant to change as the period of work disability extends over time. The findings emphasize the importance of early intervention and the need to develop strategies that specifically target disability beliefs in patients with whiplash injuries.