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Carrière JS, Donayre Pimentel S, Bou Saba S, Boehme B, Berbiche D, Coutu MF, Durand MJ. Recovery expectations can be assessed with single-item measures: findings of a systematic review and meta-analysis on the role of recovery expectations on return-to-work outcomes after musculoskeletal pain conditions. Pain 2023; 164:e190-e206. [PMID: 36155605 PMCID: PMC10026834 DOI: 10.1097/j.pain.0000000000002789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 08/15/2022] [Accepted: 09/06/2022] [Indexed: 11/26/2022]
Abstract
ABSTRACT The objective of this systematic review is to quantify the association between recovery expectations and return-to-work outcomes in adults with musculoskeletal pain conditions. In addition, this review has the second objective to compare the predictive utility of single-item and multi-item recovery expectation scales on return-to-work outcomes. Relevant articles were selected from Embase, PsycINFO, PubMed, Cochrane, and manual searches. Studies that assessed recovery expectations as predictors of return-to-work outcomes in adults with musculoskeletal pain conditions were eligible. Data were extracted on study characteristics, recovery expectations, return-to-work outcomes, and the quantitative association between recovery expectations and return-to-work outcomes. Risk of bias was assessed using the Effective Public Health Practice Project. Odds ratios were pooled to examine the effects of recovery expectations on return-to-work outcomes. Chi-square analyses compared the predictive utility of single-item and multi-item recovery expectation scales on return-to-work outcomes. Thirty studies on a total of 28,741 individuals with musculoskeletal pain conditions were included in this review. The odds of being work disabled at follow-up were twice as high in individuals with low recovery expectations (OR = 2.06 [95% CI 1.20-2.92] P < 0.001). Analyses also revealed no significant differences in the predictive value of validated and nonvalidated single-item measures of recovery expectations on work disability (χ 2 = 1.68, P = 0.19). There is strong evidence that recovery expectations are associated with return-to-work outcomes. The results suggest that single-item measures of recovery expectations can validly be used to predict return-to-work outcomes in individuals with musculoskeletal pain conditions.
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Affiliation(s)
- Junie S. Carrière
- École de réadaptation, Faculté de médecine et des sciences de la santé, Centre de Recherche Charles-Le Moyne, Centre d'action en prévention et en réadaptation de l'incapacité au travail, Université de Sherbrooke, Longueuil, QC, Canada
| | | | - Sabine Bou Saba
- School of Mind and Brain, Humboldt Universität zu Berlin, Berlin, Germany
| | - Blake Boehme
- Department of Psychology, University of Regina, Regina, Saskatchewan
| | - Djamal Berbiche
- Département des sciences de la santé communautaire, Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Marie-France Coutu
- École de réadaptation, Faculté de médecine et des sciences de la santé, Centre de Recherche Charles-Le Moyne, Centre d'action en prévention et en réadaptation de l'incapacité au travail, Université de Sherbrooke, Longueuil, QC, Canada
| | - Marie-José Durand
- École de réadaptation, Faculté de médecine et des sciences de la santé, Centre de Recherche Charles-Le Moyne, Centre d'action en prévention et en réadaptation de l'incapacité au travail, Université de Sherbrooke, Longueuil, QC, Canada
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Musculoskeletal pain in Primary Care Physiotherapy: Associations with demographic and general health characteristics. Musculoskelet Sci Pract 2018; 35:61-66. [PMID: 29547788 DOI: 10.1016/j.msksp.2018.03.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Revised: 02/22/2018] [Accepted: 03/05/2018] [Indexed: 01/27/2023]
Abstract
BACKGROUND Many patients reporting musculoskeletal pain present to Primary Care Physiotherapy with costly comorbid overlapping complaints that remain medically unexplained. These subjective health complaints (SHC) incorporate coexisting multi-site musculoskeletal pain and varied non-musculoskeletal complaints (e.g. anxiety, tiredness). The role of these non-musculoskeletal complaints is acknowledged in spinal musculoskeletal disorders, but less so for peripheral musculoskeletal disorders. OBJECTIVE This cross-sectional study explored the relationships between self-reported musculoskeletal pain sites, non-musculoskeletal complaints and disability among people reporting spinal or peripheral musculoskeletal pain. METHODS Fifty individuals with spinal musculoskeletal pain and fifty with peripheral musculoskeletal pain provided data on disability, number of musculoskeletal pain sites and non-musculoskeletal complaints. Relationships between these variables were examined for each group using Pearson's correlation coefficient and linear regression analysis. RESULTS Participants with spinal musculoskeletal pain recorded significantly more pain sites and non-musculoskeletal complaints than participants with peripheral musculoskeletal pain. However, there was no significant difference in disability between the groups. Non-musculoskeletal complaints were significantly associated with disability (correlation = 0.41, p < 0.01) and number of pain sites (correlation = 0.42, p < 0.01). Number of pain sites and disability were not significantly associated in either group. Participants with spinal musculoskeletal pain reported more tiredness, dizziness, anxiety and sleep problems. Participants reporting dizziness, anxiety, sadness/depression and sleep problems had higher disability. CONCLUSION Further studies must confirm the robustness of these associations, to permit comparisons between clinical and general populations and aid identification of causal factors. Considering SHC within individualised management programmes may improve outcomes.
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Jankowiak S, Rose U, Kersten N. Application of the ICF based Norwegian function assessment scale to employees in Germany. J Occup Med Toxicol 2018; 13:3. [PMID: 29344078 PMCID: PMC5765624 DOI: 10.1186/s12995-017-0183-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Accepted: 12/22/2017] [Indexed: 11/10/2022] Open
Abstract
Background At the interface of the occupational setting and rehabilitation, normative values for functional ability are desirable and worthwhile. The Norwegian Function Assessment Scale (NFAS) is a 39 item self-report instrument based on the International Classification of Functioning, Disability and Health (ICF). As the questionnaire was not used in a working population, we aimed to obtain functional levels of employees in Germany as measured through the NFAS. Methods The NFAS was included in the Study on Mental Health at Work (S-MGA) 2011/12, a representative German survey of employees aged 31 to 60 years. For descriptive analyses, 95% confidence intervals were applied through bootstrap estimation to the skewed data of the NFAS (range from 1 = 'no difficulty' to 5 = 'could not do it'). The data were analysed by age decades, professional qualification, and by disabilities, congenital diseases and accidents, stratified by sex. Linear regression analyses were conducted to estimate adjusted effects of age, professional qualification, and health limitations. Results The NFAS total score was 1.17 (95% CI = 1.15-1.17). Thirty-five percent of the employees' (1378 out of 3937 participants) reported the best possible functional ability (NFAS total score of 1.00). Managing and walking/standing were the NFAS' most affected domains with a score of 1.26 (95% CI = 1.23-1.27), respectively. The regression analysis confirmed more functional difficulties for elder employees, females, employees with low professional qualification, and for employees suffering from disability and accidents. Conclusions The study presents normative values of functional ability for the workforce. The results are useful for score interpretation in rehabilitation and return-to-work processes.
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Affiliation(s)
- Sylvia Jankowiak
- Division Work and Health, Federal Institute for Safety and Health (BAuA), Noeldnerstr. 40/42, D-10317 Berlin, Germany
| | - Uwe Rose
- Division Work and Health, Federal Institute for Safety and Health (BAuA), Noeldnerstr. 40/42, D-10317 Berlin, Germany
| | - Norbert Kersten
- Division Work and Health, Federal Institute for Safety and Health (BAuA), Noeldnerstr. 40/42, D-10317 Berlin, Germany
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Young AE, Besen E, Choi Y. The importance, measurement and practical implications of worker's expectations for return to work. Disabil Rehabil 2015; 37:1808-16. [PMID: 25374043 DOI: 10.3109/09638288.2014.979299] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE Workers' own expectations for return to work consistently predict work status. To advance the understanding of the relationship between RTW expectations and outcomes, we reviewed existing measures to determine those which we felt were the most likely to capture the construct. METHOD A comprehensive search of the work-disability rehabilitation literature was undertaken. The review of the measures was conducted in three steps: first, a review of terminology; second, an examination of whether a time reference was included; third, an evaluation of ease of comprehension, and applicability across contexts. RESULTS A total of 42 different measures were identified. One of the most striking findings was the inconsistency in terminology. Measures were also limited by not including a time reference. Problems were also identified with regards to ease of understanding, utility of response options, and applicability in a wide variety of research and applied settings. CONCLUSIONS Most previously used measures contain elements that potentially limit utility. However, it would seem that further development can overcome these, resulting in a tool that provides risk prediction information, and an opportunity to start a conversation to help identify problems that might negatively impact a worker's movement through the RTW process and the outcomes achieved. Implications for Rehabilitation Return to work is an integral part of workplace injury management. The capture of RTW expectations affords a way to identify the potential for less than optimal RTW processes and outcomes. A mismatch between an injured worker's expectations and what other stakeholders might expect suggests that efforts could be made to determine what is causing the injured worker's concerns. Once underling issues are identified, work can be put into resolving these so that the worker's return to the workplace is not impeded.
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Affiliation(s)
- Amanda E Young
- a Liberty Mutual Research Institute for Safety, Center for Disability Research , Hopkinton , MA , USA
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Øyeflaten I, Midtgarden IJ, Maeland S, Eriksen HR, Magnussen LH. Functioning, coping and work status three years after participating in an interdisciplinary, occupational rehabilitation program. Scand J Public Health 2014; 42:425-33. [DOI: 10.1177/1403494814528291] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Aim: The aim of this study was to explore how functional ability, coping and health were related to work and benefit status three years after participating in a four-week inpatient interdisciplinary occupational rehabilitation program. Methods: The cohort consisted of 338 individuals (75% females, mean age 51 years (SD=8.6)) who three years earlier had participated in a comprehensive inpatient interdisciplinary occupational rehabilitation program, due to long-term sick leave. The participants answered standardised questionnaires about subjective health complaints, functional ability, coping, and current work and benefit status. The relationships between these variables were analysed using logistic regression analyses. Results: At the time of the survey, 59% of the participants worked at least 50% of a full working day. Twenty-five percent received at least 50% disability pension and 16% received other benefits. Poor functional ability (OR 4.8; CI 3.0–7.6), poor general health (OR 3.8; CI 2.3–6.1), high level of subjective health complaints (OR 3.3; CI 2.1–5.2), low coping (OR 2.8; CI 1.7–4.4), poor physical fitness (OR 2.8; CI 1.7–4.6) and poor sleep quality (OR 2.4; CI 1.5–3.7) were associated with receiving allowances. In a fully adjusted model, only poor functional ability and low coping were associated with receiving allowances three years after occupational rehabilitation. Conclusions: Functional ability and coping were the variables most strongly associated with not having returned to work. More attention should therefore be paid to enhance these factors in occupational rehabilitation programs. Part-time work may be a feasible way to integrate individuals with reduced workability in working life, if the alternative is complete absence from work.
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Affiliation(s)
- Irene Øyeflaten
- The National Centre for Occupational Rehabilitation – a National Advisory Unit, Norway
- Uni Health, Uni Research, Norway
| | | | - Silje Maeland
- Uni Health, Uni Research, Norway
- Department of Occupational Therapy, Physiotherapy and Radiography, Bergen University College, Norway
| | - Hege R Eriksen
- Uni Health, Uni Research, Norway
- Hemil, Research Centre for Health Promotion, University of Bergen, Norway
| | - Liv Heide Magnussen
- Uni Health, Uni Research, Norway
- Department of Occupational Therapy, Physiotherapy and Radiography, Bergen University College, Norway
- Department of Global Public Health and Primary Care, University of Bergen, Norway
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Ursin H. Brain sensitization to external and internal stimuli. Psychoneuroendocrinology 2014; 42:134-45. [PMID: 24636510 DOI: 10.1016/j.psyneuen.2014.01.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2013] [Revised: 12/04/2013] [Accepted: 01/09/2014] [Indexed: 11/25/2022]
Abstract
Sensitization is defined as a non-associative learning process occurring when repeated administrations of a stimulus result in a progressive amplification of a response (Shettleworth, 2010). The purpose of this review paper is to discuss whether brain sensitization is helpful in common health problems in man. The paper reviews data on brain sensitization covering increased behavioral, physiological, cognitive, and emotional responses in man and animals. The paper concludes that brain sensitization may be a helpful concept to understand subjective and "unexplained" health complaints (nonspecific muscle pain, mood changes, fatigue, and gastrointestinal complaints), and, therefore, relevant for evidence based treatment and prevention of these common health problems.
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Affiliation(s)
- Holger Ursin
- University of Bergen, Uni Health, Krinkelkroken 1, Bergen 5009, Norway.
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Maeland S, Assmus J, Berglund B. Subjective health complaints in individuals with Ehlers–Danlos syndrome: A questionnaire study. Int J Nurs Stud 2011; 48:720-4. [DOI: 10.1016/j.ijnurstu.2010.10.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2010] [Revised: 10/16/2010] [Accepted: 10/23/2010] [Indexed: 11/16/2022]
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Magnussen LH, Strand LI, Skouen JS, Eriksen HR. Long-term follow-up of disability pensioners having musculoskeletal disorders. BMC Public Health 2009; 9:407. [PMID: 19903333 PMCID: PMC2777167 DOI: 10.1186/1471-2458-9-407] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2009] [Accepted: 11/10/2009] [Indexed: 11/15/2022] Open
Abstract
Background Previously we have conducted a randomised controlled trial (RCT) to evaluate the effect of a brief cognitive behavioural program with a vocational approach aiming to return disability pensioners with back pain to work, as compared to no intervention. One year after the intervention, 10 participants (22%) who received the program and 5 (11%) in the control group reported to have entered a return to work process. The aims of this study were to evaluate long-term effects of the intervention, and compare this effect to 2 reference populations not participating in the original trial. Methods Three groups of disability pensioners were investigated: 1) Disability pensioners having back pain (n = 89) previously participating in the RCT (randomized to either a brief cognitive behavioural intervention or to a control group), 2) 342 disability pensioners having back pain, but refusing to participate in the study and 3) 449 disability pensioners having other musculoskeletal disorders than back pain. Primary outcome was return to work, defined as a reduction in payment of disability pension. Results Only 2 of 89 (2.3%) participants from the RCT had reduced disability pension at 3-years follow-up, both from the control group. None of the participants that had been in a process of returning to work after 1 year had actually gained employment at 3-years follow-up. In the 2 groups not participating in the previous RCT, only 4 (1.2%) and 8 (1.6%) had returned to work after 3 years respectively. Conclusion The number of pensioners who returned to work was negligible in all groups regardless of having participated in a cognitive behavioural intervention or not.
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