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Ekhammar A, Grimby-Ekman A, Bernhardsson S, Holmgren K, Bornhöft L, Nordeman L, Larsson MEH. Prevention of sickness absence through early identification and rehabilitation of at-risk patients with musculoskeletal disorders (PREVSAM): short term effects of a randomised controlled trial in primary care. Disabil Rehabil 2024:1-14. [PMID: 38738694 DOI: 10.1080/09638288.2024.2343424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 04/11/2024] [Indexed: 05/14/2024]
Abstract
PURPOSE To evaluate short-term effects of the PREVention of Sickness Absence for Musculoskeletal disorders (PREVSAM) model on sickness absence and patient-reported health outcomes. METHODS Patients with musculoskeletal disorders were randomised to rehabilitation according to PREVSAM or treatment as usual (TAU) in primary care. Sickness absence and patient-reported health outcomes were evaluated after three months in 254 participants. RESULTS The proportion of participants remaining in full- or part-time work were 86% in PREVSAM vs 78% in TAU (p = 0.097). The PREVSAM group had approximately four fewer sickness benefit days during three months from baseline (p range 0.078-0.126). No statistically significant difference was found in self-reported sickness absence days (PREVSAM 12.4 vs TAU 14.5; p = 0.634), nor were statistically significant differences between groups found in patient-reported health outcomes. Both groups showed significant improvements from baseline to three months, except for self-efficacy, and only the PREVSAM group showed significantly reduced depression symptoms. CONCLUSIONS The findings suggest that for sickness absence, the PREVSAM model may have an advantage over TAU, although the difference did not reach statistical significance at the p < 0.05 level, and similar positive effects on patient-reported health outcomes were found in both groups. Long-term effects must be evaluated before firm conclusions can be drawn.
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Affiliation(s)
- Annika Ekhammar
- Unit of Physiotherapy, Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Primary Care Rehabilitation, Närhälsan Eriksberg, Gothenburg, Sweden
| | - Anna Grimby-Ekman
- Chronic Pain, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Biostatistics, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Susanne Bernhardsson
- Unit of Physiotherapy, Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Research, Education, Development and Innovation, Primary Health Care, Gothenburg, Sweden
| | - Kristina Holmgren
- Unit of Occupational Therapy, Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Lena Bornhöft
- Unit of Physiotherapy, Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Research, Education, Development and Innovation, Primary Health Care, Gothenburg, Sweden
- Region Västra Götaland, Primary Care Rehabilitation, Närhälsan Torslanda, Gothenburg, Sweden
| | - Lena Nordeman
- Unit of Physiotherapy, Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Research, Education, Development and Innovation, Primary Health Care, Borås, Sweden
| | - Maria E H Larsson
- Unit of Physiotherapy, Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Research, Education, Development and Innovation, Primary Health Care, Gothenburg, Sweden
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Tatta J. A Call to Action for Mental and Behavioral Health Stakeholders: Use Physical Therapists to Close the Gap in Depression Care. Phys Ther 2024; 104:pzad147. [PMID: 37930246 DOI: 10.1093/ptj/pzad147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 09/18/2023] [Accepted: 10/03/2023] [Indexed: 11/07/2023]
Affiliation(s)
- Joe Tatta
- Integrative Pain Science Institute, New York, New York, USA
- Department of Physical Therapy, Arcadia University, Glenside, Pennsylvania, USA
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Cillekens B, Mollet JM, Smit RA, Kuijer PPFM, Coenen P. 'Wait…, let me tell you, if I worked for a boss, I would be on sick leave': A Qualitative Study of Self-Employed Workers in Physically Demanding Jobs in the Netherlands. JOURNAL OF OCCUPATIONAL REHABILITATION 2023:10.1007/s10926-023-10153-z. [PMID: 38032487 DOI: 10.1007/s10926-023-10153-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/23/2023] [Indexed: 12/01/2023]
Abstract
PURPOSE The purpose of this study was to explore the perspectives of self-employed workers with a physically demanding job on work participation. METHODS We interviewed self-employed workers with a physically demanding job, using semi-structured interviews, which were audio recorded. The main topic addressed was the workers' health in relation with their work participation, work demands, and preventive measures. The interviews were transcribed verbatim and coded by three team members of the research team in several steps. We used the consolidated criteria for reporting qualitative research (COREQ) checklist to report our findings. RESULTS We interviewed 18 self-employed workers: 83% male, 49 years (SD 7), self-employed for 18 years (SD 9) and the majority (n = 14) worked in the construction sector. Thematic analysis revealed facilitators and barriers for work participation across three main themes: personal factors, work factors, and healthcare. Personal factors compassed sub-themes such as health and financial consequences. Work factors included sub-themes related to work demands and adaptations and healthcare encompassed sub-themes associated with work-related care and medication. CONCLUSION To our knowledge, this is the first qualitative study that investigated the perspectives of self-employed workers in physically demanding jobs regarding work participation. While most facilitators and barriers were consistent with those described in the literature for employees, certain factors, such as financial consequences of ceasing work, emerged important factors for work participation among self-employed workers.
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Affiliation(s)
- Bart Cillekens
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, VU University Medical Center (VUMC), Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
- Amsterdam Public Health, Societal Participation and Health, Quality of Care, Amsterdam, The Netherlands
| | - Judith M Mollet
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, VU University Medical Center (VUMC), Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
- Amsterdam Public Health, Societal Participation and Health, Quality of Care, Amsterdam, The Netherlands
| | - Rixt A Smit
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, VU University Medical Center (VUMC), Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
| | - P Paul F M Kuijer
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, VU University Medical Center (VUMC), Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
- Amsterdam Public Health, Societal Participation and Health, Quality of Care, Amsterdam, The Netherlands
- Amsterdam Movement Sciences, Musculoskeletal Health, Sports, Amsterdam, The Netherlands
| | - Pieter Coenen
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, VU University Medical Center (VUMC), Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.
- Amsterdam Public Health, Societal Participation and Health, Quality of Care, Amsterdam, The Netherlands.
- Amsterdam Movement Sciences, Musculoskeletal Health, Sports, Amsterdam, The Netherlands.
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McGrath RL, Shephard S, Parnell T, Verdon S, Pope R. Recommended approaches to assessing and managing physiotherapy clients experiencing psychological distress: a systematic mapping review. Physiother Theory Pract 2023:1-31. [PMID: 38009858 DOI: 10.1080/09593985.2023.2284823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 11/05/2023] [Indexed: 11/29/2023]
Abstract
BACKGROUND Some physiotherapists find assessing and managing clients experiencing psychological distress challenging and are uncertain regarding the boundaries of the profession's scope. OBJECTIVE To map the approaches recommended for physiotherapists in scholarly literature, with respect to the assessment and management of clients experiencing psychological distress. METHODS A systematic mapping review was conducted. CINAHL, APA PsycINFO, Embase, and Medline ALL databases were systematically searched for secondary and tertiary literature relevant to the research objective. Recommended approaches were extracted from each article and analyzed descriptively and thematically. RESULTS 3884 records were identified with 40 articles meeting the inclusion/exclusion criteria. Most recommendations related to identifying, assessing, and managing pain-related distress, with depression screening and referral also receiving some attention. Three approaches to detecting and assessing psychological distress were identified: 1) brief depression screen; 2) integrated suicide/nonsuicidal self-harm and depression screen; and 3) multidimensional screen and health-related distress assessment. Regarding the management of psychological distress the main approaches identified were: 1) education and reassurance; 2) cognitive-behavioral approaches; 3) mindfulness; and 4) case management. CONCLUSION While assessment and management of health-related distress by physiotherapists is commonly recommended, further guidance is needed to differentiate various forms of distress.
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Affiliation(s)
- Ryan L McGrath
- Department of Rural Health, University of Melbourne, Shepparton, Australia
- School of Allied Health, Exercise and Sports Sciences, Charles Sturt University, Albury, Australia
- Allied Health Education and Research Unit, Goulburn Valley Health, Shepparton, Australia
| | - Sophie Shephard
- School of Allied Health, Exercise and Sports Sciences, Charles Sturt University, Albury, Australia
| | - Tracey Parnell
- Department of Rural Health, University of Melbourne, Shepparton, Australia
| | - Sarah Verdon
- Department of Rural Health, University of Melbourne, Shepparton, Australia
| | - Rodney Pope
- Department of Rural Health, University of Melbourne, Shepparton, Australia
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5
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Senthanar S, Koehoorn M, Tamburic L, Premji S, Bültmann U, McLeod CB. Differences in Modified-Return-to-Work by Immigration Characteristics Among a Cohort of Workers in British Columbia, Canada. JOURNAL OF OCCUPATIONAL REHABILITATION 2023; 33:341-351. [PMID: 36308629 DOI: 10.1007/s10926-022-10077-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/11/2022] [Indexed: 05/12/2023]
Abstract
Introduction To investigate differences in modified-return-to work (MRTW) within the first 30 days of a work-related, short-term disability injury by immigration characteristics. This question was part of a program of research investigating differences in work and health experiences among immigrant workers and explanations for longer work disability durations. Methods Workers' compensation claims, immigration records and medical registry data were linked to identify a sample of workers in British Columbia, Canada with a short-term disability claim for a work-related back strain, concussion, limb fracture or connective tissue injury occurring between 2009 and 2015. Multivariable logistic regressions, stratified by injury type, investigated the odds of MRTW, defined as at least one day within the first 30 days on claim, associated with immigration characteristics, defined as a Canadian-born worker versus a worker who immigrated via the economic, family member or refugee/other humanitarian classification. Results Immigrant workers who arrived to Canada as a family member or as a refugee/other immigrant had a reduced odds of MRTW within the first 30 days of work disability for a back strain, concussion and limb fracture, compared to Canadian-born workers. Differences in MRTW were not observed for immigrant workers who arrived to Canada via the economic classification, or for connective tissue injuries. Conclusion The persistent and consistent finding of reduced MRTW for the same injury for different immigration classifications highlights contexts (work, health, social, language) that disadvantage some immigrants upon arrival to Canada and that persist over time even after entry into the workforce, including barriers to MRTW.
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Affiliation(s)
- Sonja Senthanar
- School of Population and Public Health, The University of British Columbia, Vancouver, BC, V6T 1Z3, Canada.
| | - Mieke Koehoorn
- School of Population and Public Health, The University of British Columbia, Vancouver, BC, V6T 1Z3, Canada
| | - Lillian Tamburic
- School of Population and Public Health, The University of British Columbia, Vancouver, BC, V6T 1Z3, Canada
| | | | - Ute Bültmann
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Christopher B McLeod
- School of Population and Public Health, The University of British Columbia, Vancouver, BC, V6T 1Z3, Canada
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6
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van Zaanen Y, Kievit AJ, van Geenen RCI, Pahlplatz TMJ, Hoozemans MJM, Blankevoort L, Schafroth MU, Haverkamp D, Vervest TMJS, Das DHPW, Scholtes VA, van der Beek AJ, Kuijer PPFM. Does Consulting an Occupational Medicine Specialist Decrease Time to Return to Work Among Total Knee Arthroplasty Patients? A 12-Month Prospective Multicenter Cohort Study. JOURNAL OF OCCUPATIONAL REHABILITATION 2023; 33:267-276. [PMID: 36083360 PMCID: PMC10172284 DOI: 10.1007/s10926-022-10068-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/17/2022] [Indexed: 05/12/2023]
Abstract
PURPOSE The aim of this study is to investigate whether total knee arthroplasty (TKA) patients who consulted an occupational medicine specialist (OMS) within 3 months after surgery, return to work (RTW) earlier than patients who did not consult an OMS. METHODS A multi-center prospective cohort study was performed among working TKA patients, aged 18 to 65 years and intending to RTW. Time to RTW was analyzed using Kaplan Meier and Mann Whitney U (MWU), and multiple linear regression analysis was used to adjust for effect modification and confounding. RESULTS One hundred and eighty-two (182) patients were included with a median age of 59 years [IQR 54-62], including 95 women (52%). Patients who consulted an OMS were less often self-employed but did not differ on other patient and work-related characteristics. TKA patients who consulted an OMS returned to work later than those who did not (median 78 versus 62 days, MWU p < 0.01). The effect of consulting an OMS on time to RTW was modified by patients' expectations in linear regression analysis (p = 0.05). A median decrease in time of 24 days was found in TKA patients with preoperative high expectations not consulting an OMS (p = 0.03), not in patients with low expectations. CONCLUSIONS Consulting an OMS within 3 months after surgery did not result in a decrease in time to RTW in TKA patients. TKA patients with high expectations did RTW earlier without consulting an OMS. Intervention studies on how OMSs can positively influence a timely RTW, incorporating patients' preoperative expectations, are needed.
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Affiliation(s)
- Y van Zaanen
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam Movement Sciences, Amsterdam UMC, University of Amsterdam, Location AMC, Meibergdreef 9, 1105 AZ, Amsterdam, Netherlands.
| | - A J Kievit
- Orthopaedic Research Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - R C I van Geenen
- Department of Orthopaedic Surgery, Amphia Hospital, Breda, Netherlands
| | - T M J Pahlplatz
- Orthopaedic Research Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - M J M Hoozemans
- Department of Human Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - L Blankevoort
- Orthopaedic Research Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - M U Schafroth
- Orthopaedic Research Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | | | - T M J S Vervest
- Department of Orthopaedic Surgery, Tergooi Hospital, Hilversum, Netherlands
| | - D H P W Das
- Department and Research Center of Orthopaedic Surgery, St. Anna Hospital, Geldrop, Netherlands
| | - V A Scholtes
- Joint Research Orthopedic Surgery, OLVG+, Amsterdam, Netherlands
| | - A J van der Beek
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - P P F M Kuijer
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam Movement Sciences, Amsterdam UMC, University of Amsterdam, Location AMC, Meibergdreef 9, 1105 AZ, Amsterdam, Netherlands
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Strijbos DO, van der Sluis G, van Houtert WFC, Straat AC, van Zaanen Y, de Groot S, Klomp S, Krijnen WP, Kooijman CM, van den Brand I, Reneman MF, Boymans TAEJ, Kuijer PPFM. Protocol for a multicenter study on effectiveness and economics of the Back At work After Surgery (BAAS): a clinical pathway for knee arthroplasty. BMC Musculoskelet Disord 2023; 24:199. [PMID: 36927339 PMCID: PMC10018987 DOI: 10.1186/s12891-023-06203-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 01/27/2023] [Indexed: 03/18/2023] Open
Abstract
BACKGROUND Optimizing return to work (RTW) after knee arthroplasty (KA) is becoming increasingly important due to a growing incidence of KA and poor RTW outcomes after KA. We developed the Back At work After Surgery (BAAS) clinical pathway for optimized RTW after KA. Since the effectiveness and cost analysis of the BAAS clinical pathway are still unknown, analysis on effectiveness and costs of BAAS is imperative. METHOD This protocol paper has been written in line with the standards of Standard Protocol Items: Recommendations for Interventional Trails. To assess the effectiveness and cost-effectiveness for RTW, we will perform a multicenter prospective cohort study with patients who decided to receive a total KA (TKA) or an unicompartmental KA (UKA). To evaluate the effectiveness of BAAS regarding RTW, a comparison to usual care will be made using individual patient data on RTW from prospectively performed cohort studies in the Netherlands. DISCUSSION One of the strengths of this study is that the feasibility for the BAAS clinical pathway was tested at first hand. Also, we will use validated questionnaires and functional tests to assess the patient's recovery using robust outcomes. Moreover, the intervention was performed in two hospitals serving the targeted patient group and to reduce selection bias and improve generalizability. The limitations of this study protocol are that the lead author has an active role as a medical case manager (MCM) in one of the hospitals. Additionally, we will use the data from other prospective Dutch cohort studies to compare our findings regarding RTW to usual care. Since we will not perform an RCT, we will use propensity analysis to reduce the bias due to possible differences between these cohorts. TRAIL REGISTRATION This study was retrospectively registered at clinicaltrails.gov ( https://clinicaltrials.gov/ct2/show/NCT05690347 , date of first registration: 19-01-2023).
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Affiliation(s)
- Daniël O. Strijbos
- grid.7177.60000000084992262Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands
- Amsterdam Public Health, Societal Participation and Health, Quality of Care, Van Der Boechorststraat 8, 1081 BT Amsterdam, the Netherlands
- Amsterdam Movement Sciences, Musculoskeletal Health, Sports, Rehabilitation & Development, Van Der Boechorststraat 7-9, 1081 BT Amsterdam, the Netherlands
- grid.477604.60000 0004 0396 9626Department of Health Innovations, Nij Smellinghe Hospital Drachten, Compagnonsplein 1, Drachten, 9202 NN the Netherlands
| | - Geert van der Sluis
- grid.477604.60000 0004 0396 9626Department of Health Innovations, Nij Smellinghe Hospital Drachten, Compagnonsplein 1, Drachten, 9202 NN the Netherlands
- grid.411989.c0000 0000 8505 0496Hanze University of Applied Sciences Groningen, Zernikeplein 7, 9747 AS Groningen, the Netherlands
| | - Wim F. C. van Houtert
- grid.477604.60000 0004 0396 9626Department of Health Innovations, Nij Smellinghe Hospital Drachten, Compagnonsplein 1, Drachten, 9202 NN the Netherlands
- grid.411989.c0000 0000 8505 0496Hanze University of Applied Sciences Groningen, Zernikeplein 7, 9747 AS Groningen, the Netherlands
| | - A. Carlien Straat
- grid.7177.60000000084992262Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands
- Amsterdam Public Health, Societal Participation and Health, Quality of Care, Van Der Boechorststraat 8, 1081 BT Amsterdam, the Netherlands
- Amsterdam Movement Sciences, Musculoskeletal Health, Sports, Rehabilitation & Development, Van Der Boechorststraat 7-9, 1081 BT Amsterdam, the Netherlands
| | - Yvonne van Zaanen
- grid.7177.60000000084992262Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands
| | | | - Simon Klomp
- a.S.R. Insurances, Archimedeslaan 10, 3584 BA Utrecht, the Netherlands
| | - Wim P. Krijnen
- grid.411989.c0000 0000 8505 0496Hanze University of Applied Sciences Groningen, Zernikeplein 7, 9747 AS Groningen, the Netherlands
| | - Carolien M. Kooijman
- grid.477604.60000 0004 0396 9626Department of Health Innovations, Nij Smellinghe Hospital Drachten, Compagnonsplein 1, Drachten, 9202 NN the Netherlands
| | - Igor van den Brand
- grid.416373.40000 0004 0472 8381Department of Orthopaedics, Elizabeth Tweesteden Hospital, Doctor Deelenlaan 5, 5042 AD Tilburg, The Netherlands
| | - Michiel F. Reneman
- grid.4830.f0000 0004 0407 1981Department of Rehabilitation, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Tim A. E. J. Boymans
- grid.412966.e0000 0004 0480 1382Maastricht UMC +, Department of Orthopaedics, P. Debyelaan 25, 6229 HX Maastricht, the Netherlands
| | - P. Paul F. M. Kuijer
- grid.7177.60000000084992262Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands
- Amsterdam Public Health, Societal Participation and Health, Quality of Care, Van Der Boechorststraat 8, 1081 BT Amsterdam, the Netherlands
- Amsterdam Movement Sciences, Musculoskeletal Health, Sports, Rehabilitation & Development, Van Der Boechorststraat 7-9, 1081 BT Amsterdam, the Netherlands
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Zhu JK, Wu FF, Yang RF, Xu FF, Lin YL, Ye MF. Postoperative subacute static progressive stretch does not increase the risk of distal lower limb venous thromboembolism. Chin J Traumatol 2023:S1008-1275(23)00018-4. [PMID: 36941178 DOI: 10.1016/j.cjtee.2023.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 01/31/2023] [Accepted: 02/27/2023] [Indexed: 03/23/2023] Open
Abstract
PURPOSE Static progressive stretch (SPS) can be applied to treat chronic joint stiffness. However, the impacts of subacute application of SPS to the distal lower limbs, where deep vein thrombosis (DVT) is common, on venous thromboembolism remain unclear. This study aims to explore the risk of venous thromboembolism events following subacute application of SPS. METHODS A retrospective cohort study was conducted on patients diagnosed with DVT following a lower extremity orthopedic surgery before being transferred to the rehabilitation ward from May 2017 to May 2022. Patients with unilateral lower limb comminuted para-articular fractures, transferred to rehabilitation ward for further treatment within 3 weeks after operation, followed up more than 12 weeks since initial manual physiotherapy, and diagnosed DVT by ultrasound before rehabilitation course were included in the study. Patients with polytrauma, without evidence of previous peripheral vascular disease or incompetence, had medication for thrombosis treatment or prophylaxis before the operation, detected with paralysis due to nervous system impairment, infected after operation during the regime, or with acute progression of DVT were excluded. The included patients were randomized to the standard physiotherapy and the SPS integrated groups for observation. Associated DVT and pulmonary embolism data were collected during the physiotherapy course to compare the groups. SSPS 28.0 and GraphPad Prism 9 were used for data processing. p < 0.05 was set significant difference. RESULTS In total of 154 patients with DVT participating in this study, 75 of them were treated with additional SPS for postoperative rehabilitation. The participants in the SPS group showed improved range of motion (12.3° ± 6.7°). However, in the SPS group, there was no difference in thrombosis volume between the start and termination (p = 0.106, p = 0.787, respectively), although difference was seen intra-therapy (p < 0.001). Contingency analysis revealed the pulmonary embolism incidence (OR = 0.703) in the SPS group compared to the mean physiotherapy. CONCLUSION The SPS technique is a safe and reliable option to prevent potential joint stiffness without aggravating the risk of distal DVT for postoperative patients suffering from relevant trauma.
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Affiliation(s)
- Jun-Kun Zhu
- Orthopedics Rehabilitation Department, Lishui Central Hospital, Lishui, Zhejiang Province, 323020, China.
| | - Feng-Feng Wu
- Rehabilitation Department, Huzhou Central Hospital, Hangzhou, 310020, China
| | - Rui-Feng Yang
- Orthopedics and Trauma Department, Lishui Central Hospital, Lishui, Zhejiang Province, 323020, China
| | - Fen-Fen Xu
- Orthopedics Rehabilitation Department, Lishui Central Hospital, Lishui, Zhejiang Province, 323020, China
| | - Ya-Li Lin
- Orthopedics Rehabilitation Department, Lishui Central Hospital, Lishui, Zhejiang Province, 323020, China
| | - Miao-Fang Ye
- Orthopedics Rehabilitation Department, Lishui Central Hospital, Lishui, Zhejiang Province, 323020, China
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9
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Strijbos DO, van der Sluis G, Boymans TAEJ, de Groot S, Klomp S, Kooijman CM, Reneman MF, Kuijer PPFM. Implementation of back at work after surgery (BAAS): A feasibility study of an integrated pathway for improved return to work after knee arthroplasty. Musculoskeletal Care 2022; 20:950-959. [PMID: 35506461 PMCID: PMC10084307 DOI: 10.1002/msc.1633] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 03/14/2022] [Accepted: 03/14/2022] [Indexed: 01/01/2023]
Abstract
PURPOSE Optimizing return to work after knee arthroplasty is becoming more important because of the growing incidence of KA among workers and poor return to work outcomes. The purpose of this study is to investigate the feasibility of Back At work After Surgery (BAAS): an integrated clinical pathway for return to work after knee arthroplasty. METHOD Working patients who received unicompartmental knee arthroplasty (UKA) or total knee arthroplasty (TKA) between January 2021 and November 2021, younger than 65 years and motivated to return to work were eligible to participate. Feasibility was investigated on five domains: reach, dose delivered, dose received, fidelity and patients' attitudes. These outcomes were obtained by a patient-reported questionnaire and an interview with the occupational case manager and medical case manager. RESULTS Of the eligible 29 patients, eleven were willing to participate (response rate 38%; due to travel distance to and from the hospital). The dose delivered was between 91 and 100%, except information given about return to work from the orthopedic surgeon which was 18%. The dose received was 100%. For fidelity, case managers reported nine shortcomings for which five solutions were mentioned. In terms of patients' attitude, all patients were satisfied and one patient mentioned an improvement. CONCLUSIONS In terms of reach, participation was low: only 29%. The BAAS clinical pathway seems feasible based on dose delivered, dose received, fidelity and patient attitudes. The next step is to assess the effectiveness of the BAAS clinical pathway for return to work.
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Affiliation(s)
- Daniël O. Strijbos
- Department of Public and Occupational HealthAmsterdam UMCUniversity of AmsterdamAmsterdamthe Netherlands
- Amsterdam Public Health Research InstituteAmsterdamthe Netherlands
- Research Programs Musculoskeletal HealthSports and Rehabilitation & DevelopmentAmsterdam Movement Sciencesthe Netherlands
- Department of Health InnovationsNij Smellinghe Hospital DrachtenDrachtenthe Netherlands
| | - Geert van der Sluis
- Department of Health InnovationsNij Smellinghe Hospital DrachtenDrachtenthe Netherlands
- Hanze University of Applied Sciences GroningenGroningenthe Netherlands
| | | | | | | | - Carolien M. Kooijman
- Department of OrthopedicsNij Smellinghe hospital Drachten9202 NNDrachtenCompagnonsplein 1the Netherlands
| | - Michiel F. Reneman
- Department of RehabilitationUniversity Medical Center GroningenUniversity of GroningenGroningenthe Netherlands
| | - P. Paul F. M. Kuijer
- Department of Public and Occupational HealthAmsterdam UMCUniversity of AmsterdamAmsterdamthe Netherlands
- Amsterdam Public Health Research InstituteAmsterdamthe Netherlands
- Research Programs Musculoskeletal HealthSports and Rehabilitation & DevelopmentAmsterdam Movement Sciencesthe Netherlands
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Celebrating the Achievements of Yet Another Challenging Year. J Orthop Sports Phys Ther 2021; 51:552-555. [PMID: 34847697 DOI: 10.2519/jospt.2021.0111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Editor-in-Chief Clare Ardern and JOSPT's editors thank all of those who contributed to JOSPT in 2021. J Orthop Sports Phys Ther 2021;51(12):552-555. doi:10.2519/jospt.2021.0111.
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Clinical Guidance to Optimize Work Participation After Injury or Illness: Using the Evidence to Guide Physical Therapist Practice. J Orthop Sports Phys Ther 2021; 51:380-381. [PMID: 34338004 DOI: 10.2519/jospt.2021.0505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Work rehabilitation refers to the process of assisting workers to remain at work or return to work (RTW) in a safe and productive manner, while limiting the negative impact of work restriction, unemployment, and work disability. The clinical practice guideline (CPG) published in the August 2021 issue of JOSPT provides guidance for physical therapy clinicians when evaluating, treating, and managing individuals who experience limitations in the ability to participate in work following injury or illness. J Orthop Sports Phys Ther 2021;51(8):380-381. doi:10.2519/jospt.2021.0505.
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