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Randomized Controlled Trial of Workplace-based Rehabilitation for Work-related Rotator Cuff Disorder

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Abstract

Introduction

Return to work following an occupational injury is a multifactoral process although many traditional clinic-based rehabilitation programs do not appreciate the importance of workplace factors. A randomized controlled trial was conducted to investigate the effect of workplace-based rehabilitation program on the return to work outcome of work-related rotator cuff disorder, which is based on the therapeutic use of actual work facilities and work environment.

Methods

A total of 103 workers were recruited and randomly assigned into Clinic-based Work Hardening (CWH) or Workplace-based Work Hardening (WWH) groups. The CWH group were given traditional generic work hardening training while WWH group received workplace-based work hardening training with rehabilitative principles of athletic rotator cuff pathology, biomechanics and specific job activities.

Results

After four weeks, a higher return to work rate was obtained in WWH group compared to CWH group (71.4% vs. 37%, p < 0.01). A statistically significant difference (p < 0.05) was also noted in lowering of self-reported shoulder problems and functional work capabilities in the WWH group versus the CWH group.

Conclusion

Workplace-based rehabilitation program appeared to be more effective in facilitating the return to work process of the injured worker as assessed immediately following intervention. In particular this approached was associated with many of the psychosocial workplace factors related to separation from the work routine. The influence of peer group and/or employer could be minimized. This initial attempt with rotator cuff injuries appears promising however long-term outcome needs to be determined.

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References

  1. Turner, J. A., Franklin, G., Fulton-Kehoe, D., Egan, K., Wickizer, T. M., Lymp, J. F., Sheppard, L., & Kaufman, J. D. (2004). Prediction of chronic disability in work-related musculoskeletal disorders: A prospective, population-based study. (cited; BMC Musculoskeletal Disorders: Available from: www.biomedcentral.com /1471–2474/5/14).

  2. Sullivan, M. J. L., Ward, L. C., Tripp, D., French, D. J., Adams, H., & Stanish, W. D. (2005). Secondary prevention of work disability: Community-based psychosocial intervention for musculoskeletal disorders. Journal of Occupational Rehabilitation, 15(3), 377–392.

    Article  PubMed  Google Scholar 

  3. Young, A. E., Roessler, R. T., Wasiak, R., McPherson, K. M., van Poppel, M. N. M., & Anema, J. R. (2005). A developmental conceptualization of return to work. Journal of Occupational Rehabilitation, 15(4), 557–568.

    Article  PubMed  Google Scholar 

  4. Mclntosh, G., Frank, J., Johnson, S. H., Bombardier, C., & Hall, H. (2000). Prognostic factors for time receiving workers’ compensation benefits in a cohort of patients with low back pain. Spine, 25(2), 147–157.

    Article  Google Scholar 

  5. Dasinger, L. K., Krause, N., Deegan, L. J., Brand, R. J. & Rudolph, L. (2000). Physical workplace factors and return to work after compensated low back injury: A disability phase-specific analysis. Journal of Occupational and Environmental Medicine, 42(3), 323–333.

    Article  PubMed  CAS  Google Scholar 

  6. Cailliet, R. (1981). Shoulder pain (2 ed.) Philadelphia: F.A. Davis Company.

    Google Scholar 

  7. Sommerich, C. M., McGlothlin, J. D., & Marras, W. S. (1993). Occupational risk factors associated with soft tissue disorders of the shoulder: A review of recent investigations in the literature. Ergonomics, 36(6), 697–717.

    Article  PubMed  CAS  Google Scholar 

  8. Reynolds, L. (1999). Zeroing in on ergonomics costs and solutions. HR Today.

  9. BLS. (2002). Occupational statistics. Bureau of labour statistics. U.S. Department of Labour.

  10. Selander, J., Marnetoft, S. U., Bergroth, A., & Erholm, J. (2002). Return to work following vocational rehabilitation for neck, back and shoulder problem: Risk factors reviewed. Disability and Rehabilitation, 24(14), 704–712.

    Article  PubMed  CAS  Google Scholar 

  11. LDHK (2003) Labour Department Annual Report 2004. Labour Department of Hong Kong.

  12. Franche, R. L., & Krause, N. (2002). Readiness for return to work following injury or illness: Conceptualizing the interpersonal impact of health care, workplace, and insurance factors. Journal of Occupational Rehabilitation, 12(4), 233–256.

    Article  PubMed  Google Scholar 

  13. MacKenzie, E., Morris, J. J. A., Jurkovich, G. J., Yasui, Y., Cushing, B. M., Burgess, A. R., DeLateur, B. J., McAndrew, M. P., & Swiontkowski, M. F. (1998). Return to work following injury: The role of economic, social, and job-related factors. American Journal of Public Health, 88(11), 630–1637.

    Article  Google Scholar 

  14. P.M.D.W (2001). Musculoskeletal disorders and the workplace. Low back and upper extremities. Washington, D.C.: Panel on Musculoskeletal Disorders and the Workplace, National Academy Press.

  15. Friesen, M. N., Yassi, A., & Cooper, J. (2001). Return-to-work: The importance of human interactions and organizational structures. Work, 17, 11–22.

    PubMed  Google Scholar 

  16. Feuerstein, M., Shaw, W. S., Lincoln, A. E., Miller, V. I., & Wood, P. M. (2003). Clinical and workplace factors associated with a return to modified duty in work-related upper extremity disorders. Pain, 102, 51–61.

    Article  PubMed  Google Scholar 

  17. Krause, N., Frank, J. W., Dasinger, L. K., Sullivan, T. J., & Sinclair, S. J. (2001). Determinants of duration of disability and return-to-work after work-related injury and illness: Challenges for future research. American Journal of Industrial Medicine, 40(40), 464–484.

    Article  PubMed  CAS  Google Scholar 

  18. WHO. (2001). International classification of functioning, disability and health. Geneva: World Health Organization.

    Google Scholar 

  19. Waddell, G., & Burton, A. K. (2005). Concepts of rehabilitation for the management of low back pain. Best Practice & Research Clinical Rheumatology, 19(4), 655–670.

    Article  Google Scholar 

  20. van der Weide, W. E., Verbeek, J. H., & van Tulder, M. V. (1997). Vocational outcome of intervention for low-back pain. Scandinavian Journal of Work, Environment & Health, 23(3), 165–178.

    Google Scholar 

  21. Frank, J. W., Brooker, A. S., DeMaio, S. E., Kerr, M. S., Maetzel, A., Shannon, H. S., Sullivan, T. J., Norman, R. W., & Wells, R. P. (1996). Disability resulting from occupational low back pain. Part II: What do we know about secondary prevention? A review of the scientific evidence on prevention after disability begins. Spine, 21(24), 2918–2929.

    Article  PubMed  CAS  Google Scholar 

  22. Frank, J. W., Sinclair, S., Hogg-Johnson, S., Shannon, H., Bombardier, C., Beaton, D., & Cole, D. (1998). Preventing disability from work-related low back pain. New evidence gives new hope – if we could just get all the players outside. Canadian Medical Association Journal, 158(12), 1625–1631.

    PubMed  CAS  Google Scholar 

  23. Anema, J. R. (2004). Low back pain, workplace intervention and return-to-work. Amsterdam: Vrije University.

    Google Scholar 

  24. Karjalainen, K., Malmivaara, A., van Tulder, M., Roine, R., Jauhiainen, M., Hurri, H., & Koes, B. (2000). Biopsychosocial rehabilitation for repetitive-strain injuries among working-age adults. Scandinavian Journal of Work, Environment & Health, 26(5), 373–381.

    CAS  Google Scholar 

  25. Karjalainen, K., Malmivaara, A., van Tulder, M., Roine, R., Jauhiainen, M., Hurri, H., & Koes, B. (2001). Multidisciplinary biopsychosocial rehabilitation for neck and shoulder pain among working age adults: A systematic review within the framework of the Cochrane collaboration back review group. Spine, 26(2), 174–181.

    Article  PubMed  CAS  Google Scholar 

  26. Williams, R. M., Westmorland, M. G., Schmuck, G., & MacDermid, J. C. (2004). Effectiveness of workplace rehabilitation interventions in the treatment of work-related upper extremity disorders: A systematic review. Journal of Hand Therapy, 17, 267–273.

    PubMed  Google Scholar 

  27. Ohlsson, K., Attewell, R. G., Johnsson, B., Ahlm, A., & Skerfving, S. (1994). An assessment of neck and upper extremity disorders by questionnaire and clinical examination. Ergonomics, 37(5), 891–897.

    Article  PubMed  CAS  Google Scholar 

  28. USDL. (1991). Dictionary of occupational titles. (revised 4th ed.). Washington, DC: United States Department of Labor.

    Google Scholar 

  29. Kibler, W. B. (1998). Rehabilitation of the shoulder. In W. B Kibler, S. A. Herring, & J. M. Press (Eds.), Functional rehabilitation of sports and musculoskeletal injuries. Gaithersburg: An Aspen Publication.

    Google Scholar 

  30. Thompson, W. O., Warren, R. F., Barnes, R. P., & Hunt, S. (1999). Shoulder injuries. In R. C. Schenck (Ed.), Athletic training and sport medicine (pp. 220–291). Roxmont: American Academy of Orthopaedic Surgeons.

    Google Scholar 

  31. Corrigan, B., & Maitland, G. D. (1994). Musculoskeletal and sports injuries. Butterworth-Heinemann Ltd.

  32. Kisner, C., & Colby, L. A. (1996). Therapeutic exercise: Foundations and techniques (3rd ed.) Philadelphia: F.A. Davis Company.

    Google Scholar 

  33. Tippett, S. R. (1990). Coaches guide to sport rehabilitation. Champaign, IL: Leisure Press.

    Google Scholar 

  34. Wilk, K. E., & Arrigo, C. (1993). Current concepts in the rehabilitation of the athletic shoulder. Journal of Sport Physical Therapy, 18(1), 365–378.

    CAS  Google Scholar 

  35. Rodgers, S. H. (1992). A functional job analysis technique. Occupational Medicine, 7(4), 679–711.

    PubMed  CAS  Google Scholar 

  36. NIOSH. (1997). Musculoskeletal disorders and workplace factors. Washington, DC: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health.

    Google Scholar 

  37. Erez, A. B., & Lindgren, K. N. (1999). Psychosocial factors in work-related musculoskeletal disorders. In K. Jacobs (Ed.), Ergonomics for therapists. Boston: Butterworth Heinemann.

    Google Scholar 

  38. Cook, K. F., Roddey, T. S., Olson, S. L., Gartsman, G. M., Valenzuela, F. F. T., & Hanten, W. P. (2002). Reliability by surgical status of self-reported outcomes in patients who have shoulder pathologies. Journal of Orthopaedic & Sports Physical Therapy, 32(7), 336–346.

    Google Scholar 

  39. Roach, K. E., Mak, E. B., Songsiridej, N., & Lertratanakul, Y. (1991). Development of a shoulder pain and disability index. Arthritis Care and Research, 4(4), 143–149.

    Article  PubMed  CAS  Google Scholar 

  40. Innes, E., & Straker, L. (1999). Reliability of work-related assessment. Work, 13, 107–124.

    PubMed  Google Scholar 

  41. Innes, E., & Straker, L. (1999). Validity of work-related assessments. Work, 13, 125–152.

    PubMed  Google Scholar 

  42. Portney, L. G., & Watkins, M. P. (2000). Foundations of clinical research. Applications to practice. New Jersey: Prentice-Hall.

    Google Scholar 

  43. Young, A. E., Roessler, R. T., Wasiak, R., McPherson, K. M., van Poppel, M. N. M., & Anema, J. R. (2005). A developmental conceptualization of return to work. Journal of Occupational Rehabilitation, 15(4), 557–568.

    Article  PubMed  Google Scholar 

  44. Shaw, W. S., & Feuerstein, M. (2004). Generating workplace accommodations: Lessons learned from the integrated case management study. Journal of Occupational Rehabilitation, 14(3), 207–216.

    Article  PubMed  Google Scholar 

  45. Krause, N., Dasinger, L. K., & Neuhauser, F. (1998). Modified work and return to work: A review of the literature. Journal of Occupational Rehabilitation, 8(2), 113–139.

    Article  Google Scholar 

  46. Shaw, W. S., & Feuerstein, M. (2004). Generating workplace accommodations: Lessons learned from the integrated case management study. Journal of Occupational Rehabilitation, 14(3), 207–216.

    Article  PubMed  Google Scholar 

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Correspondence to Andy Shu-Kei Cheng.

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Cheng, A.SK., Hung, LK. Randomized Controlled Trial of Workplace-based Rehabilitation for Work-related Rotator Cuff Disorder. J Occup Rehabil 17, 487–503 (2007). https://doi.org/10.1007/s10926-007-9085-0

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