Search

Purpose Conditions affecting the elbow, forearm, wrist, and hand can cause debilitating pain and loss of function in the working population. While there is knowledge about intervention options for this region of the body, there is limited research on systematically identifying the predictors of return to work in this population. Methods A systematic literature review identified all English-language studies that assess predictors of return to work for people with elbow, wrist, and hand conditions from 2009 to 2021 using PRISMA guidelines. Studies that examined exclusively shoulder injuries, randomized control trials, non-human studies, case studies, case reports, case series, and narrative reviews were excluded. Participants of included studies must have a health-related condition of the fingers, wrist, forearm, and elbow that is preventing work participation and must be 16 years and older. Included studies must be observational, longitudinal, and include a return to work outcome. Results Nineteen out of 170 studies were included. Average time away from work varied between seven to 304 days. Positive predictors of early return to work include: demographics, type of injury, type of treatment, work status, physical factors, psychological factors, use of self-reported outcome measures, and self-reported pain. Conclusion Five clinician recommendations were developed based on the findings of our systematic review. Clinicians should consider the type of work, use of outcome measures, psychological factors, hospitalization, and salary. These recommendations are intended to influence the behavior of clinicians when determining prognosis for return to work of people with elbow, wrist, and hand conditions.

Purpose Musculoskeletal disorders (MSDs) are often associated with long-term sick leave, productivity loss, and reduced work functioning. However, measures that assess work-related functioning are sparse. Objective To assess the psychometric properties of the Work Rehabilitation Questionnaire (WORQ)-German version in patients with MSDs in an outpatient physical therapy practice. Methods Psychometric study including patients with MSDs with restricted work participation. Data was collected in a single physical therapy outpatient clinic. For construct validity, we developed a priori hypotheses on the correlation between the functioning part of WORQ (40 items) and other questionnaires with similar concepts. For test–retest reliability, WORQ was administered twice, 7 days apart. We examined internal consistency (Cronbach’s Alpha) and Minimal Detectable Change (MDC). Feasibility of WORQ was examined using feedback from patients and physical therapists. Results There were 51 study participants. Test–retest of WORQ sum score was 0.80 (p

Purpose Since the vocational outcomes of people with schizophrenia should be viewed in a holistic way, the second edition of the World Health Organization Disability Assessment Schedule (WHODAS 2.0) might provide an evaluation regarding employment potential. To determine whether the WHODAS 2.0 scores can be used to predict employment status, we examined the probabilistic cut-off values of the scores and analyzed the relationship between work status and demographic characteristics. Methods We selected 31,793 people aged between 18 and 65 with schizophrenia or schizoaffective disorder from the disability evaluation database in Taiwan and separated them into two groups based on employment status (employed and unemployed). We used logistic regression to explore the association between employment and demographic characteristics. Moreover, we conducted a receiver operating characteristic (ROC) analysis to determine the cut-off point to assist in determining employment potential based on the WHODAS 2.0 score. Results Among the 31,793 participants, 3367 were employed and 18,801 were unemployed. The unemployed participants accounted for a higher percentage of disability in each domain of the WHODAS. The ROC analysis revealed that the optimal cut-off point of the WHODAS score to distinguish the people who were employed and unemployed was 25.78 (area under curve = 0.80). Conclusions The present study indicated that work status can be determined by the total score across the six domains of the WHODAS score. Furthermore, the probability of employment may be determined initially by the cut-off point of the WHODAS score in order to economize evaluation time and prepare prevocational training for those with scores above 25.78.

Purpose The Work Rehabilitation Questionnaire (WORQ) is a patient-reported instrument to assess work related functioning in vocational rehabilitation (VR) and work, based on the International Classification of Functioning, Disability and Health (ICF) core set for VR. The objective of this study was to cross-culturally adapt WORQ to French and to evaluate its psychometric properties. Methods The cross-cultural adaptation followed a dual-panel approach. Psychometrics was examined in one VR-centre in the French speaking part of Switzerland. Test-retest reliability was analyzed with intraclass correlation coefficient (ICC), internal consistency was assessed with Cronbach's alpha. Construct validity was determined by convergence to the self-reported general functioning scale and the Hospital Anxiety and Depression Scales (HADS). The association of patient's return-to-work expectation within 6-months and having a case manager was examined. The usability of WORQ-French was tested in 10 VR patients. Results Eighty-nine patients with musculoskeletal injuries were included. WORQ-French showed excellent internal consistency (0.968) and a high test-retest reliability (0.935). WORQ-French was positively associated with self-reported general functioning (r = 0.662) and both HADS scales (r = 0.56-0.57). Neither the patient's return-to-work expectation nor having a case manager were significantly correlated with WORQ-French. Usability in terms of understandability of questions and response options was found to be good. Seven patients rated the length of WORQ-French as good, while two found the instrument a little too long and one found it too long. Conclusions WORQ French is a valid, reliable, and easy to administer instrument to assess self-reported work functioning given our study setting and sample characteristics.

Purpose The purposes of this study were to provide an outline of the existing literature on operationalization of the International Classification of Functioning, Disability and Health (ICF) within vocational rehabilitation (VR) and to explore the ICF utility within VR. Methods The process was undertaken in five stages according to a framework of scoping review. Screening and extraction of data were done by two independent reviewers, and data was summarized according to content analysis. Results Fifty papers (25 qualitative and 25 quantitative) were included. The operationalization of the ICF was described in four different ways: In total 18 (36%) papers described use of the ICF for structuring information, 8 (15%) for linking information to ICF, 12 (24%) for analysis of results, and 12 (24%) for development of a model. In total 15 (29%) papers described VR interventions involving stakeholders, whereas 32 (62%) were reviews. Forty of the papers described all the ICF components. Conclusions The review revealed use of the ICF within the field VR in 50 papers, and in various settings. The ICF framework was most often operationalized for structuring or linking information of functioning. A majority of papers were reviews and involved researchers only, whereas different stakeholders and VR professionals were involved in the interventions. In 40 papers all the ICF components were described, and the ICF was considered a useful tool to inform the VR professionals´ assessment of functioning. However, more research within VR is needed to standardize and ease the use of the ICF. Electronic supplementary material The online version of this article (10.1007/s10926-018-9788-4) contains supplementary material, which is available to authorized users.

Background Vocational rehabilitation (VR) is a key process in work disability (WD) management which aims to engage or re-engage individuals to work and employment. The International Classification of Functioning, Disability and Health (ICF) by the World Health Organization (WHO) can be interfaced with VR but there is a lack of evidence of what ICF contents experts in the field consider. The objective of this study is to survey the experts in the VR field with regard to what factors are considered important to patients participating in VR using the ICF as the language to summarize the results. Methods An internet-based survey was conducted with experts from six WHO Regions (Africa, the Americas, Eastern Mediterranean, Europe, South-East Asia, and Western Pacific). Experts were asked six open-ended questions on factors that are important in VR. Each question was related to a component of the ICF (body functions, body structures, activities and, environmental factors, and personal factors). Responses were linked to the ICF. Results Using a modified stratified randomized sampling, 201 experts were sent the survey and 151 experts responded (75% response rate). We identified 101 ICF categories: 22 (21.8%) for body functions, 13 (12.9%) for body structures, 36 (35.6%) for activities and participation, and 30 (29.7%) for environmental factors. Conclusions There was a multitude of ICF functioning domains according to the respondents which indicates the complexity of VR. This expert survey has provided a list of ICF categories which could be considered in VR.

Background Worker productivity outcome is essential in examining the rehabilitation of workers with arthritis and other musculoskeletal conditions. There is great variation in the contents of worker productivity questionnaires. The International Classification of Functioning Disability and Health (ICF) offers the possibility to serve as a reference to describe and compare the contents of these questionnaires. Methods A literature review identified published self-report worker productivity questionnaires. All meaningful concepts were identified and linked to the corresponding ICF category according to established rules. Results Eighteen questionnaires were identified which contained a total of 519 meaningful concepts and which were linked to 64 unique 2nd level ICF categories. All questionnaires addressed Activities and Participation, thirteen (72%) addressed Body Functions, seven (39%) addressed Environmental Factors, seven (39%) addressed Personal Factors and only one questionnaire (6%) for Body Structures component. Overall, Work Role Functioning (WRF) questionnaire addressed the most number of different categories while Quantity and Quality method contained only one ICF category. The Rheumatoid Arthritis-Work Instability Scale had the highest number of categories for Body Functions, the Work Activity Limitations Scale and WRF had the most number of categories for Activities and Participation. The Health and Labour Questionnaire had the highest number of categories referring to unpaid work participation. The Health and Work Questionnaire was the only that included contextualization of both Environmental and Personal Factors. Conclusion Self-report worker productivity questionnaires differed largely in their contents. This content analysis study could guide us in selecting an appropriate questionnaire for a specific study question.

Background Work disability is a major burden to individuals and the society. To mitigate this burden, vocational rehabilitation has been at the forefront of facilitating work participation. With the complexity of vocational rehabilitation, we need a unifying framework to capture the essential domains of functioning. The International Classification of Functioning, Disability and Health (ICF) could serve as the common reference and language. The purpose of this special section is to demonstrate the use and benefits of the ICF to stakeholders and advocates of vocational rehabilitation. Methods The project on the ICF Core Set for vocational rehabilitation was conducted in collaboration with national and international organizations. The project consisted of three sequential phases: (1) four development studies, (2) international consensus conference, and (3) testing and validation of the ICF Core Set. Results In the first article, a conceptual definition of vocational rehabilitation based on the ICF is proposed. Findings from the first phase of the project are presented in the following four articles. Our findings reflected a wide range of factors that could influence success (or failure) in vocational rehabilitation. Conclusion This special section has presented five articles in an effort to advance our understanding and measurement of vocational rehabilitation process and outcomes. This special section also illustrates the complexity of the contents of vocational rehabilitation and offers the vocational rehabilitation community the added value of integrating the ICF in practice and research.

Background The International Classification of Functioning, Disability and Health (ICF) is a conceptual framework and classification system by the World Health Organization (WHO) to understand functioning. The objective of this discussion paper is to offer a conceptual definition for vocational rehabilitation (VR) based on the ICF. Method We presented the ICF as a model for application in VR and the rationale for the integration of the ICF. We also briefly reviewed other work disability models. Results Five essential elements of foci were found towards a conceptual definition of VR: an engagement or re-engagement to work, along a work continuum, involved health conditions or events leading to work disability, patient-centered and evidence-based, and is multi-professional or multidisciplinary. Conclusions VR refers to a multi-professional approach that is provided to individuals of working age with health-related impairments, limitations, or restrictions with work functioning and whose primary aim is to optimize work participation. We propose that the ICF and VR interface be explored further using empirical and qualitative works and encouraging stakeholders' participation.

Introduction A mixed-methods (qualitative-quantitative), multicenter study was conducted using a focus group design to explore the lived experiences of persons in vocational rehabilitation (VR) with regard to functioning and contextual factors using six open-ended questions related to the ICF components. The results were classified by using the International Classification of Functioning, Disability and Health (ICF) as a frame of reference. Methods The meaningful concepts within the transcribed data were identified and linked to ICF categories according to established linking rules. Results The seven focus groups with 26 participants yielded a total of 4,813 relevant concepts which were linked to a total of 160 different second-level ICF categories. From the client perspective, the ICF components (a) body functions, (b) activities and participation and (c) environmental factors were equally represented, while (d) body structures appeared less frequently. Out of the total number of concepts, 864 concepts (18%) were assigned to the ICF component personal factors which is not yet classified but could indicate important aspects of resource management and strategy development of patients in VR. Conclusion Therefore, VR of patients must not be limited to anatomical and pathophysiologic changes, but should also consider a more comprehensive view which includes client’s demands, strategies and resources in daily life and the context around the individual and social circumstances of their work situation.

Introduction the consequences of accidents, injuries, and health conditions that prevent workers from engaging in employment are prevailing issues in the area of work disability. Vocational rehabilitation (VR) programs aim to facilitate return-to-work process but there is no universal description of functioning for patients who participate in VR. Our objective is to develop a Core Set for VR based on the international classification of functioning, disability, and health (ICF). An ICF Core Set is a short list of ICF categories with alphanumeric codes relevant to a health condition or a health-related event. Methods development process consists of three phases. First is the preparatory phase which consists of four parallel studies: (1) systematic review of the literature, (2) worldwide survey of experts, (3) cross-sectional study, and (4) focus group interview. Patients with various health conditions are to be recruited from five VR centers located in Switzerland and Germany. The second phase is a consensus conference where findings from the preparatory phase will be presented followed by a multi-stage consensus process to determine the ICF categories that will comprise the Core Set for VR. The final phase consists of validation studies in several health conditions and settings. Conclusions we expect the first version of the ICF Core Set for VR to be completed in 2010. The Core Set can serve as a guide in the evaluation of patients and in planning appropriate intervention within VR programs. This Core Set could also provide a standard and common language among clinicians, researchers, insurers, and policymakers in the implementation of successful VR.