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Background: Employees and self-employed persons have, among others, different personal characteristics and different working conditions, which may influence the prognosis of sick leave and the duration of a disability claim. The purpose of the current study is to identify prognostic factors for the duration of a disability claim due to non-specific musculoskeletal disorders (MSD) among self-employed persons in the Netherlands., Methods: The study population consisted of 276 self-employed persons, who all had a disability claim episode due to MSD with at least 75% work disability. The study was a cohort study with a follow-up period of 12 months. At baseline, participants filled in a questionnaire with possible individual, work-related and disease-related prognostic factors., Results: The following prognostic factors significantly increased claim duration: age > 40 years (Hazard Ratio 0.54), no similar symptoms in the past (HR 0.46), having long-lasting symptoms of more than six months (HR 0.60), self-predicted return to work within more than one month or never (HR 0.24) and job dissatisfaction (HR 0.54)., Conclusions: The prognostic factors we found indicate that for self-employed persons, the duration of a disability claim not only depends on the (history of) impairment of the insured, but also on age, self-predicted return to work and job satisfaction.

Background: Despite the fact that the population of self-employed persons is still growing and at risk for long term disability due to a number of risk factors, there is still a lack of information on the effectiveness of interventions for this specific group., Methods: To determine the effectiveness of physical training without a cognitive behavioral component and workplace specific exercises (PT) and physical training with a cognitive behavioral component and workplace specific exercises (PTCBWE), we conducted a pragmatic Randomized Controlled Trial, stratified into two groups. Self-employed persons with a new work disability claim because of musculoskeletal disorders were randomized to PT (n = 53) or PTCBWE (n = 76), or to a corresponding usual care group (n = 50 and n = 75 respectively). Both types of training consisted of cardiovascular training, strengthening, relaxation and posture exercises and took place two or three times a week, for 1-1.5 hours, during three months, also if someone had already returned to work full-time. The primary outcome measure was claim duration (in days) during 12 months follow-up. Pain severity and functional status were secondary outcome measures. All data were assessed at baseline and at 6 and 12 months follow-up. The data with regard to claim duration were analyzed by survival analysis and Cox regression analysis. Secondary outcome measures were analyzed by means of linear regression analysis., Results: After 12 months of follow-up there was no difference in claim duration between PT and usual care (Hazard Ratio 0.7; 95%CI, 0.4-1.1; p = 0.12) or PTCBWE and usual care (Hazard Ratio 0.9; 95%CI, 0.6-1.4; p = 0.72). Both types of physical training and usual care improved in pain and functional status over time, but there was only a statistically significant difference in favor of PT on pain improvement at 6 months., Conclusion: In this study, physical training with and without a cognitive behavioral component and workplace specific exercises for self-employed persons with musculoskeletal disorders was not shown to be effective on claim duration, pain severity and functional status at 12 months follow-up., Trial Registration: Current Controlled Trials ISRCTN67766245.

Objectives: The aim of this study was to investigate the effect of raised bricklaying on physical workload, reported musculoskeletal disorders, sickness absence, and job satisfaction., Methods: A controlled intervention study with a follow-up period of 10 months was performed among 202 bricklayers from 25 construction companies., Results: The introduction of devices for raised bricklaying decreased the physical load on the lower back and, to a less extent, on the shoulders and upper extremities. Although raised bricklaying had no effect on the number of lifts, decreases in trunk bending lowered the biomechanical moment. The results showed no decrease in reported musculoskeletal symptoms as a result of the adoption of raised bricklaying. Irrespective of the reason(s), the percentage of bricklayers in the intervention group reporting sickness absence was significantly lower than the same percentage in the control group. The results also showed that, in general, the bricklayers in this study were very satisfied with the use of devices for raised bricklaying., Conclusions: Controlled intervention studies on ergonomic improvements are rare. This study shows that the introduction of an ergonomic improvement in the construction industry may reduce physical load and the incidence of sickness absence.