Mark E. Hardison, Shawn C. Roll; Factors Associated With Success in an Occupational Rehabilitation Program for Work-Related Musculoskeletal Disorders. Am J Occup Ther 2016;71(1):7101190040. https://doi.org/10.5014/ajot.2016.023200
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© 2021 American Occupational Therapy Association
Work-related musculoskeletal disorders are a significant burden; however, no consensus has been reached on how to maximize occupational rehabilitation programs for people with these disorders, and the impact of simulating work tasks as a mode of intervention has not been well examined. In this retrospective cohort study, the authors used logistic regression to identify client and program factors predicting success for 95 clients in a general occupational rehabilitation program and 71 clients in a comprehensive occupational rehabilitation program. The final predictive model for general rehabilitation included gender, number of sessions completed, and performance of work simulation activities. Maximum hours per session was the only significant predictor of success in the comprehensive rehabilitation program. This study identifies new factors associated with success in occupational rehabilitation, specifically highlighting the importance of intensity (i.e., session length and number of sessions) of therapy and occupation-based activities for this population.
Treadmill walking on level surface
Recumbent bike at low resistance
Upper-body ergometer at low resistance.
Treadmill walking on an incline and progressive program
Recumbent bike at moderate resistance
Upper-body ergometer at moderate resistance
Stair climber and outdoor walking.
Lower-extremity strengthening using pulley weight machines
Upper-extremity strengthening using free weights.
Lifting and carrying with standard lifting box
Pushing and pulling using a weighted sled or rolling cart
Standing tolerance with upper-extremity tasks (Valpar 9).
Occupational therapy practitioners should provide an intensive, multicomponent rehabilitation program that supports recovery for people with WRMSDs who are unable to return to work after traditional, injury-focused therapy services.
Participation in simulated work activities is a strong predictor of successful occupational rehabilitation and supports the need to use an occupational perspective not only when providing a comprehensive rehabilitation program but also in a general occupational rehabilitation program.
Intensity of participation in therapy is an important consideration in the success of occupational rehabilitation programs, indicating that clients in these programs should be allowed to progress in both frequency of sessions per week and hours per session as tolerated.
Additional large-scale prospective research and evaluation of client success through qualitative inquiry is needed to better understand the nuances of predictors for success in occupational rehabilitation.
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