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WORK: A Journal of Prevention, Assessment & Rehabilitation is an interdisciplinary, international journal which publishes high quality peer-reviewed manuscripts covering the entire scope of the occupation of work. The journal's subtitle has been deliberately laid out: The first goal is the prevention of illness, injury, and disability. When this goal is not achievable, the attention focuses on assessment to design client-centered intervention, rehabilitation, treatment, or controls that use scientific evidence to support best practice.
WORK occasionally publishes thematic issues, but in general, issues cover a wide range of topics such as ergonomic considerations with children, youth and students, the challenges facing an aging workforce, workplace violence, injury management, performing artists, ergonomic product evaluations, and the awareness of the political, cultural, and environmental determinants of health related to work.
Dr. Karen Jacobs, the founding editor, and her editorial board especially encourage the publication of research studies, clinical practice, case study reports, as well as personal narratives and critical reflections of lived work experiences (autoethnographic/autobiographic scholarship),
Sounding Board commentaries and
Speaking of Research articles which provide the foundation for better understanding research to facilitate knowledge dissemination.
Narrative Reflections on Occupational Transitions, a new column, is for persons who have successfully transitioned into, between, or out of occupations to tell their stories in a narrative form. With an internationally renowned editorial board,
WORK maintains high standards in the evaluation and publication of manuscripts. All manuscripts are reviewed expeditiously and published in a timely manner.
WORK prides itself on being an author-friendly journal.
WORK celebrates its 25th anniversary in 2015.
*WORK is affiliated with the Canadian Association of Occupational Therapists (CAOT)* *WORK is endorsed by the International Ergonomics Association (IEA)* *WORK gives out the yearly Cheryl Bennett Best Paper Award*
Abstract: Return to work after injury or illness is important for the worker and the employer. Medical providers manage and treat the worker with the illness or injury. Except in cases of focused specialists, the medical professional's role is to take care of a patient, rather than empower a worker. As much as there is promotion of the workers compensation health care system to be similar to sports medicine, there are significant dissimilarities. One major barrier is…that the medical caregivers do not know the demands of jobs as they would know the details of sports. Thus, there is a gap in returning a worker to function as the medical professional cannot accurately match the worker to specific jobs. A new model of job function matching, based on research and skills of occupational rehabilitation professionals, is proposed to bridge the gap between the medical community, the employers and the workers.
Keywords: Functional capacity evaluation, work conditioning, work hardening, job descriptions, post offer testing
Abstract: Despite increased efforts to address musculoskeletal disorders (MSDs) in the work place, these injuries continue significantly impact the bottom line financial performance of companies, not to mention the health and safety of their most important resource – their workers. As MSD costs continue to rise, rehabilitation professionals must approach effective injury management and prevention processes from an onsite perspective. A paradigm shift is in order. Successful practitioners need to transform themselves from a…clinical specialist to an onsite consultant. This article introduces various elements that are critical to the successful transformation of an onsite consultant. Effective onsite injury management and prevention concepts are discussed. Case studies are also presented to further illustrate the value of the onsite consultant approach.
Abstract: Preventing work place injuries requires more than ergonomically correct work stations. In 1999, flexible plastic packaging producer, Pliant Corporation of Macedon, NY, initiated the presence of an onsite Physical Therapist to further efforts in making work stations safe and to develop a comprehensive approach in preventing and managing worker injuries. The process started with analysis of the functional demands of the work performed, elimination of ergonomic stressors, and development of daily stretching…programs for employees to perform. In the second and third year of the program, objective functional job descriptions and minimum strength criteria were created as well as work task specific post-offer pre-work screens. This comprehensive approach has reduced the total number of OSHA recordable injuries, reduced the overall incident rate and assisted in reducing turnover.
Abstract: Systematic reviews have been described by leaders in the field of evidence-based practice as the most powerful and useful evidence available to guide practice. This paper gives a description and analysis of systematic reviews currently included in the Cochrane Database for Systematic Reviews which have been identified by newly formed Cochrane Occupational Health Field as having an occupational health focus.
Abstract: Background: Comprehensive medical assessments in the majority of patients with chronic low back pain (CLBP) have failed to assess working capacity. Functional Capacity Evaluation (FCE) has become increasingly popular in the evaluation of working capacity in CLBP patients. This study investigates the influence of functional testing on decision making concerning medical fitness assessments for work. Methods: A randomized clinical trial comparing the effect of a function-centred (FCT) versus a pain-centred treatment (PCT) in patients…with CLBP was performed. According to the legal requirements physicians issued Fitness for Work Certificates (FWCs) after rehabilitation. In the FCT group physicians were in possession of the results of FCE while this was not the case in the PCT group. Three experts assessed the FWCs and rated the quality and the information provided regarding working capacity in the previous work. Results: Rating of the issued FWCs proved reliable (ICC=0.77–0.92). Quality of FWCs and information regarding working capacity in the previous work differed significantly between the two groups (chi-square, p=0.03, resp. =0.008). There was a trend towards a higher attested work capacity in the FCT group (Mann-Whitney, p=0.071). Conclusions: Functional Capacity Evaluation positively influences quality and information regarding working capacity of medical Fitness for Work Certificates in patients with chronic low back pain.
Keywords: Randomized controlled trial, assessment, work capacity, quality
Abstract: The aim of this study was to determine test-retest reliability of a Functional Capacity Evaluation for patients with non-specific Work Related Upper Limb Disorders (WRULD FCE). The study sample included 33 healthy adults, consisting of 14 males and 19 females with a mean age of 29.2 years. The WRULD FCE consisted of 8 different tests including 26 items measuring repetitive movements, duration, working in awkward positions, forceful movements and static postures. Two FCE sessions were held…with a 10-day interval. Means, 95% confidence intervals, one-way random Intraclass Correlation Coefficients (ICCs), 95% limits of agreement and repeated measures were calculated. An ICC between 0.75 and 0.90 was considered as good and an ICC above 0.90 was considered as an excellent reliability. The results showed that 14 of 26 items (54%) had excellent reliability, 9 of 26 items (35%) had good reliability and 3 of 26 items (11%) had moderate reliability based on ICC values. Significant learning effects were present in the Purdue Pegboard Task and in the Complete Minnesota Dexterity Test. It is concluded that the WRULD FCE is reliable in healthy adults.
Abstract: Disability assessment remains a significant challenge especially in welfare systems like workers' compensation and disability insurance. Many of today's managed care strategies do not impact on the seminal issue of return to gainful employment. Employers, insurers, attorneys and case managers routinely request independent medical examinations (IMEs) as a means of determining degree of disability, functional limitations, work restrictions and "estimated" physical capacities. However, this approach is limited because physicians are not trained…in the functional model of disability assessment. IMEs address pathology and impairments which represent a portion of the disability continuum described by the World Health Organization, Nagi, Guccione and others [e.g. pathology-impairment-disability-handicap]. Functional capacity evaluations or FCEs are often performed by physical and occupational therapists who are trained in a function-based model of disability assessment. Unlike an IME physician who completes "Estimated Physical Capacities", therapists measure actual physical functioning. The value of both IMEs and FCEs can be enhanced through a "functional IME" that combines both models; medical-based examination and a function-based disability evaluation. This combination enhances the assessment of the relationship of pathology to impairment and impairment to disability status especially, in musculoskeletal disorders which tend to drive costs in workers' compensation.
Abstract: Returning the disabled worker to maximum productivity is a shared responsibility between the treating health practitioners and employers, with the insurer as an overseer of the injury management plan. Allied health professionals have responded to the need for standardized tools to assess work capacity by developing Functional Capacity Evaluations (FCEs). Literature exists outlining the limitations of FCEs in injury management systems; however, little is known about their uses and perceived usefulness. Questionnaires were posted…to managers and therapists of accredited rehabilitation providers. The questionnaires consisted of both open and closed format questions. The response rate for the managers' questionnaire was 53%, while the therapists' questionnaire was 27%. The majority of rehabilitation providers use an assessment of their Own Design. Eight commercial FCEs were identified as being used. The majority of therapists use only one type of FCE. Therapists rated FCEs highly on their flexibility with Own Design assessment rated as significantly more flexible than the most frequently used commercial FCEs. From the data collected, it appears that cost is the main factor influencing choice of assessment. Level of evidence supporting capabilities of particular assessments does not appear to influence use. It seems that, despite there being poor research evidence to support the use of many brands of FCEs, they are still commonly used by rehabilitation providers. To achieve optimal use of FCEs, further research is required on the types of adaptations therapists make to commercial assessments and properties of Own Design assessments, including reliability and validity studies.
Abstract: The purpose of this article is to help focus attention on why clinical health professionals need to be concerned about cultural diversity. It is not intended to be an exhaustive report on cultural diversity. Rather, attention is focused on the practitioner and how this provider can and should use and understand cultural diversity. While most of the examples in this article come from the press in the United States, the information has a much broader, universal…and global implication.
Keywords: Cultural diversity, ethnocentrism, folkways