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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: BACKGROUND: Music and meditation have affirmative effects on the parasympathetic nervous system. OBJECTIVE: To investigate individual preferences for background sounds during meditation, using a series of paired, forced-choice comparisons. METHOD: Interventions included music with a distinct melody (one sample) and without a distinct melody (MWDM) (three samples), nature sounds with embedded alpha brainwave pulses (one sample), alpha brainwave pulses alone (one sample), and silence. Participants rated how much they liked hearing a sample during meditation and whether they felt they could meditate deeply while listening to it. Heart rhythm coherence scores were recorded using HeartMath emWavePro…software and hardware. Participants were ranked as novice or adept meditators (NM vs AM) based on coherence scores. Rankings were based on preference selections, rating scales, and coherence scores. RESULTS: Rankings were highest for silence and MWDM. AMs preferred silence, followed by MWDM. NMs preferred listening to MWDM during meditation. DISCUSSION: Those with greater experience preferred meditating in silence. A preference was also seen for a composition style that incorporated altering arrhythmic and rhythmic patterns, and alternating asynchronous and synchronous patterns. CONCLUSION: These results indicate a compelling case for further research investigating meditation, music, and the potential interactive effect of the two on mind, body, and personal performance.
Abstract: BACKGROUND: A standard, reliable, objective measure is needed for identifying individuals with mild to moderate traumatic brain injury (TBI). OBJECTIVE: The purpose of this study was to examine balance using an AMTI OR6-7 force platform (FP), neurocognition and mood using the Automated Neuropsychological Assessment Metric4 (ANAM4), blood flow comparisons using a Brain Acoustic Monitor (BAM), and voice using Voice Analysis software (VA) for screening service members for a mild to moderate TBI. METHODS: Active duty and retired service member volunteers (n = 88, 35 with a diagnosis of mild to moderate TBI and 53 who never had…a TBI) completed an informed consent document, and evaluations using the four technologies. RESULTS: Development of a clinical prediction rule yielded two FP variables and one ANAM4 Mood Scale variable (vigor) as helpful in predicting the presence of a TBI. Assuming a 15% pre-test probability, these predictors yield a post-test probability of 75.7% for a positive result with any two or more measures being positive, and a post-test probability of 2.3% for a negative result with zero measures being positive. CONCLUSIONS: This study demonstrated the usefulness of a force platform and a self-reported mood scale for predicting presence of mild to moderate TBI.
Abstract: BACKGROUND: Chronic pain is a complex accumulation of physical, psychological, and social conditions, thus interventions that address pain and promote occupational performance are needed. A holistic intervention, with mind and body components, is likely necessary to best treat the complexities of chronic pain. Thus, we developed and tested a yoga intervention for people with chronic pain. OBJECTIVES: In a randomized control trial (RCT), participants with chronic pain were randomized to a yoga intervention or usual care group. Between and within group differences for pre-and post-outcome measure scores were assessed for: occupational performance, completion of activities, and depression.…METHODS: Pilot RCT with participant allocation to 8 weeks of yoga or usual care. Both groups received ongoing monthly self-management programming. Data were collected before and after the 8-week intervention. Participants were randomized to yoga or usual care after baseline assessments. Demographics were collected and measures included: Canadian Occupational Performance Measure (COPM) to assess occupational performance; the 15-item Frenchay Activities Index (FAI)(activities); and the 9-item Patient Health Questionnaire (PHQ-9) for depression. Independent t -tests were used to assess differences between groups. Paired t -tests were used to assess differences between pre- and post 8-week intervention for both the yoga and the usual care groups. Percent change scores and effect sizes were calculated. RESULTS: 83 people were recruited for the study and completed baseline assessments; 44 individuals were randomized to yoga and 39 to the control group. The average age of all participants was 51.4±10.5 years, 68% were female; and 60% had at least some college education. There were no significant differences in demographics or outcome measures between groups at baseline or 8 weeks; however, the study was not powered to see such differences. Individuals randomized to the control group did not significantly improve in any outcome measure over the 8 weeks. There were significant improvements in COPM performance and COPM satisfaction scores for individuals randomized to the yoga group; both scores significantly improved. COPM performance improved by 27% with a moderate to large effect size (3.66±1.85 vs 4.66±1.93, p < 0.001, d = 0.76). COPM satisfaction significantly improved by 78% (2.14±2.31 vs. 3.80±2.50, p < 0.001) and had a large effects size (d = 1.02). FAI scores improved, indicating increased activity or engagement in daily occupation during the 8-week intervention. Scores increased by 5% (38.13±8.48 vs. 39.90±8.57, p = 0.024) with a small effect size (d = 0.37). Depression significantly decreased from 13.21±5.60 to 11.41±5.82, p = 0.041, with a small effect size. CONCLUSION: Data from this pilot RCT indicate yoga may be an effective therapeutic intervention with people in chronic pain to improve occupational performance, increase engagement in activities, and decrease depression. Occupational therapy practitioners may consider adding yoga as a treatment intervention to address the needs of people with pain.
Keywords: Occupational therapy, chronic pain, occupation, mind body interventions, function
Abstract: Patients in the medical intensive care unit (MICU) face life-threatening conditions leading to physical and psychological stress, and decreased occupational engagement. Mind-body interventions include techniques based on connecting the mind, body, brain, and behavior to positively influence health. The purpose of this study was to explore the use of mind-body interventions as a tool for use by occupational therapists (OT) to improve health and occupational performance. This was an exploratory case study completed with the patient, “Ann” in a MICU. Ann was a 57-year-old female who was admitted to the MICU for abdominal pain and later diagnosed with septic shock.…Two mind-body sessions were completed with Ann and her responses were assessed via multiple variables, including: respiratory rate; blood pressure; heart rate; oxygen saturation; and anxiety. Ann stayed within normal ranges for all variables. This study demonstrates it was feasible to elicit mind-body interventions in this setting, with this patient.
Abstract: BACKGROUND: Emotional Freedom Techniques (EFT) and Eye Movement Desensitization and Reprocessing (EMDR) have been empirically validated as effective psychotherapeutic interventions for treating Post Traumatic Stress Disorder (PTSD). This single subject design case study is of a survivor of the Twin Towers collapse who was treated for prolonged PTSD complicated by dissociated memories. OBJECTIVE: EMDR and EFT’s effectiveness in treating PTSD were evaluated. METHOD: Multiple assessments using Trauma Symptom Inventory (TSI) and Personality combination with EMDR were conducted. RESULTS: Effects of a single session of EFT assessed immediately after treatment demonstrated an elimination of clinically…significant scores on both the TSI and PAI. The participant concluded treatment with nearly complete symptom remediation and a return to work. CONCLUSION: The combination of treatment methods appears to be highly effective and allowed this subject to return to work after many years of disability.
Keywords: Trauma, dissociation, energy psychology, 9/11 survivor
Abstract: BACKGROUND: Mindfulness interventions aim to foster greater attention and awareness of present moment experiences. Uptake of mindfulness programs in the workplace has grown as organizations look to support employee health, wellbeing, and performance. OBJECTIVE: In support of evidence-based decision making in workplace contexts, we created an evidence map summarizing physical and mental health, cognitive, affective, and interpersonal outcomes from systematic reviews of randomized controlled trials (RCTs) of mindfulness interventions. METHODS: We searched nine electronic databases to July 2017, dually-screened all reviews, and consulted topic experts to identify systematic reviews on mindfulness interventions. The distribution of evidence…is presented as an evidence map in a bubble plot. RESULTS: In total, 175 systematic reviews met inclusion criteria. Reviews included a variety of mindfulness-based interventions. The largest review included 109 randomized controlled trials. The majority of these addressed general health, psychological conditions, chronic illness, pain, and substance use. Twenty-six systematic reviews assessed studies conducted in workplace settings and with healthcare professionals, educators, and caregivers. The evidence map shows the prevalence of research by the primary area of focus. An outline of promising applications of mindfulness interventions is included. CONCLUSIONS: The evidence map provides an overview of existing mindfulness research. It shows the body of available evidence to inform policy and organizational decision-making supporting employee wellbeing in work contexts.
Keywords: Systematic review, organizational behavior, complementary and integrative
Abstract: BACKGROUND: Several comfort perception models have proposed an objective method to evaluate “effects in the internal body” and “perceived comfort”. Postural comfort is one aspect of comfort/discomfort perception, and this current work adds to existing knowledge toward a more objectified posture evaluation for comfort. OBJECTIVE: The authors have used the concept of Range of Rest Posture (RRP), as proposed by Apostolico et al. The study focused on the identification of RRP within the Comfort Range of Motion (CROM) for lower limbs. METHODS: The proposed method is based on extensive experimental work involving 114 healthy individuals (59 males…and 55 females) ranging from 20 to 40 years old. The age range was narrowed to avoid an age-clustering of results due to inhomogeneity of the statistical sample. Data were processed using statistical methods for identifying the RRP in the experimental CROM. Several Maximum Level of Comfort (MLC) positions were found within the RRP. RESULTS: RRPs for lower limbs of men and women have been identified and can be used for virtual comfort assessment. CONCLUSIONS: This paper shows a method to evaluate in a more objective way the subjective postural comfort perception and results allow researchers to improve models for the virtual preventive comfort assessment.
Keywords: Comfort evaluation, rest posture, lower limbs joints, range of
Abstract: BACKGROUND: Obesity prevalence in the workforce is clearly increasing. Simultaneously, manual lifting/lowering loads, referred to as Vertical Handling Tasks (VHT) in this paper, are common in industries and services. Performing VHT exposes workers to physical overload, which can be measured using a psychophysical approach. Various risk factors can increase this overload, including individual factors such as workers’ Body Mass Index (BMI). OBJECTIVE: To study the possible effects of workers’ BMI and some task conditions on physical overload during VHT. METHODS: Psychophysical data were collected from 51 participants having different body constitutions (including non-obese, overweight and obese).…The participants performed 6 VHT (3 different loads ×2 workstation configurations), during which they lifted and lowered a test-box between their knees and shoulders. For each task, they reported their perceived exertion using the Borg Category Ratio-10 (CR-10) scale. RESULTS: The results showed that the CR-10 scale is sensitive to the variation of the task conditions tested. However, the psychophysical data pointed to a tendency to decrease the perception of physical overload as workers’ BMI increases. CONCLUSIONS: This may compromise the validity of the application of psychophysical data as an ergonomic approach for Work-Related Musculoskeletal Disorders (WRMSD) prevention in obese workers.
Keywords: Lifting and lowering, obesity, psychophysical approach, Borg CR-10 scale