Work - Volume 63, issue 2

Authors: Jacobs, Karen

Article Type: Editorial

DOI: 10.3233/WOR-192915

Citation: Work, vol. 63, no. 2, pp. 151-152, 2019

Authors: Rice, Valerie

Article Type: Editorial

DOI: 10.3233/WOR-192932

Citation: Work, vol. 63, no. 2, pp. 153-154, 2019

Authors: Liu, Baoxia | Rice, Valerie J.

Article Type: Research Article

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. Show more

Keywords: HeartMath, heart rate coherence, alpha brainwaves, alphamusic, DAVID-PAL

DOI: 10.3233/WOR-192917

Citation: Work, vol. 63, no. 2, pp. 155-163, 2019

Authors: Rice, Valerie | Boykin, Gary | Alfred, Petra | Lindsay, Gaylord | Overby, Cory | Jeter, Angela | Lester, Mark | Allison, Stephen | Cooper, Douglas

Article Type: Research Article

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. Show more

Keywords: Automated neuropsychological assessment metrics, brain acoustic monitor, balance, voice analysis

DOI: 10.3233/WOR-192918

Citation: Work, vol. 63, no. 2, pp. 165-180, 2019

Authors: Schmid, Arlene A. | Van Puymbroeck, Marieke | Fruhauf, Christine A. | Bair, Matthew J. | Portz, Jennifer Dickman

Article Type: Research Article

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. Show more

Keywords: Occupational therapy, chronic pain, occupation, mind body interventions, function

DOI: 10.3233/WOR-192919

Citation: Work, vol. 63, no. 2, pp. 181-189, 2019

Authors: Provancha-Romeo, Alexa F. | Hoffman, Amanda L. | Malcolm, Matt P. | Coatsworth, J. Douglas | Laxton, Lyndsay R. | Freeman, Katherine M. | Schmid, Arlene A.

Article Type: Research Article

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. Show more

Keywords: Occupational therapy, complementary and integrative health, mind-body, holistic, occupational performance

DOI: 10.3233/WOR-192920

Citation: Work, vol. 63, no. 2, pp. 191-197, 2019

Authors: Nicosia, Gregory J. | Minewiser, Lorna | Freger, Amanda

Article Type: Research Article

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. Show more

Keywords: Trauma, dissociation, energy psychology, 9/11 survivor

DOI: 10.3233/WOR-192921

Citation: Work, vol. 63, no. 2, pp. 199-204, 2019

Authors: Hilton, Lara G. | Marshall, Nell J. | Motala, Aneesa | Taylor, Stephanie L. | Miake-Lye, Isomi M. | Baxi, Sangita | Shanman, Roberta M. | Solloway, Michele R. | Beroesand, Jessica M. | Hempel, Susanne

Article Type: Review Article

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. Show more

Keywords: Systematic review, organizational behavior, complementary and integrative health

DOI: 10.3233/WOR-192922

Citation: Work, vol. 63, no. 2, pp. 205-218, 2019

Authors: Naddeo, A. | Cappetti, N. | Vallone, M.

Article Type: Research Article

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. Show more

Keywords: Comfort evaluation, rest posture, lower limbs joints, range of motion

DOI: 10.3233/WOR-192916

Citation: Work, vol. 63, no. 2, pp. 219-229, 2019

Authors: Colim, Ana | Arezes, Pedro | Flores, Paulo | Braga, Ana Cristina

Article Type: Research Article

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. Show more

Keywords: Lifting and lowering, obesity, psychophysical approach, Borg CR-10 scale

DOI: 10.3233/WOR-192923

Citation: Work, vol. 63, no. 2, pp. 231-241, 2019

Authors: Telles, Shirley | Kala, Niranjan | Gupta, Ram Kumar | Verma, Sadhana | Vishwakarma, Babita | Agnihotri, Savita | Gandharva, Kumar | Balkrishna, Acharya

Article Type: Research Article

Abstract: BACKGROUND: Military occupations require heightened vigilance with resultant sleep disturbances, increased anxiety and reduced vigilance. OBJECTIVE: To compare yoga with physical training to reduce insomnia, anxiety and increase vigilance in security personnel. METHODS: One hundred and twelve Border Security Force personnel (BSF group, males; mean age±SD = 30.4±7.4 years) were compared with 112 personnel of a private security firm (SIS group). The BSF group received yoga for nine days and the SIS group received physical training for the same period. Assessments were at baseline and after 9 days, with the digit vigilance test (DVT), Spielberger’s STAI-S, and a …sleep rating questionnaire. RESULTS: (1) Between groups: (i) at baseline the BSF group had higher vigilance and more daytime naps compared to the SIS group and (ii) after nine days the SIS group had higher state anxiety compared to the BSF group (ANOVA, Bonferroni adjusted post-hoc comparisons; SPSS Version 24.0) (2) In post-pre intervention comparisons (i) the BSF group increased vigilance and decreased state anxiety after yoga, with improved sleep, while (ii) the SIS group showed increased vigilance after physical training. CONCLUSION: Yoga may improve sleep, reduce anxiety while increasing vigilance in occupations requiring vigilance. Show more

Keywords: Alertness, insomnia, armed forces, unease

DOI: 10.3233/WOR-192925

Citation: Work, vol. 63, no. 2, pp. 243-251, 2019

Authors: Orantes-Gonzalez, E. | Heredia-Jimenez, J.

Article Type: Research Article

Abstract: BACKGROUND: Carrying a backpack and pulling a school trolley have been previously related to changes in spatiotemporal gait parameters. OBJECTIVE: Analyze gait asymmetry and rating of perceived exertion carrying a backpack and pulling a trolley with different loads. METHODS: Fifteen students from an elementary school (aged 10.1 ± 1.7 years) participated in this study. The participants walked with no bag, and carrying a backpack or pulling a trolley, both with 10%, 15% and 20% of the participant’s body weight (BW). A 3D motion capture system was used to analyze the spatiotemporal gait variables. Then, the ratios, symmetry angles …and gait asymmetry of the step length, swing time, and stance time were analyzed. Furthermore, the rating of perceived exertion was recorded. RESULTS: None of the asymmetry parameters were significantly different between those who carried a backpack and those who pulled a trolley. In the backpack condition, the ratings of perceived exertion were higher among participants in the 20% BW (2.07 ± 2.09, p  = 0.003) and 10% BW (0.27 ± 0.59, p  = 0.004) conditions compared to those in the control condition (0.07 + 0.26). Pulling a trolley did not significantly increase the perceived exertion ratings. CONCLUSIONS: Carrying a backpack and pulling a trolley from 10% – 20% BW did not induce gait asymmetry in children. The use of the school trolley required less subjective effort than carrying a backpack with the same loads. Show more

Keywords: Children, OMNI scale, wheeled backpack, students, load

DOI: 10.3233/WOR-192926

Citation: Work, vol. 63, no. 2, pp. 253-259, 2019

Authors: Alnaser, Musaed Z. | Aljadi, Sameera H.

Article Type: Research Article

Abstract: BACKGROUND: In the US, as the demands for rehabilitation services increase, work-related musculoskeletal disorders (WMSDs) have increased among rehabilitation practitioners. This trend has been noticed among physical therapists (PTs) in the State of Kuwait. OBJECTIVE: The purpose of this study was to determine the prevalence and risk factors associated with WMSDs among PTs in Kuwait over a 12-month period. In addition, the result compared across countries and health care professions. METHODS: A descriptive cross-sectional design was used in this study. A self-administered questionnaire was distributed to the PT departments at Kuwait government hospitals and schools. A …total of 312 returned questionnaires (69.3% response rate) were received. RESULTS: Results showed that 149 (48%) PT respondents experienced WMSDs. The lower back and muscle spasm were the most common area of the body injured and type of injury, respectively. Manual therapy techniques and patient transfers were most common activities associated with injuries. CONCLUSIONS: The prevalence of PTs with WMSDs in Kuwait was high and similar to other studies of PTs with WMSDs working in other countries. The performance of work activities was the leading risk factor for WMSDs, and WMSDs were prevalent among industrialized, industrially developing, and underdeveloped countries. Education of PTs regarding ergonomic and biomechanical principles as well as hands-on training of patient handling are the key tools to help prevent WMSDs. Show more

Keywords: Musculoskeletal injuries, therapists, occupational injuries, work incidence

DOI: 10.3233/WOR-192927

Citation: Work, vol. 63, no. 2, pp. 261-268, 2019

Authors: Stiefel, F. | Stiefel, Fa. | Terui, T. | Machino, T. | Ishitani, K. | Bourquin, C.

Article Type: Research Article

Abstract: BACKGROUND: While investigation of physicians’ work experience is often limited to issues of satisfaction or burnout, a broader view of their experiences is lacking. OBJECTIVE: To explore professional experiences, we asked Japanese physicians (N = 18, 12 men and 6 women) of a general hospital to react to so-called “narrative facilitators”. METHODS: The narrative facilitators – inspired by clinical psychology, visual sociology and purpose-designed techniques – oriented physicians’ narratives towards clinical practise, relationship with peers and context. Transcribed interviews were subject to thematic analysis. RESULTS: The thematic analysis of participants’ narratives revealed a lonely physician with …a tough job, torn between the ideal of patient-centred care and a clinical reality, which limits these aspirations. Patients emerged as anxious and burdensome consumers of medicine. Feeling neither supported by peers nor the institution, physicians also perceived the society as somewhat negligent, delegating its problem to medicine. Communication difficulties, with patients and peers, and the absence of joyful aspects of the profession constituted fundamental elements of their narratives. CONCLUSIONS: Comprehensive investigation of physicians’ lived professional experience could become a key to conceive ways to support them. Show more

Keywords: Narrative facilitators, physicians, qualitative research, thematic analysis, lived experience

DOI: 10.3233/WOR-192928

Citation: Work, vol. 63, no. 2, pp. 269-282, 2019

Authors: Harris, J. Irene | Strom, Thad Q. | Erbes, Christopher R. | Ruzek, Josef

Article Type: Research Article

Abstract: BACKGROUND: PTSD is associated with high levels of vocational difficulty, and research on relationships between PTSD and vocational adjustment may be relevant to vocational rehabilitation services to achieve optimal outcomes. Veteran perception of ability to cope with stressors in the workplace setting may play a role in rehabilitation outcome. OBJECTIVE: This article outlines preliminary steps in the development of the Vocational Efficacy in Trauma Survivors Scale (VETSS), to measure perceived efficacy in managing PTSD symptoms in the workplace. This has potential to expand future options for research in vocational rehabilitation for veterans with PTSD. METHODS: Veterans …in outpatient treatment for PTSD at a large, mid-western Veterans Affairs Health Care System facility responded to items on the proposed instrument and items on other measures of vocational and psychological functioning to assess the potential validity of items for an instrument to measure vocational self-efficacy among veterans managing PTSD. RESULTS: In a sample of 63 working veterans who receive outpatient care for PTSD, exploratory factor analysis identified two viable subscales, one tapping Workplace Coping, and another tapping Self-Disclosure. CONCLUSIONS: Preliminary findings indicate that the measure demonstrated acceptable indications of reliability and validity, suggesting promise for future use in vocational rehabilitation research. Show more

Keywords: Veteran, vocational rehabilitation, social support, measurement

DOI: 10.3233/WOR-192929

Citation: Work, vol. 63, no. 2, pp. 283-289, 2019

Authors: Cary, Doug | Collinson, Roger | Sterling, Michele | Briffa, Kathryn

Article Type: Research Article

Abstract: BACKGROUND: Spinal symptoms of pain and stiffness on waking have been linked to sleep posture. Sleep posture is commonly classified as supine, side lying and prone. It is clinically postulated that sleeping postures with sustained end of range rotation and extension may influence pain sensitive spinal tissues. However, the lack of a valid and reliable method of assessing sleep posture, means clinicians are unable to provide corrective advice based upon evidenced based research. OBJECTIVE: To determine the validity and reliability of a sleep posture recording protocol in the home environment. METHOD: Twenty health professionals viewed a …pre-recorded video recording of randomised sleep postures under natural and infrared light situations, with a variety of bed coverings, to represent the habitual environment. Sleep postures were classified into six categories including two intermediate postures (supported side lying and provocative side lying). Viewing was repeated after two days. RESULTS: Intra-and inter-rater reliability were excellent; Cohen’s Kappa = .93 (95% CI 0.80 to 1.0) and Fleiss Kappa = 0.83 (95% CI 0.82 to 0.84) respectively. Validity, determined as concordance between the health professionals’ classifications and the known postures, was also excellent Cohen’s Kappa = .91 (95% CI 0.77 to 1.0). CONCLUSIONS: Reliable and valid assessment of sleep posture, including intermediate postures, could be achieved using low cost, portable, infrared video recording equipment, under a variety of lighting conditions and a variety of bed cover situations typical of the home environment. Show more

Keywords: Ergonomics, spine pain, spine stiffness, sleep posture assessment, habitual environment, sleep posture classification, intermediate sleep postures

DOI: 10.3233/WOR-192930

Citation: Work, vol. 63, no. 2, pp. 291-298, 2019

Authors: García-Remeseiro, Tania | Gutiérrez-Sánchez, Águeda

Article Type: Review Article

Abstract: BACKGROUND: In modern society, there is an increase both in the demand and the duration of computer work. Failure to correct body posture while using the computer has become a serious health hazard. OBJECTIVE: To identify global trends in research related to body posture and visual display terminals (VDTs) using a bibliometric approach. METHODS: In the search process, the keywords (posture * ) AND (computer* OR “visual display terminal”) were used in the study title section, in the Wos, Scopus and Medline databases. RESULTS: 149 references published between 1970 and 2016 were analyzed. …The studied variables were the years of publication, authorship and collaboration index, publication type, titles of journals, most used languages, impact of the publications, as well as content of the articles. CONCLUSIONS: In recent years, the studies on body posture in relation to VDT have been increased both in quantity and quality of publications. The analysis and/or design of the workplace, as well as the elements that make up the computer (keyboard and mouse) are the most researched topics in the area. Show more

Keywords: Computer, workplace, ergonomics, scientific production

DOI: 10.3233/WOR-192931

Citation: Work, vol. 63, no. 2, pp. 299-308, 2019

Authors: Early, Amy | Walsh, Ryan | Douglas, Bruce

Article Type: Research Article

Abstract: As the population of individuals aged sixty-five and older continues to grow, the number of older individuals participating in the workforce rises alongside, with projections estimating as many as 72 million older workers by 2030. Due to this rapid increase in the number of older workers, new challenges to worker health and to health-related productivity will arise in the coming years. Occupational therapy practitioners are uniquely suited to address many of these challenges given their background in activity analysis, assessment and modification of job demands, health promotion and successful aging. However, there is need for continued research in this area …to expand the role of the occupational therapy practitioner in prevention and return-to-work interventions focused on the older worker, and to advocate for the value occupational therapy practitioners can contribute to this field. Show more

Keywords: work, gerontology, participation, prevention

DOI: 10.3233/WOR-192924

Citation: Work, vol. 63, no. 2, pp. 309-318, 2019