Early workplace dialogue in physiotherapy practice improved work ability at 1-year follow-up—WorkUp, a randomised controlled trial in primary care

Sennehed, Charlotte Post; Holmberg, Sara; Axén, Iben; Stigmar, Kjerstin; Forsbrand, Malin; Petersson, Ingemar; Grahn, Birgitta

doi:10.1097/j.pain.0000000000001216

Cited by 39 publications

(71 citation statements)

References 49 publications

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“…It is important to realise that rehabilitation being conducted only within the framework of health care services cannot create new suitable employments or customise employment for patients with limited work ability in their current work due to health problems. Workplace interventions, for example, contact between health care professionals and employers have been found to have effect on RTW (Williams et al, 2007;Kuoppala et al, 2008;Sennehed et al, 2018). More initiatives and studies involving labour market, workplace, employers and rules for conversion of work and remuneration are needed.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of a multimodal pain rehabilitation programme in primary care based on clinical register data: a feasibility study

Sennehed

Stigmar

Grahn

et al. 2020

Prim Health Care Res Dev

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Aim: Investigate the feasibility of identifying a well-defined treatment group and a comparable reference group in clinical register data. Background: There is insufficient knowledge on how to avert neck/back pain from turning chronic or to impair work ability. The Swedish Government implemented a national multimodal rehabilitation (MMR) programme in primary care intending to promote work ability, reduce sick leave and increase return to work. Since randomised control trial data for effect is lacking, it is important to evaluate existing observational data from clinical settings. Methods: We identified all unique patients with musculoskeletal pain (MSP) diagnoses undergoing the MMR programme in primary care in the Skåne Health care Register (n = 2140) during 2010–2011. A reference cohort in primary care (n = 56 300) with similar MSP diagnoses, same ages and the same level of sick leave before baseline was identified for the same period. The reference cohort received ordinary care and treatment in primary care. The final study group consisted of 603 eligible MMR patients and 2874 eligible reference patients. Socio-economic and health-related baseline data including sick leave one year before up to two years after baseline were compared between groups. Findings: There were significant socio-economic and health differences at baseline between the MMR and the reference patients, with the MMR group having lower income, higher morbidity and more sick leave days. Sick leave days per year decreased significantly in the MMR group (118–102 days, P < 0.001) and in the reference group (50–42 days, P < 0.001) from one year before baseline to two years after. Conclusions: It was not feasible to identify a comparable reference group based on clinical register data. Despite an ambitious attempt to limit selection bias, significant baseline differences in socio-economic and health were present. In absence of randomised trials, effects of MMR cannot be sufficiently evaluated in primary care.

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Section: Discussionmentioning

confidence: 99%

Evaluation of a multimodal pain rehabilitation programme in primary care based on clinical register data: a feasibility study

Sennehed

Stigmar

Grahn

et al. 2020

Prim Health Care Res Dev

Self Cite

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“…In addition to this, all participants received weekly text messages (SMS) where they answered three questions on the impact of the acute/sub-acute BP and/or NP on work and leisure time. The primary outcome measures in WorkUp were work ability and health-related quality of life [14].…”

Section: Settingmentioning

confidence: 99%

“…The PTs involved in the intervention received education in CDM by researchers experienced in occupational health. The education consisted of a lecture on work-oriented rehabilitation and practical training [14].…”

Section: Settingmentioning

confidence: 99%

“…In this study, we wanted to deepen the understanding of patients' experiences of a workplace dialogue conducted within a cluster-randomised controlled trial (ClinicalTrials.gov ID: NCT02609750) in primary care; WorkUp [14]. In WorkUp, a new approach in treating patients with acute/sub-acute BP and/or NP was tried where the PTs communicated in a workoriented way with patients and employers at an early stage, mainly even before sick leave had occurred.…”

Section: Introductionmentioning

confidence: 99%

“…In WorkUp, a new approach in treating patients with acute/sub-acute BP and/or NP was tried where the PTs communicated in a workoriented way with patients and employers at an early stage, mainly even before sick leave had occurred. The main results from WorkUp showed that a higher proportion of patients in the intervention group had work ability at 12 months followup compared to the control group [14]. Before this dialogue method can be implemented in ordinary healthcare, it is important to gain knowledge of the patients' experiences of the workplace dialogue in WorkUp.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Patients’ experience of a workplace dialogue in physiotherapy practice in primary care: an interview study

Östlind

Grahn²,

Stigmar

2019

European Journal of Physiotherapy

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Purpose: To describe how patients with acute/subacute back pain and/or neck pain experienced a workplace intervention, conducted as a structured workplace dialogue (convergence dialogue meeting, CDM) within physiotherapy practice in primary care. Materials and methods: Semi-structured interviews were performed with 10 patients who took part in the CDM. Qualitative content analysis was applied to the data. Results: Three categories emerged from the analysis: physiotherapist (PT) as a facilitator, the employer as a key stakeholder and lack of transparency and concrete changes. Conclusion: This study describes patients' experiences of a workplace dialogue in physiotherapy practice. Even though few patients experienced concrete changes at the workplace, they were supportive for the intervention as well as how the PTs conducted the CDM. The patients expressed trust in the PTs who were seen as someone who could facilitate changes at the workplace, being proficient and supportive. The CDM could be a method to facilitate communication between stakeholders and support work ability.

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Effectiveness of fitness for work interventions for workers with low back pain: A systematic review

Ishimaru

Chimed‐Ochir

Arphorn

et al. 2021

Journal of Occupational Health

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Objectives Safety at work is important for workers with low back pain (LBP). This requires good job design that considers both worker capacities and work requirements, a concept called “Fitness for Work.” This systematic review aimed to evaluate the effects of fitness for work interventions on workers with LBP. Methods We searched PubMed, the Cochrane Library, and Scopus from 2000 through 2020, using relevant terms. Results We reviewed nine randomized controlled trials (RCTs) out of 3052 unique references. All studies were RCTs conducted in Western countries. Some RCTs reported positive findings that fitness for work interventions were effective for LBP in facilitating shorter return to work time and reducing short‐term sick leave. However, the results of the reviewed studies were inconsistent; therefore, there is insufficient evidence to draw firm conclusions about the effectiveness of fitness for work interventions. Furthermore, the interventions were not effective in reducing long‐term sick leave over a 24‐month period. There were consistent findings that fitness for work interventions were no more effective than control interventions on pain intensity, disability, and work ability of workers with LBP. Conclusions These results suggest that fitness for work interventions may be somewhat effective in facilitating return to work and preventing short‐term recurrence in workers with LBP. However, workers need to carefully manage their condition to prevent long‐term recurrence.

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Early workplace dialogue in physiotherapy practice improved work ability at 1-year follow-up—WorkUp, a randomised controlled trial in primary care

Abstract: An early workplace dialogue with the employer in addition to physiotherapy significantly improved work ability in comparison with structured physiotherapy only.

Cited by 39 publications

References 49 publications

Evaluation of a multimodal pain rehabilitation programme in primary care based on clinical register data: a feasibility study

Evaluation of a multimodal pain rehabilitation programme in primary care based on clinical register data: a feasibility study

Patients’ experience of a workplace dialogue in physiotherapy practice in primary care: an interview study

Effectiveness of fitness for work interventions for workers with low back pain: A systematic review

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