Return to work a bumpy road: a qualitative study on experiences of work ability and work situation in individuals with chronic whiplash-associated disorders

Abstract

Background Work resumption is a big challenge in the rehabilitation process for individuals with whiplash-associated disorders (WAD). To better meet the needs of individuals with WAD in their return to work process, more knowledge on their experiences and perspectives is needed. The aim of this study was to explore the experiences of work ability and the work situation of individuals who participated in a neck-specific exercise programme for chronic WAD. Methods This qualitative study has an exploratory and descriptive design based on data collected through open-ended interviews with 17 individuals with chronic WAD. Data were analysed inductively using conventional content analysis. Results Analysis of the data yielded the following five categories related to the participants’ narratives on their experiences of work ability and their work situation: Return to work – a process of setbacks and bureaucracy; The need to be understood by health care professionals, and to receive a treatment plan; Individual resources are important for work ability; The consequences of reduced work ability; and Working conditions are important for work ability. Conclusion Individuals with chronic WAD often struggle to return to work. Emotional and practical support from stakeholders is imperative and needs to be strengthened. Participating in a neck-specific exercise programme, including being acknowledged and receiving information about WAD, could positively affect the work ability of WAD sufferers. This study has provided management strategies to improve the ability to work for individuals with chronic WAD, and highlights the need to incorporate a healthy and sustainable return to work in the rehabilitation of individuals with WAD, thereby making their return to work a success.

Results of neck-specific exercise for altered postural sway in individuals with chronic whiplash-associated disorders: a longitudinal case–control study

“…In the present study, virtually the same neck-specific exercise programme was used as in the study by Treleaven et al 33 , but with two additional ventral neck muscle endurance exercises included, which seems to have been successful not only to improve ventral neck muscle endurance (unpublished data), but also to reduce postural sway double stance. Although the effectiveness on postural sway after a neck-specific exercise programme had to be investigated in RCTs, the results of the present study are promising as chronic WAD grades 2 and 3 have been reported to be disabling conditions influencing the whole of life 1 , 3 , 4 , 7 , and to be rather resistant to treatment 1 , 56 – 58 . Despite no significant differences between the healthy group and the WAD group in single leg stance eyes open, the WAD group improved after intervention, confirming existing knowledge in healthy individuals that sensorimotor disturbance and muscle fatigue are of importance for balance 59 and may be improved after an exercise programme including these elements.…”

“…Whiplash-associated disorders (WAD) is a disabling condition 1 after an indirect neck trauma, a whiplash injury, often in connection with a car accident 2 . About half of those with WAD will experience chronic (≥ 6 months) pain and disability 3 , 4 , influencing their health, work and daily life 4 – 7 .…”

Work Ability After Anterior Cervical Decompression and Fusion Followed by a Structured Postoperative Rehabilitation: Secondary Outcomes of a Prospective Randomized Controlled Multi-Centre Trial with a 2-year Follow-up

“…At the short-term follow-up after surgery, it is important to identify individuals who require further or extended interventions to gain and promote work ability [ 40 ]. A qualitative study on experiences with work ability in chronic WAD grade II and III showed that neck-specific exercise, information about the condition, and practical and emotional support from stakeholders need to be strengthened for increased work ability [ 41 ]. In a review of 18 qualitative studies [ 42 ], moderate evidence was found for collaboration between stakeholders; support from family, friends, colleagues, workplace settings, and health care personnel; and workplace adjustments and self-management strategies for return to work in individuals with musculoskeletal pain.…”

“…The WAI is a reliable and valid selfreport scale scored from 7 to 49, with higher scores indicating higher work ability [17]. Scores can be presented as mean values or categorized into four levels when used as an outcome measure: poor , moderate (28)(29)(30)(31)(32)(33)(34)(35)(36), good (37)(38)(39)(40)(41)(42)(43), and excellent (44-49) [18,19].…”

Efficacy of Neck-Specific Exercise With Internet Support Versus Neck-Specific Exercise at a Physiotherapy Clinic in Chronic Whiplash-Associated Disorders: Multicenter Randomized Controlled Noninferiority Trial

“…Patient satisfaction with the exercises, information, tests, and their total experience with the interventions were measured post intervention. Qualitative interviews were conducted with a proportion of patients after the study [ 31 ], and patients have been involved in the further development of the internet-based program.…”