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Journal of Occupational Rehabilitation

, Volume 18, Issue 2, pp 140–151 | Cite as

A Prospective Study of the Effectiveness of Early Intervention with High-risk Back-injured Workers—A Pilot Study

  • I. Z. Schultz
  • J. Crook
  • J. Berkowitz
  • R. Milner
  • G. R. Meloche
  • M. L. Lewis
Article

Abstract

Introduction It was postulated that workers, at the sub-acute stage after injury, respond differently to clinical and occupational interventions offered in a workers’ compensation environment. Individual worker risk of disability, it was further believed, would influence the effectiveness of early intervention. The objective of the current pilot study was to evaluate return to work (RTW) outcomes following proactive, combined clinical, occupational and case management-based interdisciplinary early intervention, provided in a workers’ compensation environment 4–10 weeks of onset of back pain, to workers with medium and high risk for disability. Methods The project was a controlled study comparing conventional workers’ compensation case management with integrated, interdisciplinary and multimodal early intervention (hereinafter referred to as “EI”). At baseline, risk status was determined by a validated Risk for Disability Questionnaire by Carragee et al. (Spine 5(1):24–35, 2005). Seventeen workers at high risk of protracted disability and 20 workers at moderate risk of disability received conventional case management, and 17 workers assessed at high risk of protracted disability and 18 workers at moderate risk of disability received the Early Intervention. Results At 3 months post back pain onset, no statistically significant differences were identified in RTW outcomes between conventional case management and the Early Intervention. However, by 6 months post back pain onset, workers at high risk of work disability who received the Early Intervention were significantly more likely to RTW than high risk workers who received conventional case management. In contrast, moderate risk workers continued to exhibit no statistically significant differences in RTW outcomes. Conclusion Multimodal Early Intervention in the workers’ compensation case management context is likely effective for workers with sub-acute back pain who are at high risk of occupational disability. The comprehensive Early Intervention is, however, likely redundant for workers who are not at high risk for disability and should not be applied indiscriminately. Further studies are required to determine longer-term Early Intervention outcomes, and to replicate the findings using a randomized control design. Also, with a larger sample size, it will be possible to determine predictors of occupational outcomes.

Keywords

Biopsychosocial Case management Cognitive behavioral Early intervention Occupational disability Return to work Low back pain (Sub)acute back pain Musculoskeletal injury Risk for disability Predictive factors Workers’ compensation 

Notes

Acknowledgements

The authors would like to thank the WorkSafeBC Research Secretariat for their grant support. The authors would also like to thank the following people for their assistance in the preparation of this paper: Alison Stewart, Research Coordinator and Researcher, Pilot EI Study, University of British Columbia; Zoe Paris, Pilot EI Researcher, University of British Columbia; and Wendy Meloche, Research Coordinator, Pilot EI Study. In addition, the authors are grateful to Dr. Mark Jensen from the University of Washington for the training of case management team members at WorkSafeBC in motivational interviewing.

References

  1. 1.
    Koes BW, van Tulder MW, Thomas S. Diagnosis and treatment of low back pain. Br Med J 2006;332:1430–4.CrossRefGoogle Scholar
  2. 2.
    Waddell G. The epidemiology of back pain. In: Waddell G, editor. The back pain revolution. Revised 2nd ed. Edinburgh, UK: Churchill Livingston [Elsevier]; 2004. 456 pp.Google Scholar
  3. 3.
    Burdorf A, Jansen JP. Predicting the long term course of low back pain and its consequences for sickness absence and associated work disability. Occup Environ Med 2006;63:522–9.PubMedCrossRefGoogle Scholar
  4. 4.
    Boersma K, Linton SJ. Expectancy, fear and pain in the prediction of chronic pain and disability: a prospective analysis. Eur J Pain 2006;10(6):551–7.PubMedCrossRefGoogle Scholar
  5. 5.
    Chen C, Hogg-Johnson S, Smith P. The recovery patterns of back pain among workers with compensated occupational back injuries. Occup Environ Med 2007;64(8):534–40.PubMedCrossRefGoogle Scholar
  6. 6.
    Pulliam CB, Gatchel RJ, Gardea MA. Psychosocial differences in high risk versus low risk acute low back patients. J Occup Rehabil 2001;11(1):43–52.PubMedCrossRefGoogle Scholar
  7. 7.
    Hills EC. Mechanical Low Back Pain. In: Wieting JM, Talavera F, Foye PM, Allen KL, Lorenzo CT, editors. eMedicine Specialties, 2006. 26 pp.Google Scholar
  8. 8.
    Pransky G. Return to work—from research to practice. J Occup Environ Med 2007;49(3):249–51.PubMedCrossRefGoogle Scholar
  9. 9.
    Schultz IZ, Stowell AW, Feuerstein M, Gatchel RJ. Models of return to work for musculoskeletal disorders. J Occup Rehabil 2007;17:327–52.PubMedCrossRefGoogle Scholar
  10. 10.
    Marhold C, Linton SJ, Melin L. A cognitive-behavioral return-to-work program: effects on pain patients with a history of long-term versus short-term sick leave. Pain 2001;91:155–63.PubMedCrossRefGoogle Scholar
  11. 11.
    Karjalainen K, Malmivaara A, van Tulder M et al. Multidisciplinary biopsychosocial rehabilitation for subacute low back pain among working age adults (Review). The cochrane database of systematic reviews 2003;(2). doi:  10.1002/14651858.CD002193.
  12. 12.
    Hunt DG, Zuberbier OA, Kozlowski AJ et al. Are components of a comprehensive medical assessment predictive of work disability following an episode of occupational low back trouble? Spine 2002;27(23):2715–9.PubMedCrossRefGoogle Scholar
  13. 13.
    George SZ, Fritz JM, Bialosky JE, Douglas AD. The effect of a fear-avoidance-based physical therapy intervention for patients with acute low back pain: results of a randomized clinical trial. Spine 2003;28(23):2551–60.PubMedCrossRefGoogle Scholar
  14. 14.
    George SZ, Fritz JM, McNeil D. Fear-avoidance beliefs as measured by the fear-avoidance beliefs questionnaire: change in fear-avoidance beliefs questionnaire is predictive of change in self-report of disability and pain intensity for patients with acute low back pain. J Pain 2006;22(2):197–203.Google Scholar
  15. 15.
    Swinkels-Meewisse IEJ, Roelofs J, Schouten EGW. Fear of movement/(re)injury predicting chronic disabling low back pain. A prospective inception cohort study. Spine 2006;31(6):658–64.PubMedCrossRefGoogle Scholar
  16. 16.
    Sullivan MJL, Feuerstein M, Gatchel RJ, Linton SJ, Pransky G. Integrating psychosocial and behavioral interventions to achieve optimal rehabilitation outcomes. J Occup Rehabil 2005;15:475–89.PubMedCrossRefGoogle Scholar
  17. 17.
    Linton SJ, Boersma K, Jansson M, Svärd L, Botvalde M. The effects of cognitive-behavioral and physical therapy preventive interventions on pain related sick leave: a randomized controlled trial. Clin J Pain 2005;21:109–19.PubMedCrossRefGoogle Scholar
  18. 18.
    Swinkels-Meewisse IE, Roelofs J, Verbeek AL, Oostendorp RA, Vlaeyen JW. Fear-avoidance beliefs, disability, and participation in workers and non-workers with acute low back pain. Clin J Pain 2006;22(1):45–54.PubMedCrossRefGoogle Scholar
  19. 19.
    Loisel P, Abenhaim L, Durand P et al. A population-based, randomized clinical trial on back pain management. Spine 1997;22(24):2911–8.PubMedCrossRefGoogle Scholar
  20. 20.
    Frank JW, Brooker A, DeMaio SE et al. Disability resulting from occupational low back pain: part II: what do we know about secondary prevention? A review of the scientific evidence on prevention after disability begins. Spine 1996; 21(24):2918–29.PubMedCrossRefGoogle Scholar
  21. 21.
    Frank J, Sinclair S, Hogg-Johnson S et al. Preventing disability from work-related low-back pain. Can Med Assoc J 1998;158(2):1625–31.Google Scholar
  22. 22.
    Loisel P, Durand M, Berthelette D et al. Disability prevention: new paradigm for the management of occupational back pain. Dis Manag Health Outcomes 2001;9(7):351–60.CrossRefGoogle Scholar
  23. 23.
    Loisel P, Buchbinder R, Hazard R et al. Prevention of work disability due to musculoskeletal disorders: the challenge of implementing evidence. J Occup Rehabil 2005;15(4):507–24.PubMedCrossRefGoogle Scholar
  24. 24.
    Karjalainen K, Malmivaara A, Mutanen P, Roine R, Hurri H, Pohjolainen T. Mini-intervention for subacute low back pain: two-year follow-up and modifiers of effectiveness. Spine 2004;29(10):1069–76.PubMedCrossRefGoogle Scholar
  25. 25.
    Schultz IZ, Crook JM, Winter A. Evidence informed best practices for injured workers at high risk for disability at the subacute stage: secondary prevention in the compensation context. Schultz IZ, Gatchel RJ, Editors. Handbook of complex occupational disability claims: early risk identification, intervention and prevention. New York: Springer; 2005. p. 443–60.CrossRefGoogle Scholar
  26. 26.
    Lincoln AE, Feuerstein M, Shaw WS, Miller VI. Impact of case manager training on worksite accommodations in workers’ compensation claimants with upper extremity disorders. J Occup Environ Med 2002;44(3):237–45.PubMedCrossRefGoogle Scholar
  27. 27.
    Gatchel RJ, Polatin PB, Noe C, Gardea M, Pulliam C, Thompson J. Treatment- and cost-effectiveness of early intervention for acute low-back pain patients: a one-year prospective study. J Occup Rehabil 2003;13(1):1–9.PubMedCrossRefGoogle Scholar
  28. 28.
    Bernacki EJ, Tsai SP. Ten years’ experience using an integral workers’ compensation management system to control workers’ compensation costs. J Occup Environ Med 2003;45(5):508–16.PubMedCrossRefGoogle Scholar
  29. 29.
    Russo D. An organizational case study of the case manager’s role in a client’s return-to-work programme in Australia. Occup Ther Int 2002;9(1):57–75.PubMedCrossRefGoogle Scholar
  30. 30.
    Rossignol M, Abenhaim L, Séguin P et al. Coordination of primary health care for back pain: a randomized controlled trial. Spine 2000;25(2):251–9.PubMedCrossRefGoogle Scholar
  31. 31.
    Bernacki EJ, Tao XG, Yuspeh L. An investigation of the effects of a healthcare provider network on costs and lost time in workers’ compensation. J Occup Environ Med 2006;48(9):873–82.PubMedCrossRefGoogle Scholar
  32. 32.
    Staal JB, Hlobil H, van Tulder MW et al. Occupational health guidelines for the management of low back pain: an international comparison. Occup Environ Med 2003;60(9):618–26.PubMedCrossRefGoogle Scholar
  33. 33.
    Anema JR, Steenstra IA, Bongers PM et al. Multidisciplinary rehabilitation for subacute low back pain: graded activity or workplace intervention or both? A randomized controlled trial. Spine 2007;32(2):291–8.PubMedCrossRefGoogle Scholar
  34. 34.
    Franche R-L, Cullen K, Clark J, Irvin E, Sinclair S, Frank J. Workplace-based return-to-work interventions: a systematic review of the quantitative literature. J Occup Rehabil 2005;15(4):607–31.PubMedCrossRefGoogle Scholar
  35. 35.
    Hagen ME, Erikson HR, Ursin H. Does early intervention with a light mobilization program reduce long-term sick leave for low back pain? Spine 2000;25(15):1973–6.PubMedCrossRefGoogle Scholar
  36. 36.
    Lindström I, Öhlund C, Eek C et al. The effect of graded activity on patients with subacute low back pain: a randomized prospective clinical study with an operant-conditioning behavioral approach. Phys Ther 1992;72(4):279–93.PubMedGoogle Scholar
  37. 37.
    Pengel LHM, Refshauge KM, Maher CG, Nicholas MK, Herbert RD, McNair P. Physiotherapist-directed exercise, advice, or both for subacute low back pain: a randomized trial. Ann Intern Med 2007;146(11):787–96.PubMedGoogle Scholar
  38. 38.
    Linton SJ, Andersson T. Can chronic disability be prevented? A randomized trial of a cognitive-behavior intervention and two forms of information for patients with spinal pain. Spine 2000;25(21):2825–31.PubMedCrossRefGoogle Scholar
  39. 39.
    Moore JE, Von Korff M, Cherkin D, Saunders K, Lorig K. A randomized trial of cognitive-behavioral program for enhancing back pain self care in a primary care setting. Pain 2000;88:145–53.PubMedCrossRefGoogle Scholar
  40. 40.
    Raine R, Haines A, Sensky T, Hutchings A, Larkin K, Black N. Systematic review of mental health intervention for patients’ common somatic symptoms: can research evidence from secondary care be extrapolated to primary care? Br Med J 2002;325:1082–5.CrossRefGoogle Scholar
  41. 41.
    Storheim K, Brox JI, Holm I, Bo K. Predictors of return to work in patients sick listed for sub-acute low back pain: a 12 month follow-up study. J Rehabil Med 2005;37(6):365–71.PubMedCrossRefGoogle Scholar
  42. 42.
    Gohner W, Schlicht W. Preventing chronic back pain: evaluation of a theory-based cognitive-behavioral training programme for patients with subacute back pain. Patient Educ Couns 2006;64(1–3):87–95.PubMedCrossRefGoogle Scholar
  43. 43.
    Henrotin E, Cedraschi C, Duplan B, Bazin T, Duquesnoy B. Information and low back pain management: a systematic review. Spine 2006;31(11):E326–34.PubMedCrossRefGoogle Scholar
  44. 44.
    Shaw WS, Pransky G, Patterson W, Linton S, Winters T. Patient clusters in acute, work-related back pain based on patterns of disability risk factors. J Occup Environ Med 2007;49(2):185–93.PubMedCrossRefGoogle Scholar
  45. 45.
    Sullivan MJL, Adams H, Thibault P, Corbiere M, Stanish WD. Initial depression severity and the trajectory of recovery following cognitive-behavioral intervention for work disability. J Occup Rehabil 2006;16(1):63–74.PubMedCrossRefGoogle Scholar
  46. 46.
    Udermann BE, Spratt KF, Donelson RG, Mayer J, Graves JE, Tillotson J. Can a patient educational book change behaviour and reduce pain in chronic low back pain patients? Spine J 2004;4:425–35.PubMedCrossRefGoogle Scholar
  47. 47.
    Linton SJ, Gross D, Schultz IZ et al. Prognosis and the identification of workers risking disability: research issues and directions for future research. J Occup Rehabil 2005;15(4):459–74.PubMedCrossRefGoogle Scholar
  48. 48.
    Harris I, Mulford J, Solomon M, van Gelder JM, Young J. Association between compensation status and outcome after surgery: a meta-analysis . JAMA 2005;293(13):1644–52.PubMedCrossRefGoogle Scholar
  49. 49.
    Feuerstein M, Berkowitz SM, Huang GD. Predictors of occupational low back disability: implications for secondary prevention. J Occup Environ Med 1999;41(12):1024–31.PubMedCrossRefGoogle Scholar
  50. 50.
    Shaw WS, Feuerstein M, Lincoln AE, Miller VI, Wood PM. Case management services for work related upper extremity disorders. AAOHN J 2001;49(8):378–89.PubMedGoogle Scholar
  51. 51.
    Feuerstein M , Huang GD, Ortiz JM, Shaw WS, Miller VI, Wood PM. Integrated case management for work-related upper-extremity disorders: impact of patient satisfaction on health and work status. J Occup Environ Med 2003;45(8):803–12.PubMedCrossRefGoogle Scholar
  52. 52.
    McGuirk B, Bogduk N. Evidence-based care for low back pain in workers eligible for compensation. Occup Med 2007;57:36–42.CrossRefGoogle Scholar
  53. 53.
    Schultz IZ, Crook J, Fraser K, Joy PW. Models of diagnosis and rehabilitation in musculoskeletal pain-related occupational disability. J Occup Rehabil 2000;10(4):271–93.CrossRefGoogle Scholar
  54. 54.
    Waddell G, Burton AK. Occupational health guidelines for the management of low back pain at work: evidence review. Occup Med 2001;51(2):124–35.CrossRefGoogle Scholar
  55. 55.
    Schultz IZ, Crook JM, Berkowitz J et al. Biopsychosocial multivariate predictive model of occupational low back disability. Spine 2002;27(23):2720–5.PubMedCrossRefGoogle Scholar
  56. 56.
    Crook J, Moldofsky H. The clinical course of musculoskeletal pain in empirically derived groupings of injured workers. Pain 1996;67:427–33.PubMedCrossRefGoogle Scholar
  57. 57.
    Bigos S, Roland M, Waddell G, Moffett JK, Burton K, Main C. The back book: the best way to deal with back problems. American Edition. Norwick, UK: The Stationery Office, 2002.Google Scholar
  58. 58.
    Carragee EJ, Alamin TF, Miller JL, Carragee JM. Discographic, MRI and psychosocial determinants of low back pain disability and remission: a prospective study in subjects with benign persistent back pain. Spine 2005;5(1):24–35.CrossRefGoogle Scholar
  59. 59.
    Schultz IZ, Crook J, Berkowitz J, Milner R, Meloche GR. Predicting return to work after low back pain injury using the psychosocial risk for occupational disability instrument: a validation study. J Occup Rehabil 2005;15(3):365–76.PubMedCrossRefGoogle Scholar
  60. 60.
    Elders LAM, van der Beek AJ, Burdorf A. Return to work after sickness absence due to back disorders—a systematic review on intervention strategies. Int Arch Occup Environ Health 2000;73:339–48.PubMedCrossRefGoogle Scholar
  61. 61.
    Nordin M, Balagué F, Cedraschi C. Nonspecific lower-back pain: surgical versus nonsurgical treatment. Clin Orthopaedics Related Res 2006;443:156–67.CrossRefGoogle Scholar
  62. 62.
    Wand BM, Bird C, McAuley JH, Doré CJ, MacDowell M, de Souza LH. Early intervention for the management of acute low back pain: a single-blind randomized controlled trial of biopsychosocial education, manual therapy, and exercise. Spine 2004;29(21):2350–6.PubMedCrossRefGoogle Scholar
  63. 63.
    Miller WR, Rollnick S. Motivational Interviewing. New York: Guildford Press; 2002.Google Scholar
  64. 64.
    Jensen MP. Motivating the pain patient for behavioral change. In: Loeser JD, Butler SH, Chapman CR, Turk DC, editors. Bonica’s management of pain. 3rd edition. Philadelphia: Lippincott, Williams & Wilkins; 2001. p. 1796–804.Google Scholar
  65. 65.
    Waddell G, Burton AK, Main CJ. Screening to identify people at risk of long-term incapacity for work: a conceptual and scientific review. London: Royal Society of Medicine Press Ltd, 2003.Google Scholar
  66. 66.
    Burton AK, Waddell G, Tillotson KM, Summerton N. Information and advice to patients with back pain can have a positive effect: a randomized controlled trial of a novel educational booklet in primary care. Spine 1999;24(23):2484–91.PubMedCrossRefGoogle Scholar
  67. 67.
    Rollnick S, Mason P, Butler C, Eds. Health behavior change: a guide for practitioners. New York: Churchill Livingstone; 2000.Google Scholar
  68. 68.
    Rollnick S, Bell A. Brief motivational interviewing for use by the nonspecialist. In: Miller WR, Rollnick S, editors. Motivational interviewing. New York: The Guilford Press; 1991. p. 203–13.Google Scholar
  69. 69.
    Emmons KM, Rollnick S. Motivational interviewing in health care settings: opportunities and limitations. Am J Prev Med 2001;20(1):68–74.PubMedCrossRefGoogle Scholar
  70. 70.
    Ware JE Jr, Sherbourne CD. The MOS 36-item short-form health survey (SF-36) 1. Conceptual framework and item selection. Med Care 1992;30(6):473–83.PubMedCrossRefGoogle Scholar
  71. 71.
    Waddell G, McCulloch JA, Kummel E, Venner RM. Nonorganic physical signs in low-back pain. Spine 1980;5(2):117–25.PubMedCrossRefGoogle Scholar
  72. 72.
    Karasek R, Kawakami N, Brisson C, Houtman I, Bongers P, Amick B. The Job Content Questionnaire (JCQ): an instrument for internationally comparative assessments of psychosocial job characteristics. J Occup Health Psychol 1998;3(4):322–55.PubMedCrossRefGoogle Scholar
  73. 73.
    Loisel P, Durand MJ. Working with the employer: the Sherbrooke model. In: Schultz IZ, Gatchel RJ, editors. Handbook of complex occupational disability claims: early risk identification, intervention, prevention. New York NY: Springer; 2005. p. 479–88.CrossRefGoogle Scholar
  74. 74.
    Butler RJ, Johnson WG, Côté DC. It pays to be nice: employer-worker relationships and the management of back pain claims. J Occup Environ Med 2007;49:214–25.PubMedCrossRefGoogle Scholar
  75. 75.
    Indahl A, Velund L, Reikeraas O. Good prognosis for low back pain when left untampered: a randomized clinical trial. Spine 1995;20(4):473–7.PubMedCrossRefGoogle Scholar
  76. 76.
    Pengel LHM, Herbert RD, Maher CG, Refshauge KM. Acute low back pain: systematic review of its prognosis. Br Med J 2003;327:1–5 or 323–8.Google Scholar
  77. 77.
    Krause N, Frank JW, Sullivan TJ, Dasinger LK, Sinclair SJ. Determinants of duration of disability and return to work after work-related injury and illness: challenges for future research. Invited Paper for Special Issue of American Journal of Industrial Medicine 2001;40(4):464–84.Google Scholar
  78. 78.
    Harris IA, Young JM, Rae H, Jalaudin B, Solomon MJ. Factors associated with back pain after physical injury. Spine 2007;32(14):1561–5.PubMedCrossRefGoogle Scholar
  79. 79.
    Linton SJ, Nodrin E. A 5-year follow-up evaluation of the health and economic consequences of an early cognitive behavioral intervention for backpain: a randomized controlled trial. Spine 2006;31( 8):853–8.PubMedCrossRefGoogle Scholar
  80. 80.
    Wasiak R, Kim J, Pransky G. Worker disability and costs caused by recurrence of low back pain: longer and more costly than in first episodes. Med Care 2006;31(2):219–25.Google Scholar
  81. 81.
    Wasiak R, Pransky G, Verma S, Webster B. Recurrence of low back pain: definition-sensitivity analysis using administrative data. Spine 2003;28:2283–91.PubMedCrossRefGoogle Scholar
  82. 82.
    Pole JD, Franche R-L, Hogg-Johnson S, Vidmar M, Krause N. Duration of work disability: a comparison of self-report and administrative data. Am J Ind Med 2006;49:394–401.PubMedCrossRefGoogle Scholar
  83. 83.
    Sullivan MJL, Stanish WD. Psychologically based occupational rehabilitation: the pain-disability prevention program. Clin J Pain 2003;19:97–104.PubMedCrossRefGoogle Scholar
  84. 84.
    Shaw WS, Linton SJ, Pransky G. Reducing sickness absence from work due to low back pain: how well do intervention strategies match modifiable risk factors? J Occup Rehabil 2006;16(4):591–605.PubMedCrossRefGoogle Scholar
  85. 85.
    Fulton-Kehoe D, Gluck J, Wu R, Mootz R, Wickizer TM, Franklin GM. Measuring work disability: what can administrative data tell us about patient outcomes? J Occup Environ Med 2007;49(6):651–8.PubMedCrossRefGoogle Scholar
  86. 86.
    Gatchel RJ, Mayer TG, Kidner CL, McGeary DD. Are gender, marital status or parenthood risk factors for outcome of treatment for chronic disabling spinal disorders? J Occup Rehabil 2005;15(2):191–201.PubMedCrossRefGoogle Scholar
  87. 87.
    McGeary DD, Mayer TG, Gatchel RJ, Anagnostis C, Proctor TJ. Gender-related differences in treatment outcomes for patients with musculoskeletal disorders. Spine J 2003;3(3):197–203.PubMedCrossRefGoogle Scholar
  88. 88.
    Gheldof EL, Vinck J, Vlaeyen JW, Hidding A, Crombez G. The differential role of pain, work characteristics and pain-related fear in explaining back pain and sick leave in occupational settings. Pain 2005;113(1–2):71–81.PubMedCrossRefGoogle Scholar
  89. 89.
    Gheldof EL, Vinck J, van den Bussche E, Vlaeyen JW, Hidding A, Crombez G. Pain and pain-related fear are associated with functional and social disability in an occupational setting: evidence of mediation by pain-related fear. Eur J Pain 2006;10:513–25.PubMedCrossRefGoogle Scholar
  90. 90.
    Durand MJ, Vézina N, Loisel P, Baril R, Richard MC, Diallo B. Workplace interventions for workers with musculoskeletal disabilities: a descriptive review of content. J Occup Rehabil 2007;17(1):123–36.PubMedCrossRefGoogle Scholar
  91. 91.
    Li EJQ, Li-Tsang CWP, Lam CS, Hui KY, Chan CCH. The effect of a “training on work readiness” program for workers with musculoskeletal injuries: a randomized control trial (RCT) study. J Occup Rehabil 2006;16(4):529–41.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • I. Z. Schultz
    • 1
  • J. Crook
    • 2
  • J. Berkowitz
    • 3
  • R. Milner
    • 4
  • G. R. Meloche
    • 5
  • M. L. Lewis
    • 6
  1. 1.Department of Educational and Counselling Psychology, and Special EducationUniversity of British ColumbiaVancouverCanada
  2. 2.Faculty of Health SciencesMcMaster UniversityHamiltonCanada
  3. 3.Department of Family Practice, Faculty of MedicineUniversity of British ColumbiaVancouverCanada
  4. 4.Department of Surgery, Faculty of MedicineUniversity of British ColumbiaVancouverCanada
  5. 5.Psychology ServicesWorkers’ Compensation Board of British Columbia/WorkSafeBCRichmondCanada
  6. 6.Worker and Employer ServicesWorkers’ Compensation Board of British Columbia/WorkSafeBCRichmondCanada

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