Biomedical subjects

Marie-José Durand

Publications and source records attributed to Marie-José Durand.

15 recordsLinked to original sources

PubMed2006

[Test-retest reliability of the Work-related Physical Capacity Evaluation].

BACKGROUND: Functional capacity evaluations are used to quantify and qualify the physical abilities of an individual in relation to the physical requirements of an occupation. One major observation associated with functional capacity evaluations is a lack of evidence on their psychometric properties. PURPOSE: This article presents the results of a study on the test-retest reliability of a functional capacity evaluation tool: the Physical Work Performance Evaluation (PWPE). The PWPE is an instrument for evaluating the physical work capacities of individuals with physical limitations resulting from a health problem. METHODS: The PWPE was administered twice to a convenience sample of 30 workers in good health. RESULTS: In the section on 'Dynamic Strength', the tasks demonstrate a good test-retest reliability (0.79 < ICC < 0.91). The three sections and the global score of the PWPE demonstrate a moderate stability (0.43 < kappa > 0.52). PRACTICE IMPLICATIONS: The PWPE score should be interpreted with caution and further studies on its psychometric properties will be necessary to clarify its clinical utility.

Adult↗

PubMed2005

Physical exposure of sign language interpreters: baseline measures and reliability analysis.

Measurement of physical exposure to musculoskeletal disorder risk factors must generally be performed directly in the field to assess the effectiveness of ergonomic interventions. To perform such an evaluation, the reliability of physical exposure measures under similar field conditions must be known. The objectives of this study were to estimate the reliability of physical exposure measures performed in the field and to establish the baseline values of physical exposure in sign language interpreters (SLI) before the implementation of an intervention. The electromyography (EMG) of the trapezius muscles as well as the wrist motions of the dominant arm were measured using goniometry on nine SLI on four different days. Several exposure parameters, proposed in the literature, were computed and the generalizability theory was used as a framework to assess reliability. Overall, SLI showed a relatively low level of trapezius muscle activity, but with little time at rest, and highly dynamic wrist motions. Electromyography exposure parameters showed poor to moderate reliability, while goniometry parameter reliability was moderate to excellent. For EMG parameters, performing repeated measurements on different days was more effective in increasing reliability than extending the duration of the measurement over one day. For goniometry, repeating measurements on different days was also effective in improving reliability, although good reliability could be obtained with a single sufficiently long measurement period.

Adult↗

PubMed2005

Training the next generation of researchers in work disability prevention: the Canadian Work Disability Prevention CIHR Strategic Training Program.

INTRODUCTION: There is a need to create, disseminate, and implement new knowledge in the work disability prevention (WDP) field. Training programs attracting high-quality applicants and taking into account the complexity of this emerging field are urgently needed. METHODS: An advanced training program, funded by the Canadian Institutes of Health Research (CIHR), was developed by 24 mentors affiliated with nine different universities. The main objective of this program is to develop transdisciplinary knowledge, skills, and attitudes regarding WDP. This program has been developed for PhD students or post-doctoral fellows already registered full-time in a Canadian or recognized foreign university whose main interest is WDP, regardless of the health problem. RESULTS: Since its implementation, the program received two successive cohorts of 10 students. They were registered in 13 universities in five countries and trained in nine different disciplines. CONCLUSIONS AND SIGNIFICANCES: Appropriate WDP research may save major societal costs attributable to prolonged work disability. The proposed training program will contribute to developing tomorrow's research workforce.

Attitude of Health Personnel↗

PubMed2005

Interorganizational collaboration in occupational rehabilitation: perceptions of an interdisciplinary rehabilitation team.

INTRODUCTION: Various obstacles to and facilitators of collaboration between an interdisciplinary work rehabilitation team and the stakeholders (workers, insurers, physicians, and employers) exist, but are not well characterized. METHODS: An observational study was conducted, using videotapes of interdisciplinary team discussions of ongoing cases involving 22 workers absent from work due to musculoskeletal disorders. The actions taken and strategies adopted by the team in an effort to overcome the obstacles to collaboration were studied. RESULTS: Various factors influence collaboration between the rehabilitation team and the stakeholders. In general, stakeholder endorsement of the team's therapeutic principles and confidence in their approach emerged as particularly important factors. Diverse strategies, most often, education and awareness-raising, were used by the team to foster collaboration among the parties. CONCLUSIONS: This study provides greater insight into the factors affecting collaboration among a rehabilitation team, an injured worker and other stakeholders. The results may improve understanding of the actions taken by rehabilitation teams and help to optimize their practices.

Decision Making↗

PubMed2004

Development of a biosensor for the detection of tributyltin.

A biosensor (LUMISENS I), based on the inducible bioluminescence of the Escherichia coli strain TBT3 (Ec::luxAB TBT3), was developed for the detection of the biocide tributyltin. LUMISENS I was set up with a minibioreactor and additional equipment for growth monitoring and light acquisition. The 100-mL minibioreactor has allowed us to establish a stable and reproducible environment for the bacteria (regulation of the growth rate, temperature, pH, and oxygenation), as well as for in situ contact with the xenobiotic. The optical components of the transducer were chosen according to the spectral emission of the strain being studied using a highly sensitive spectrophotometer that was initially devoted to Raman scattering. LUMISENS I was patented according to the in situ, automatic, and simultaneous measurement of the cell density and bioluminescence in the bioreactor. The first results showed that cells cultivated in a synthetic glucose medium provided a better detection limit than did those cultivated in a complex Luria-Bertani (LB) medium (0.02 and 1.5 microM of tributyltin, respectively). Cells maintained at a high growth rate (0.9 h(-1)) led to maximum bioluminescence. Moreover, air bubbling was efficient enough to provide suitable quantities of oxygen for both growth and light emission. When the TBT3 strain used the luxAB genes on its own, decanal, a long-chain aldehyde, had to be added to obtain the bioluminescence reaction. We found that the continuous addition of decanal was the most effective means of obtaining this reaction. The monitoring of the bioluminescence after tributyltin induction showed that the aldehyde was not toxic up to 300 microM during a 7-day experiment. Measurement of tributyltin with LUMISENS I was performed, which showed significant response up to 0.125 microM without any effect on optical density. Even though optimization of the performance of LUMISENS I is still under development, because of its original design, this biosensor is already in use as a warning system for the online monitoring of tributyltin.

Biosensing Techniques↗

PubMed2004

Treatment of lateral epicondylitis: where is the evidence?

Lateral epicondylitis is the most commonly diagnosed elbow condition and affects about 1-3% of the population at large. It produces a heavy burden of workdays lost and residual impairments. Although many treatment modalities are used, few of them rest on scientific evidence and none has been proven more effective than the others. This paucity of evidence on treatments for lateral epicondylitis may stem from several sources, including the possible self-limiting nature of the condition, the lack of pathophysiological data, the methodological shortcomings of available studies, and the existence of numerous factors influencing the outcome.

Evidence-Based Medicine↗

PubMed2004

The interrater reliability of a functional capacity evaluation: the physical work performance evaluation.

The purpose was to evaluate the interrater reliability of the Dynamic Strength, Position Tolerance, and Mobility tasks of the Physical Work Performance Evaluation (PWPE), a Functional Capacity Evaluation often used with workers disabled due to back pain. For each worker's evaluation, two raters were preselected among five trained raters. One of the raters administered the PWPE while the other functioned as a silent rater. A convenience sample of 40 workers disabled due to back pain and referred to an occupational rehabilitation center was used. In general, the reliability was "substantial" (0.61 < or = kappa < or = 0.80) to "almost perfect" (0.81 < or = kappa < or = 1.00) for most of the 21 tasks and three sections of the PWPE evaluated with the exception of three tasks in the Mobility section (ladder climbing (kappa = 0.47), repetitive trunk rotation--standing (kappa = 0.54), and repetitive trunk rotation--sitting (kappa = 0.37)) task and the Mobility section itself (kappa = 0.54). Several reasons could explain the lower agreement on the observation of the physical signs associated with these tasks. Since these tasks involve rotation movements or complex neuromuscular integration, it seemed difficult for the raters to define what are the normal physical signs and when physical signs of maximal functional capacity are present. The criteria for establishing the presence of the physical signs in the PWPE should be improved.

Adolescent↗

PubMed2004

The cross-cultural adaptation of the Work Role Functioning Questionnaire in Canadian French.

The Work Role Functioning Questionnaire (WRFQ) is a new work disability measurement tool assessing the perceived impact of a health problem on the worker's ability to perform his job. The objective of this study was to make the cross-cultural adaptation of the WRFQ for the French Canadian population. The methodology was composed of five steps: forward translation, synthesis of the translations, back translation, revision by an expert committee and test of the pre-final version. The psychometric properties of the translated version were evaluated by administering the questionnaire to forty workers with a musculoskeletal disorder (MSD). Results indicated good content validity and internal consistency (Cronbach alpha > 0.80 for each scale). Construct validity was tested and confirmed through three hypotheses: (1) subjects with MSD scored higher for the Physical, Work Scheduling and Output demands scales than for the Mental and Social demands scales, (2) subjects having back pain had lower scores than subjects having pain at other body sites and (3) subjects with an MSD had lower scores than healthy workers working full time. This study confirmed that the process used for the adaptation of the Canadian French version of the WRFQ was successful and that this version had good psychometric properties.

Adult↗

PubMed2003

[When graduate education is interested in renewal of rehabilitation practices: study of needs].

BACKGROUND AND PURPOSE: In order to meet the new challenges facing the professional practice in rehabilitation, a study of practitioners in the rehabilitation field in Québec was undertaken to evaluate their needs in terms of continuing education in graduate level studies. METHOD: A total of 99 participants were involved in focus groups and phone interviews. An analysis of the content of the discussions was performed. RESULTS: According to this analysis, the participants wished to develop skills that could be divided into two main categories of competencies: the development of the "self as a tool", that is improving the practitioner's ability to show insight into his professional practice, and the "self as a service provider", that is developing knowledge in the cognitive area associated with the improvement in the quality of service. In addition, the participants favored different teaching methods, such as intensive teaching preferably on week-ends as well as short term training programs (9 to 15 credits). PRACTICE IMPLICATIONS: This study succeeded in identifying the special needs of practitioners in order to face the changes in health services. The need to create a graduate program in rehabilitation was highlighted and the participants were enthusiastic at the thought of the creation of such a program.

Curriculum↗

PubMed2003

Constructing the program impact theory for an evidence-based work rehabilitation program for workers with low back pain.

PURPOSE: Several low back pain work rehabilitation programs have been developed and evaluated for their outcomes. Unfortunately, the program impact theory for these programs is not described, and consequently, the exact mechanisms of action by which these programs intend to increase the probability of return to work remain unknown. This lack of knowledge jeopardizes the implementation of effective programs by health professionals and managers. The objective of this paper is to present the results of an exploratory study aimed at building the program impact theory for the PREVICAP work rehabilitation program. METHODS: The program impact theory was develop by conducting: unpublished documents and scientific literature analyses, individual and group discussions with multiple stakeholders and observation of program reality by reviewing the files of workers who completed the program. RESULTS: The PREVICAP program's impact theory was elaborated based on an ecological approach to work rehabilitation. Program goals and objectives were defined for the three dimensions of the model: the worker, the work environment and the interaction between the worker and his work environment. Two program action mechanisms were defined and describe how the program was intended to achieve its expected outcomes. CONCLUSIONS: This study made explicit the PREVICAP program impact theory and can help rehabilitation practitioners to address work disability according to an ecological model.

Canada↗

PubMed2002

Discriminative and predictive validity assessment of the quebec task force classification.

STUDY DESIGN: A prospective cohort study of workers with low back pain who had been absent from work for more than 4 weeks was conducted. OBJECTIVE: To assess the discriminative and predictive validity of the Quebec Task Force Classification for workers during the subacute phase of disability from back pain. SUMMARY OF BACKGROUND DATA: The Quebec Task Force Classification was designed for clinical decision making, prognosis establishment, quality of care evaluation, and scientific research in low back pain. METHODS: For this study, 104 workers absent from work because of back pain were classified according to the first four categories of the Quebec Task Force Classification 4 weeks after their first day of work absence. They then were randomized into four treatment groups: standard care (control), clinical-rehabilitation intervention, occupational intervention, and the Sherbrooke model (a combination of the clinical-rehabilitation and occupational interventions). Functional status, pain level, and work status were assessed at baseline and after 1 year. Duration of full compensation and back-related costs were calculated over a mean follow-up period of 6.5 years. The discriminative validity of the Quebec Task Force Classification was evaluated using Kendall tau correlation coefficients. Predictive validity was evaluated using logistic regression analyses. Age, gender, comorbidities, body mass index, and treatment group were considered as potential confounders. RESULTS: Significant but low correlation coefficients were found between Quebec Task Force Classification categories and functional status scores at baseline. Subjects classified as having distal radiating pain (categories 3 and 4) at baseline were more likely to have a lower functional status, higher pain level, and no return to regular work at the 1-year follow-up evaluation. They also were more likely to accumulate more days of full compensation and to cost more after a mean follow-up period of 6.5 years. CONCLUSION: The Quebec Task Force Classification demonstrated good predictive ability by discriminating between subjects with and those without distal radiating pain.

Adult↗

PubMed2002

Helping clinicians in work disability prevention: the work disability diagnosis interview.

Recent evidence has demonstrated that disability from musculoskeletal disorders is a multifactorial problem that is not only due to workers' characteristics but also closely related to environmental factors, such as the workplace, the health care system, the compensation system, and the interactions among all stakeholders regarding the disability problem. The Work Disability Diagnosis Interview (WoDDI) was developed following a systematic method in order to help clinicians detect possible disability prognostic factors in subacute or chronic musculoskeletal pain patients. A structured literature review, followed by expert input and a second round of revisions after 4-year's usage led to the current version. The WoDDI is composed of open-ended questions on physical, psychosocial, occupational, and administrative factors, collated into an interview form used at the first encounter with the disabled worker. It enables clinicians to develop a rehabilitation plan and focus on disability resolution in patients absent from work due to a musculoskeletal disorder. Initial application demonstrated a high prevalence of sociodemographic, work-related, and psychosocial factors that may contribute to prolonged work absence.

Absenteeism↗

PubMed2001

Therapeutic Return to Work: Rehabilitation in the workplace.

Therapeutic Return to Work is a work rehabilitation program linking graded work exposure with functional restoration therapy for chronic low back pain. This study evaluates the impact of the program on stable return to work (RTW) and compares it with the impact on RTW of three frequently used ways of management of back pain (normative comparison). At two year follow-up, 93% of participants of the Therapeutic Return to Work program were working. This rate was higher than in the comparison groups. Although limited by its norm-referenced evaluation design, the results of this study indicate the importance of placing the work site in the center of the of work rehabilitation process. In this program occupational therapists make full use of the client's natural environment.

Journal Article↗

PubMedDate not supplied

From evidence to community practice in work rehabilitation: the Quebec experience.

BACKGROUND: The causes of prolonged disability due to back pain are multiply determined, involving medical, social, and environmental factors. Possible solutions to the problem of prolonged back pain disability have emerged from recent research but few efforts have been made to transfer evidence-based programs to large community settings. OBJECTIVE: This article describes three phases of the process of transfer of evidence from rehabilitation research to community practice in the province of Quebec. METHODS AND RESULTS: Phase A: Based on literature review and expert knowledge, the Sherbrooke model was developed and assessed through a population-based, randomized clinical trial. Results at 1-year follow-up showed quicker return to regular work and improvement of quality of life; the 6-year follow-up showed the cost-effectiveness of the method. Phase B: Based on the Sherbrooke model experience and recent evidence, a new program addressing the disability paradigm was developed and implemented in the province of Quebec (Canada). Results at 1- and 3-year follow-ups showed that only 24% of workers were not working owing to their musculoskeletal disorder. The program is presently being tested through a population-based, randomized clinical trial in a population of construction workers. Phase C: To implement the program at a provincial level, a network for management, research and education in work rehabilitation was developed. An external assessment is presently planned to evaluate return to work and economic outcomes and quality of implementation of the program in various settings.

Adult↗

PubMedDate not supplied

The cross-cultural adaptation of the DASH questionnaire in Canadian French.

The purpose of this study was to perform a cross-cultural adaptation of the original version of the Disability of Arm, Shoulder and Hand (DASH) questionnaire to Canadian French. The cross-cultural adaptation followed five steps: forward translations into Canadian French, a synthesis of the translations, back translations into English, revision by a committee of experts, and test of the prefinal version. The content validity and the internal consistency of the Canadian French version of the questionnaire were assessed by experts involved in the study and by subjects who participated in the pilot study. Results indicate that the scores were adequately distributed without floor or ceiling effect. Item completion was excellent and item responses had a good distribution. Internal consistency of the total score was high (Cronbach alpha = 0.94) and item-total correlations were substantial for most items (0.43-0.88). These results are similar to previous studies on the DASH questionnaire supporting linguistic and conceptual equivalence of the Canadian French version.

Adult↗