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PubMed1986

Using work simulation to treat adults with back injuries.

Occupational therapy at the Liberty Mutual Medical Service Center, Boston, Massachusetts, offers a diverse variety of modalities for the treatment of patients with low back pain. Treatment may include the use of a balance monitor, a multiwork station, a pneumatic lifting-lowering device, a computerized upper extremity work simulator, and a truck-driving simulator. The primary objective of occupational therapy in this setting is to provide a supportive environment where patients can practice and improve the execution of the work-related activities they need to perform their jobs while they are learning to live with or control their symptoms.

Activities of Daily Living↗
PubMed2005

Confirmatory factor analysis of the Pain Catastrophizing Scale in African American and Caucasian Workers' Compensation claimants with low back injuries.

Pain catastrophizing is an important cognitive construct that has been linked with many aspects of the pain experience, including pain intensity, emotional distress, pain-related disability, and pain behavior. The Pain Catastrophizing Scale (PCS), an instrument often used to assess this construct, reflects three aspects of catastrophizing: Rumination, Magnification, and Helplessness. Its factor structure, however, has never been examined in clinical samples of persons with occupational injury or as a function of race. In this study, exploratory and confirmatory factor analyses were used to examine the factor structure of the PCS in a large, racially diverse sample of Workers' Compensation claimants with low back injuries. Results indicated that a two-factor model of the PCS (Rumination and 'Powerlessness,' the latter a combination of the PCS Magnification and Helplessness scores) was the most parsimonious fit to the data, particularly in the African American sample. Future research in other clinical samples that include African Americans is needed to examine the stability of the results reported here.

Adaptation, Psychological↗
PubMed1999

Back injury in primary care: three sides of the coin.

Low-back pain is the most common job-related injury in the United States. This diagnosis is often accompanied by complexities that make effective treatment options varied and inconclusive. The primary care nurse practitioner who manages industrial injuries must consider 3 perspectives: the patient, the employer, and the practitioner providing care. This research study compares 2 treatment options: conservative and active physical rehabilitation for the patient with an acute first-time low-back injury. Recommendations are made for customizing treatment plans to individual practice settings.

Absenteeism↗
PubMed1984

Body movements and events contributing to accidental and nonaccidental back injuries.

During 1980, 1153 employees attended the Occupational Health Department with back pain out of a working population of 13,958 in a car factory. Four hundred one were absent from work and a further 64 patients were restricted by back pain and unable to perform their normal work. One hundred forty-seven cases of back pain arose at work, and 71 in and around the home. All those who were absent or restricted were questioned about the onset of back pain in order to distinguish between accidental and nonaccidental injuries (NAI), and an accident model was used to structure the information. There were 122 accidents, 114 NAI, and 165 patients who could not attribute a cause to their back pain. A significantly higher proportion of the NAI arose at home and, conversely, a higher proportion of accidents occurred at work. Eighty (66%) of the accidents were underfoot accidents, including 57 slips. There were highly significant differences between the body movements contributing to accidents and NAI. Significantly more of the NAI than the accidents involved load handling, but 52% of the patients able to attribute a cause to their back pain were not moving loads. While handling of loads is important, attention should be directed to other contributory factors such as unsafe floor surfaces and bending and twisting movements--not only at work but also in and around the home.

Accidents, Home↗
PubMed1999

Alternative approaches for measuring duration of work disability after low back injury based on administrative workers' compensation data.

BACKGROUND: Studies of low back pain (LBP) disability remain largely incomparable because of different outcome definitions. To date, systematic comparisons of alternative outcome measures have not been made. METHODS: Duration of work disability was studied in a 3-year cohort of 850 workers' compensation LBP claimants. Eleven administrative outcome measures were compared using Kaplan-Meier estimates of the proportion of claimants still on disability benefits during 3.5 years of follow-up. RESULTS: The estimated mean duration of work disability was 75 days for the first temporary disability (TD) episode, 108 days for cumulative time on TD, and 337 for total compensated days, which includes all types of wage replacement benefits during vocational rehabilitation, temporary and permanent disability. CONCLUSIONS: Commonly used administrative measures of lost workdays--time to first return to work and time on temporary disability--substantially underestimate the duration of work disability compared to measures based on all wage replacement benefits.

Adult↗