Physical disability due to musculoskeletal conditions.
ABSTRACT Musculoskeletal conditions (MSC) are common throughout the world and their impact on individuals is diverse and manifold. Knowledge of the determinants for disability and of strategies for prevention and rehabilitation management according to the scientific evidence is critical for reducing the burden of MSC. The first section of this chapter reviews the evidence for common determinants of functioning and disability in patients with MSC. We have focussed on environmental factors (EF) and personal factors (PF) and have structured them according to the International Classification of Functioning, Disability and Health (ICF) framework. The second section discusses prevention strategies. Generally, prevention needs to address those EF and PF that were presented in the first section. The final section describes modern principles of rehabilitation and reviews the evidence for specific rehabilitation interventions.
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ABSTRACT: To describe limitations in 12 activities at baseline, after multidisciplinary rehabilitation and at a 6-month follow-up for patients with spinal pain and, further, to investigate whether low limitation in any of the activities or in the mean score at baseline might predict increased working time at follow-up. A prospective cohort study of 302 patients, 22- to 63-years old, who participated in multidisciplinary rehabilitation because of chronic neck, thoracic and/or lumbar pain. Data from the Disability Rating Index questionnaire were obtained at baseline, after the 4-week rehabilitation programme, and at the 6-month follow-up. Two subgroups are described: patients who at baseline (1) worked full-time or (2) were on part- or full-time sick leave. The degree of limitation in the 12 activities (items) showed large variations in median scores (7-91). Both subgroups showed significant improvements in most activities after rehabilitation, which remained at the follow-up. Nevertheless, in the sick-leave group, patients who had increased their working time at follow-up (62%) were still very limited in running, heavy work, and lifting heavy objects. In logistic regressions, low limitation in standing bent over a sink at baseline was the only single activity that predicted increased working time at the follow-up: odds ratio (OR) 1.93 (95% CI 1.1-3.5). OR for the mean score was 1.8 (1.0-3.3). A profile of the separate activities demonstrates the large variation in the degree of limitation, which is concealed in a mean score. The single items can be useful when evaluating interventions. However, to predict increased working time after rehabilitation, the mean score, as well as the activity standing bent over a sink, proved useful.Disability and Rehabilitation 11/2009; 32(4):292-9. DOI:10.3109/09638280903095940 · 1.84 Impact Factor
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ABSTRACT: The aim of this study was to determine personal factors that are reported in medical work capacity evaluations of Swiss disability claimants with chronic widespread pain. A mixed-methods study, involving a retrospective qualitative and quantitative secondary analysis of the content of medical reports, was carried out. Two personal factor categorizations (the Geyh categorization and the Grotkamp categorization) were used for coding and specifying the personal factors in the reports. The most relevant personal factor categories were determined by calculating their relative frequency across reports and setting a relevance threshold. Using the Geyh categorization, 27 personal factor categories passed the relevance threshold and six of them appeared in all medical reports. Applying the Grotkamp categorization, 32 personal factor categories passed the threshold and four of them showed up in all reports. The most relevant personal factors identified in medical reports on Swiss disability claimants with chronic widespread pain refer to biographical, occupational, and educational background, behavior patterns as well as personal feelings and cognitions. The development of a standardized documentation involving these personal factors could contribute to more transparency and better comparability of medical work capacity evaluations.International journal of rehabilitation research. Internationale Zeitschrift fur Rehabilitationsforschung. Revue internationale de recherches de readaptation 04/2013; 36(4). DOI:10.1097/MRR.0b013e3283618d48 · 1.14 Impact Factor
- Revista Brasileira de Fisioterapia 01/2009; 13(4). DOI:10.1590/S1413-35552009005000046 · 0.98 Impact Factor