Table 3.
Intervention description, OT elements in the intervention, assessment instruments and general conclusions
Author | Description intervention | OT elements in the intervention | Instruments used for assessments | General conclusions |
---|---|---|---|---|
Jousset et al., 2004 |
Functional restoration programme (FRP) including intensive physical training, occupational therapy, psychological support and dietic advices a day, 5 days a week, 5 weeks. Active individual therapy (AIT): 1 hour treatment sessions, 3 times a week during 5 weeks (programme of exercises to perform alone at home for 50 min. on the 2 remaining weekdays. |
Daily for 1.15 hrs. • Flexibility, • Endurance, • Co-ordination, • Weight lifting, • Work simulation |
• Trunk flexibility by fingertip-floor distance • Trunk strength by isometric contraction (ITO et al & Biering-Sorensen) • Lifting: Progressive ISO-inertial lifting evaluation (PILE) • Level op pain: VASQoL & functional indexes • French version of Dallas pain questionnaire • Quebec back pain disability scale • Hospital anxiety depression scale • Use of prescript medication |
FRP was more efficient then AIT in reducing the number of sick leave days, improving physical condition: • FRP from 102,3 to 28 days • AIT 109,8 to 48 days |
Joy et al., 2001 |
Work hardening programme: • Job-specific work simulations • Physical conditioning • Education Patients who did RTW after work hardening program to patients who did not RTW after work hardening program |
• Initial intake evaluation, • Daily activities schedules, • Case-management, • Pain management techniques, • Individual work simulation activities, • Discharge planning |
• Study specific questionnairepain drawing (indicating where pain was felt) • 10 point pain level indication scale • Physical assessment • Functional abilities testing for 16 physical demands • Exit-questionnaire • Improvement scale (pain tolerance, activity tolerance) at exit program • Determining RTW by contacting patients after discharge (1, 6, 12 and 24 months) |
No significant differences due to age, gender, length of injury, days spent in work hardening program or change in pain level Significant difference in pain tolerance (men: 26,8% vs 42,0%; women: 24,2% vs 39,1%) No significant difference in activity tolerance |
Lambeek et al. (2010) |
Care as usual • medical specialist • occupational physician • general practitioner • and/or allied health professionals Integrated care • coordination by clinical occupational physician • team members: • medical specialist, • OT, • physiotherapist; • integrated care protocol: • care-management by occupational physician (from 1 to full sustainable work or to week 12) • work place intervention (using occupational therapist brainstorm (from week 3 tot week 12) • graded activity (from week 2 till1 full sustainable work or to max. week 12) |
• Assessment patients functional capacity at baseline • Workplace intervention • 26 sessions of graded activity |
• Questionnaires at baseline and 3,6,9,12 months • primary outcome (full RTW): - Self reported sick leave - Data from dbase of the occupational health service • Secondary outcome: - VAS (pain) - Roland disability questionnaire (functional status) • Prognostic factors for duration of sick leave - Job content questionnaire (potential work related psycho-social factors) -Dutch musculoskeletal questionnaire (data on workload) |
The integrated care programme substantially reduced disability due to chronic low back pain in private and working life |
Schene et al., 2007 |
Treatment as usual (TAU) (out-patient psychiatric treatment for depression) • Clinical management • antidepressants • 30 min visits every 2-3 weeks compared to TAU + Occupational Therapy (OT) |
• Diagnostic phase (4 weeks) : five contacts with a detailed occupational history, video observation in a role -played work situation, contact with an occupational physician of the patients employer and a plan for work reintegration • Therapeutic phase (24 weeks): 24 weekly group sessions and 12 individual sessions3 sub phases: preparation to work reintegration, contacting the place of work and if possible starting to workin individual sessions: further analysis of the relationship between work and depression, exploration of work problems, support and evaluation of work resumption • Follow-up phase (20 weeks) : three individual visits |
• DSM-IV (major depression Episode) • Beck Depression Inventory (BDI) • Questionnaire organisation stress (QOS) • Study specific questionnaires |
The addition of OT did not accelerate recovery from depression The addition of OT accelerates and increases work resumption The addition of OT did not increase work stress |
Sullivan et al., 2006 | Compare RWT rates of additionally Progressive goal attainment programme (PGAP) to the results of a historical cohort enrolled in a functional restoration physical therapy intervention. | • Education and reassurance • Maintaining activity log • Activities scheduling • Walking programme • Increasing activity involvement • Overcoming psychological obstacles to activity involvement |
McGill pain questionnaire, pain rating index (MPQ) Pain catastrophizing scale (PCS) Tampa scale for kinesiophobia(TSK) Pain disability Index (PDI) |
A psychosocial risk factor targeted intervention in combination with physical therapy can lead to significant increases in the probability of RTW following whiplash injuries. (75% vs 50%) The combination of psychosocial intervention with physical therapy may emerge as a viable and cost-effective approach for the prevention of prolonged pain and disability following musculoskeletal injury. |
Vanderploeg et al., 2008 |
Cognitive-didactic programme (CD): 1,5 to 2,5 hours of protocol specific cognitive-didactic interventions (Individual treatment) with another 2 to 2,5 h daily of OT & physiotherapy Emphasis on building self-awareness No real life tasks and settings Functional experiential rehab therapy (FE) 1,5 to 2,5 hrs of protocol specific functional-experimental treatment with another 2 to 2,5 h daily of OT & physiotherapy. Focus on developing useful functional abilities or skills |
All Basic activities of daily living, range of motion, mobility CD: Training 4 cognitive domains (attention, memory executive functions, pragmatic communication) Trial and error approach FE: Real life performance situations and common tasks Learning by doing |
Functional Independence Measure (FIM) Disability Rating Scale (DRS) present state examapathy evaluation scaleneurobehavioral rating scalelife satisfaction (self-rating and clinical interview) |
No difference between cognitive-didactic and functional-experiential approaches to TBI rehab on primary 1 year global outcome measures. However, patients at the cognitive treatment arm had better post treatment cognitive performance. At 1 year post injury, the overall rates of independent living and employment and/or student status were 58,9% and 37,2% respectively. |