Prevention of Work Disability Due to Musculoskeletal Disorders: The Challenge of Implementing Evidence

• Published in: Journal of occupational rehabilitation Vol. 15; no. 4; pp. 507 - 524
• Main Authors: Loisel, Patrick, Buchbinder, Rachelle, Hazard, Rowland, Keller, Robert, Scheel, Inger, van Tulder, Maurits, Webster, Barbara
• Format: Journal Article
• Language: English
• Published: Netherlands Springer Nature B.V 01.12.2005
• Subjects: Absenteeism; Attitude to Health; Back pain; Canada; Decision making; Disability; Education; Effectiveness; Employees; Epidemiology; Evidence-Based Medicine; Health Plan Implementation; Humans; Intervention; Literature reviews; Musculoskeletal diseases; Musculoskeletal Diseases - prevention & control; Musculoskeletal Diseases - rehabilitation; Occupational Diseases - prevention & control; Occupational Diseases - rehabilitation; Occupational Health Services - organization & administration; Prevention; Preventive medicine; Return to work programs; Sick Leave; Systematic review; Training; United States; Workers with disabilities; Canada; United States
• ISSN: 1053-0487; 1573-3688
• DOI: 10.1007/s10926-005-8031-2

The process of returning disabled workers to work presents numerous challenges. In spite of the growing evidence regarding work disability prevention, little uptake of this evidence has been observed. One reason for limited dissemination of evidence is the complexity of the problem, as it is subject to multiple legal, administrative, social, political, and cultural challenges. A literature review and collection of experts' opinion is presented, on the current evidence for work disability prevention, and barriers to evidence implementation. Recommendations are presented for enhancing implementation of research results. The current evidence regarding work disability prevention shows that some clinical interventions (advice to return to modified work and graded activity programs) and some non-clinical interventions (at a service and policy/community level but not at a practice level) are effective in reducing work absenteeism. Implementation of evidence in work disability is a major challenge because intervention recommendations are often imprecise and not yet practical for immediate use, many barriers exist, and many stakeholders are involved. Future studies should involve all relevant stakeholders and aim at developing new strategies that are effective, efficient, and have a potential for successful implementation. These studies should be based upon a clearer conceptualization of the broader context and inter-relationships that determine return to work outcomes.