RTW Knowledge Base
RTW Knowledge Base
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The issue for employees

When an injury or illness requires sick leave, taking time off work becomes an issue in itself
Improving return to work outcomes, the Knowledge Base, and the world wide movement to reduce work disability

After sick leave, most people return to work quickly and do well.
How to use the site

The site has been organized so article viewing can be done in a number of ways.
Research in work disability

Evidence-based medicine is a worldwide movement to help understand effective prevention, treatment and management approaches in health.
Medical Factors
Treatment Approaches and RTW
Healthcare Provider participation is important in achieving early return to work

When health care professionals communicate with both the patient and their workplace an injured worker's likelihood of returning to work improves.
People who receive financial compensation are less likely to recover well after surgery

People who receive financial compensation for their condition are less likely to recover well after surgery.
Chronic pain can be a struggle for everyone

Chronic pain is a difficult problem for patients and doctors.
How patients communicate their illness

Patient communication may play a significant role in health care.
The role and obstacles faced by family GP's assisting patients to return to work

Quality information, rather than assumptions, is fundamental to return to work
Move it or lose it, underuse as a cause of injuries to muscles and bones

Underuse may contribute to musculoskeletal problems
Key messages and advice about rehabilitation from lumbar surgery

An information booklet, providing clear, evidence-based information, can help patients after spine surgery.
The effects of a specialist healthcare provider network for workplace injuries on costs and lost time

Directing injured employees to a health care network can reduce their medical costs and time off work.
Stress Management and Workplace Disability.

Stress-management is a cost-effective way to improve recovery after injury or illness.
Occupational wellbeing and its effect on performance

Improving wellbeing improves productivity.
Current trends in stress claims.

Stress-related compensation claims are a costly problem. This review investigates the role of compensation in recovery and factors that influence return to work.
Low back pain - how long does it last? The normal course of pain experienced by people who visit their general practitioner

Patients with back problems are often told by general practitioners that they should get better within a matter of weeks.
Low back pain - what do patients think about it? What do they need from their doctor?

Back pain is a common condition. Patients are looking for a better understanding about the condition.
Spinal imaging - is it a help or a hindrance?

There is a poor correlation between scan findings and the severity of back problems.
Low back pain - how common is it and how often does it cause disability?

How common are back problems? Back pain is experienced by the majority of people at some point in their lives.
Spinal radiographic findings and nonspecific low back pain: A systematic review of observational studies

X-ray findings are not a good indicator of whether a person is likely to experience back pain.
Why do Spinal Surgeons who have spine surgery get back to work quickly?

Spinal surgeons who have surgery on their own backs return to work quickly.
People who get clear advice about their back problem do much better.

People with back pain increase their chance of recovery and return to work when they remain active, stretch back muscles, and return to everyday activity.
Are treating practitioners overly cautious with people with back pain?

General practitioner and physical therapists' beliefs about back pain influence their treatment practice.
Will an episode of low back pain become a long-term problem? Our psychology is important in deciding.

Psychological factors like distress levels and depressive mood influence whether or not an episode of back pain will be the beginning of a long term problem.
Patients whose treaters explain their subacute low back pain condition in detail have better outcomes

Simple clear information about back pain early on in the condition can help reduce patients' daily symptoms and sick leave in the future.
The impact of Back Schools on return to work

After an episode of back pain, education, training and exercise programs can help people to return to work.
Preventing low back pain

European guidelines for preventing the negative consequences of low back pain
Strength training as treatment for chronic neck pain

Physical training to improve strength or endurance can reduce pain and disability in work-related neck pain.
Upper Limb (arm)
Integrated case management for work-related arm pain

A co-ordinated approach to managing work-related arm pain improves return to work, and results in higher levels of patient satisfaction.
Return to work after carpal tunnel surgery

Patients are likely to have better function after carpal tunnel surgery if they work in a supportive environment and are confident they can manage their symptoms.
Ergonomic and psychosocial factors affect function in workers with upper extremity disorders.

Management of non specific arm pain is helped by improving problem solving skills and workplace ergonomics.
Factors behind work related neck and upper limb problems: Psychosocial and personal risk factors, and effective interventions from a bio behavioural perspective.

Work-related psychological and social factors can put people at risk of neck and upper limb conditions.
Consequences of being off work
Use it or lose it - No really!

The Disuse Syndrome. Being physically inactive can kill you.
Unemployment and mental health: Understanding the interactions among gender and family roles

The effects of being out of work and resulting health complications are different for men and women and vary with their roles in family life.
The health effects of being out of work

Being out of work increases your risk of getting sick or dying
Loss of self: A fundamental form of suffering resulting from chronic illness

Long term health problems often restrict people's lives. This can mean they are no longer able to function in roles that are central to their sense of identity. This can have serious consequences.
The effect of financial compensation on rehabilitation

Those who receive compensation payments after an injury are less likely to return to work.
Unemployment can affect your children's health

Long-term unemployment of parents can affect the health of their children, even if money is not scarce.
Workplace Factors
Workplace Interventions
A review of workplace rehabilitation approaches for back pain

Treatment with light activity and early return to work resulted in less pain and disability, and fewer sick leave absences for people with back pain.
A workplace education program that prevents neck and back problems, and limits reinjury

Teaching workers to minimise strain at work, change posture and exercise regularly had a long-lasting positive effect on workers with back and neck injuries.
Identifying the causes of back and arm pain in an office environment

Ergonomic and time factors in an office environment can contribute to arm and back pain.
Manager's Influence
A controlled case study of supervisor training to optimise response to injury in the food processing industry

Training supervisors how to respond to employees' work-related health and safety concerns reduces new injury claims and disability costs.
Employee perspectives on the role of supervisors in preventing work disability

Good communication between an injured worker and their supervisor can affect return to work outcomes as powerfully as health treatments and workplace adjustments.
Communication by supervisors plays a critical role in the return to work process

Regular communication from a supervisor helps people with mental health problems return to work.
The impact of workplace culture
Blame makes it harder to recover

People who blame their employer for their pain have poorer expectations for their future recovery, and report less success with treatments for their condition.
A people oriented culture creates a safer workplace

A positive workplace culture, one which prioritises people and has strategies for assisting injured workers helps prevent and manage work disability.
The social side of returning to work is important

Good communication and a positive relationship with a supportive, well trained supervisor are important for the social accommodation of an injured employee at work.
People Factors
Factors influencing RTW
Understanding the person's state of mind helps you help them

Understanding how people view their pain and their work environment is needed so that these important factors can be addressed.
Different influences combine to affect whether a person will return to work after sick leave

Many factors influence whether a person on sick leave will return to work.
Tools for creating goals with patients as a part of therapy

Focusing on what the patient wants to get out of therapy improves results.
The challenges of returning to work with a disability

What helps people with disabilities to reenter the workforce?
Policies and procedures that help workers return after an injury

The attitude of the workplace towards health, safety and return-to-work influence whether a worker will return.
Does multidisciplinary rehabilitation work? How does patient motivation affect outcomes?

Rehabilitation programs are often provided for musculoskeletal conditions. When these programs treat the 'whole person' rather than focusing purely on medical problems, they are more cost effective. The best results are produced when patients are highly motivated.
Beliefs and attitudes and RTW
Factors that can affect a person's ability to return to work

An in-depth look at some of the issues that can influence return to function and work
Motivation is valuable in rehabilitation and return to work

Motivation in the process of rehabilitation and return to work after injury can be improved. Increased motivation helps both employers and employees in work rehabilitation.
Does screening work? Psychosocial risk factors for work absence due to sprains and strains

Questionnaires can identify employees who are more likely to take time off work, but not those at risk of disability, or long term absence from work.
Pessimists take longer to return to normal activities after an operation

Patients who are pessimistic take longer than those who are not to return to everyday activities after an operation.
What motivates people to return to work?

This study identified factors that motivated and de-motivated people to return to work after work-related injury.
The impact of expectations on return to work

Beliefs and expectations about returning to work can affect the outcome for people with low back pain.
Beliefs and expectations affect return to work

Beliefs, expectations, and physical symptoms affect how long a person will take to return to work.
Fear of pain is likely to slow recovery

If people think that any pain means their condition is being aggravated, they sometimes avoid their normal activities. This can slow their recovery.
On being stuck in the system and how to get out of it

A bureaucratic claims process causes a number of problems for employees.
Does how you recover depend on how you think you'll recover?

A person's expectations about recovery have an impact on what happens.
Pride, empowerment, and return to work

Being off work can cause negative social emotions that hinder rehabilitation
'Self-efficacy' is your ability to confidently manage your health condition and return to normal activities, including work

Those who feel capable of achieving a positive return to work outcome are more likely to make it.
People on compensation experience more pain, but not because of economic gain

Traumatic injuries and compensation: two issues that effect a patien's experience of chronic pain.
Building confidence: the first step in successful rehabilitation

Rehabilitation is most successful when it first improves patients' confidence.
Predicting delayed RTW
Knowing the return to work expectation of an injured worker is an important first step

The predictions of injured workers regarding returning to work are 98% accurate.
RTW Approaches and Interventions
Elements of effective schemes
Common ingredients of successful rehabilitation programs

Rehabilitation programs are more likely to be effective when they provide participants with education, physical and psychological treatment, worksite modification and training in good work practices.
Workplace based early intervention programs get people back to work sooner

A well designed, correctly implemented workplace program can reduce sickness absence.
The importance of goal-setting in rehabilitation

Goal setting is a powerful way to aid the rehabilitation process.
System factors
Procedural fairness, disputes and return to work

When a dispute occurs, an injured worker's perception of the fairness of proceedings depends primarily on the quality of communication and co-operation during the dispute.
All hands on deck! Designing and implementing a return to work program

Return to work programs are more likely to be successful when everyone affected by the program (employers, employees, unions etc) is involved in its design and operation.
Injury recovery may be affected by compensation

When a person is compensated for their injury they may not achieve a desirable recovery outcome.