The Contribution of Onsite Physiotherapy to an Integrated Model for Managing Work Injuries: A Follow Up Study

Evaluation of the Early Intervention Physiotherapist Framework for Injured Workers in Victoria, Australia: Data Analysis Follow-Up

PURPOSE

This study evaluates the performance of the Early Intervention Physiotherapist Framework (EIPF) for injured workers. This study provides a proper follow-up period (3 years) to examine the impacts of the EIPF program on injury outcomes such as return to work (RTW) and time to RTW. This study also identifies the factors influencing the outcomes.

METHODS

The study was conducted on data collected from compensation claims of people who were injured at work in Victoria, Australia. Injured workers who commenced their compensation claims after the first of January 2010 and had their initial physiotherapy consultation after the first of August 2014 are included. To conduct the comparison, we divided the injured workers into two groups: physiotherapy services provided by EIPF-trained physiotherapists (EP) and regular physiotherapists (RP) over the three-year intervention period. We used three different statistical analysis methods to evaluate the performance of the EIPF program. We used descriptive statistics to compare two groups based on physiotherapy services and injury outcomes. We also completed survival analysis using Kaplan-Meier curves in terms of time to RTW. We developed univariate and multivariate regression models to investigate whether the difference in outcomes was achieved after adjusting for significantly associated variables.

RESULTS

The results showed that physiotherapists in the EP group, on average, dealt with more claims (over twice as many) than those in the RP group. Time to RTW for the injured workers treated by the EP group was significantly lower than for those who were treated by the RP group, indicated by descriptive, survival, and regression analyses. Earlier intervention by physiotherapists led to earlier RTW.

CONCLUSION

This evaluation showed that the EIPF program achieved successful injury outcomes three years after implementation. Motivating physiotherapists to intervene earlier in the recovery process of injured workers through initial consultation helps to improve injury outcomes.

Associations Between Work-Zone Groups and Compensation Claims: Experience From a Poultry Meat Processing Plant

OBJECTIVE

At a poultry meat processing plant, work-zone group was an influencing factor upon an intervention program aimed at reducing musculoskeletal disorders (MSD), and also upon safety climate and disability management practices. This study aimed to explore if compensation claim outcomes also differed across work-zones in this plant.

METHODS

De-identified workers' compensation claims data from the processor were categorized according to three main work-zones (kill, process, and despatch). Multivariable generalized linear modeling explored the compensation claims costs across these work-zones, adjusted for age, shift, and claim type.

RESULTS

For MSDs, costs per claim were 3.5 times lower in the kill-zone compared to the despatch-zone. Shift worked and claim type were significant covariates in the modeling.

CONCLUSION

Organizations should prioritize interventions within work-zones with poorer compensation outcomes and consider the association of organizational microclimates upon these claims.

Musculoskeletal Disorders' Classification Proposal for Application in Occupational Medicine

Occupational-specific classifications of musculoskeletal disorders (MSD) are scarce and do not answer specific clinical questions. Thus, a specific classification was developed and proposed, covering criteria applicable to daily clinical activity. It was considered that the disorder development process is the same across all work-related MSDs (WRMSDs). Concepts of clinical pathology were applied to the characteristics of WRMSDs pathophysiology, cellular and tissue alterations. Then, the correlation of the inflammatory mechanisms with the injury onset mode was graded into four levels (MSDs 0-3). Criteria of legal, occupational and internal medicine, semiology, physiology and orthopaedics, image medicine and diagnostics were applied. Next, the classification was analysed by experts, two occupational physicians, two physiatrists and occupational physicians and one orthopaedist. This approach will allow WRMSD prevention and improve therapeutic management, preventing injuries from becoming chronic and facilitating communication between occupational health physicians and the other specialities. The four levels tool relate aetiopathogenic, clinical, occupational and radiological concepts into a single classification. This allows for improving the ability to determine a WRMSD and understanding what preventive and therapeutic measures should be taken, avoiding chronicity. The developed tool is straightforward, easy to understand and suitable for WRMSDs, facilitating communication between occupational physicians and physicians from other specialities.