Disability Management Research Articles

Work Disability Prevention and Management.

Objective: This abbreviated version of the American College of Occupational and Environmental Medicine's (ACOEM) Work Disability Prevention and Management Guideline reviews the available evidence and provides recommendations to clinicians regarding interventions to help patients remain at or return to work.Methods: Systematic literature reviews were conducted. Studies were graded and evidence tables were created, with involvement of a multidisciplinary expert panel that evaluated the evidence and finalized recommendations for all clinical questions. Extensive peer review was performed. Consensus recommendations were formulated when evidence was lacking.Results: Evidence-based recommendations have been developed to guide work disability prevention and management.Conclusion: Clinicians should utilize quality evidence in determining treatment methods to prevent and alleviate work disability for workers.

The mediating role of depression and disability in the association between widowhood and cognitive function among elderly Chinese individuals.

The incidence of mild cognitive impairment among the elderly in China was increasing. Widowhood, depression, and disability were significant factors that impacted cognitive function. Yet, there was currently no research, both domestically and internationally, that comprehensively examines all these factors together. Therefore, in order to achieve successful aging, the objective of this study is to investigate the impact and pathway of depression and disability on the association between widowhood and cognitive function in the elderly population of China, with the aim of establishing a robust foundation for developing evidence-based strategies to prevent and manage cognitive impairment among older adults in China. The 2018 Chinese Longitudinal Healthy Longevity Survey data was utilized to assess cognitive function, depression level, and disability status using the Mini-Mental State Examination, The Center for Epidemiological Studies Depression-10 scale, and the Katz scale. The mediating role of depression and disability in the association widowhood and cognitive function were tested by the bruceR package in R Studio. A total of 7973 elderly individuals aged over 65 were included in the study, with nearly 50% being widowed. Widowhood was identified as a significant risk factor for cognitive impairment in the elderly population. The results from the analysis of mediating effects indicated that both depression and disability independently mediated this relationship, while also contributing to a chain-mediated effect on the association between widowhood and cognitive function in the population. We recommend that greater attention be dedicated to this population, and measures be implemented to enhance their mental well-being and disability management, thereby improving cognitive function.

The Efficacy and Factors Associated With Epidural Injections in the Management of Lumbar Spinal Stenosis and in Terms of Delaying Laminectomy: A Retrospective Study.

Lumbar epidural injections have been studied as symptomatic treatments for lumbar spinal stenosis (LSS). However, results about their efficacy have been controversial, and data regarding their use is scarce. Our purpose in this article is to study the efficacy of epidural injections in the management of pain and disability in patients suffering from spinal stenosis, to study the factors which can affect their efficacy, and to discuss whether they could replace surgery or not. A retrospective study between 2021 and 2022 took place in a Pain Clinic located in Notre-Dame des Secours University Hospital-Lebanon. The study was done on 128 patients, of whom 18 were excluded because they underwent laminectomy before taking the transforaminal lumbar epidural injections. Medical records were viewed. Outcome measures were checked before and after epidural injections using the numerical pain scale and the Oswestry Disability Index (ODI) scale. Physical activity was assessed with a physical activity index. Back pain scores (9.46 ± 1.07 vs. 3.91 ± 3.13; P < 0.001), leg pain scores (9.31 ± 1.41 vs. 3.75 ± 3.17; P < 0.001), and ODI scores (27.45 ± 8.97 vs. 9.40 ± 9.42; P < 0.001) decreased after the injection compared to before it. A higher physical activity index was significantly associated with a decrease in back pain, leg pain, and ODI scores after epidural injection. In 57.8% of the patients, epidural injections were sufficient for pain management without the need for surgery. Epidural injections are effective in the management of back and leg pain associated with LSS and in improving patients' disability. Engaging in activities like walking and swimming is associated with better results. In some cases, epidural injections may replace surgery.

Successful Strategies for Occupational Health and Safety in Small and Medium Enterprises: Insights for a Sustainable Return to Work.

The objectives of this paper were to summarize successful strategies in occupational health and safety (OHS) management in small and medium-sized enterprises (SMEs) and to explore their potential applicability for disability management (DM) and return-to-work (RTW) after work-related injuries. A scoping review was conducted, using a consensus-based iterative approach, and a consultation with stakeholders. Twelve databases were searched in collaboration with a specialized librarian, using keywords and combinations of terms. The reviewers identified pertinent articles, selected those which corresponded to the inclusion criteria, extracted data, and analyzed information using qualitative content analyses. A synthesis was presented to the stakeholders, and their comments on overall applicability of these strategies in the Quebec context of DM and RTW were detailed. A total of 638 references were retrieved from all sources, resulting in 37 scientific articles being analyzed. Four main strategies for improving OHS management in SMEs were identified: dissemination and exchange of information; transmission and acquisition of knowledge, skills, and abilities; using a participatory and collaborative approach; and considering the organizational context. Even if DM and sustainable RTW were sometimes mentioned by authors as important for OHS management in SMEs, specific strategies and implementation elements were not actually described by authors. However, different resources, structures, and activities, associated with one or more of the OHS management strategies described, through their different interactions between the various stakeholders, seem having the potential to act also in sustainable RTW. This review has provided an overview of strategies deployed to improve OSH in SME. The results invite stakeholders to a deep reflection on the potential application of such strategies to encompass sustainable RTW in SMEs.

Sarcopenic Obesity: A Comprehensive Approach for Postmenopausal Women.

Sarcopenic obesity, characterized by the concurrent presence of muscle loss and obesity, poses significant health challenges, especially in the elderly. This review explores the impact of sarcopenic obesity on disability, metabolic health, comorbidities, and potential management strategies. With the aging global population, the prevalence of sarcopenic obesity is expected to increase, necessitating a comprehensive management approach. Early screening, prevention, and ongoing research on its underlying mechanisms and therapeutic options are crucial for promoting healthy aging.

Manual physical therapy for neck disorders: an umbrella review

ABSTRACT Introduction Neck pain is a common musculoskeletal disorder, with a prevalence rate (age-standardized) of 27.0 per 1000 in 2019. Approximately 50–85% of individuals with acute neck pain do not experience complete resolution of symptoms, experiencing chronic pain. Manual therapy is a widely employed treatment approach for nonspecific neck pain (NSNP), cervical radiculopathy (CR) and cervicogenic headaches (CGH). This umbrella review synthesized systematic reviews examining manual physical therapy for individuals with cervical disorders. Methods Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed with Prospero registration (CRD42022327434). Four databases were searched from January 2016 to May 2023 for systematic reviews with or without meta-analysis examining manual therapy for individuals with neck pain of any stage. Interventions included any manual physical therapy of the cervical or thoracic spine as well as neuromobilization of the upper quarter. Primary outcomes included pain and disability. Two reviewers screened for eligibility and completed data extraction. Methodological quality was assessed using the Assessment of Multiple Systematic Reviews (AMSTAR 2) tool. Results A total of 35 SRs were included: 15 NSNP, 7 cervical radiculopathy, 9 CGH and 4 samples with combined diagnoses. AMSTAR 2 ratings of the SRs support high confidence in results for 10 reviews, moderate confidence in 12 reviews and low to critically low confidence in 13 reviews. For NSNP, there was high confidence in the results showing manual therapy combined with exercise was superior to either treatment in isolation. In cervical radiculopathy, neural mobilization, distraction, soft tissue treatment and mobilization/manipulation to cervical and thoracic spine were supported with moderate confidence in results. For CGH, there was high confidence in the results supporting the use of cervical spine mobilization/manipulation, soft tissue mobilization, and manual therapy combined with exercise. Original authors of SRs reported varying quality of primary studies with lack of consistent high quality/low risk of bias designs. Conclusion Manual therapy plus exercise, cervical or thoracic mobilization and manipulation, neuromobilization, and other types of manual therapy were supported as effective interventions in the management of pain and disability for individuals with NSNP, CGH, or CR in the short-term.

Work ability meetings - Challenges and Resolutions, a survey to Finnish occupational physicians.

Work ability meetings (WAM) are an essential and common tool of disability management in occupational health services in Finland. Meetings are held between an employee, a supervisor, and an occupational physician (OP). The aim is mainly to support work ability. To describe challenges and resolutions in the meetings as described by OPs. An internet survey was emailed to the members (n = 1304) of the Finnish Society of Occupational Health Physicians in August 2014. We asked physicians to describe those WAMs they had attended, especially challenges and resolutions concerning WAM. A total of 302 (23%) OPs responded to the survey. Most severe of the challenges were personal conflicts and a lack of confidence between the parties at the workplace. Also, the participants' views may differ about the purpose and goal of the meeting. The respondents noted that the employer might be unable to organize modified work for disabled employees. As a resolution, OPs need to prepare well and maintain their professional and neutral role in WAMs in all cases. OPs also mentioned the need for training in insurance medicine and rehabilitation as well as skills as a mediator. WAM is a potential tool for return to work and disability management in collaboration between employees, employers, and occupational health when all the participants reach a common goal and become aware of their role in the process. OPs need to recognize possible conflicting interests and contact each party before WAM. Keeping confidentiality in WAMs is a crucial matter.

Mainstream Technologies in Facilities for People With Intellectual Disabilities: Multiple-Methods Study Using the Nonadoption, Abandonment, Scale-Up, Spread, and Sustainability Framework.

People with intellectual disabilities in residential or outpatient facilities for people with disabilities run the risk of being digitally excluded by not having opportunities for taking advantage of digitalization possibilities. We aimed to investigate how disability caregivers and managers describe barriers and facilitating factors to implement and adopt mainstream technology for people with intellectual disabilities in residential or outpatient facilities and how the competencies and capabilities of the caregivers are assessed in the process. For this reason, we conducted a multiple-methods study applying the nonadoption, abandonment, scale-up, spread, and sustainability framework. As a result, we identified barriers and facilitators across the nonadoption, abandonment, scale-up, spread, and sustainability framework domains: (1) condition-people with intellectual disabilities are a diverse group, where the individual condition of the person and, for example, their communication skills were seen as a prerequisite for implementing mainstream technologies; (2) technology-the extent to which mainstream technology fits the individual needs and demands contributed to the implementation process; (3) value proposition-communication was seen as a life area where mainstream technology can add value; (4) adopters-the caregivers needed competencies and capabilities to accompany their care recipients' technology use; (5) organization-missing legal regulations and lack of personnel resources were described as barriers; (6) wider context-funding opportunities were seen as unclear in disability services as mainstream technologies could not be financed as participation benefits; (7) embedding and adaptation over time-the COVID-19 pandemic forced facilities to become digitalized to some extent. The disability services investigated were still in need of standardized procedures to promote the digital participation of their residents.

Applying training to disability management: insights from a scoping review

Applying training to disability management: insights from a scoping review

The Use of Telehealth Technology in the Medical Management of Adults with Intellectual Disability: A Scoping Review.

Background: Individuals with intellectual disability (ID) experience substantial inequalities and barriers accessing health care despite requiring constant accessibility to healthcare providers as they are more likely to die from avoidable causes of death than those without ID. Telehealth technologies have the capacity to improve access to health providers and health information and could greatly reduce morbidity and mortality rates in people with ID. This study aims to explore the use of mobile health technology in the medical management of adults with intellectual disability. Methodology: PubMed, IEEE Explore, ACM, and Scopus databases were examined to extract peer-reviewed articles published from January 2000 to January 2022. Original research, published in English and focused on the use of telehealth technologies in the medical management of intellectual disability were deemed eligible. A narrative synthesis of the results was completed, structured around the characteristics of telehealth technologies used and the outcomes of the studies. Results: Thirteen of 1008 reviewed articles were considered eligible for inclusion. Most of the studies used videoconferencing platforms for real-time telehealth, while others focused on symptom or medication monitoring applications. The evidence supports the feasibility, potential effectiveness and satisfaction of using telehealth to manage intellectual disability among adults despite accessibility issues including poor internet connectivity and poor knowledge of technology which may limit its use. Conclusion: The use of telehealth was feasible, acceptable and potentially effective for the management of ID among adults though the varied methodology of included studies maybe inadequate. A more structured methodology will be useful in future studies.

Attention deficit hyperactivity disorder and specific learning disability co-occurring in a case with Silver-Russell syndrome

This case presentation discusses the management of comorbid attention deficit hyperactivity disorder (ADHD) and specific learning disability (SLD) in a female adolescent diagnosed with Silver-Russell syndrome (SRS). A 13-year-old female patient presented to the child psychiatry outpatient clinic eight months ago with complaints of reading and writing difficulties and forgetfulness. When she was four years old, she was diagnosed with SRS. Somatotropin therapy was initiated for the patient. Based on psychiatric examination, family interviews, psychometric assessments, and information obtained from school, the patient was diagnosed with ADHD and SLD. The patient was started on methylphenidate treatment, gradually titrated to a dose of 27 mg/day. She was also referred for special education for the SLD diagnosis. In the literature, it has been reported that in most children with SRS, intelligence is within the normal range, and they often receive diagnoses of ADHD and/or SLD. Studies have shown that although, executive function disorders are not significantly associated with SRS in comparison to control groups, there is an increased risk. Children and adolescents with this rare congenital disorder are at risk for psychiatric disorders, and periodic evaluation by a child psychiatrist is recommended.

Living with a chronic disease: tertiary prevention tools in asbestos-exposed patients

Abstract Background The main asbestos-related pathology is asbestosis, frequently associated with pleural plaques. The spirometric pattern is mainly restrictive, with reduction in all lung volumes (FEV1, FVC, TLC). Also a reduction in alveolus-capillary diffusion of carbon monoxide (DLCO) may be added, related to the fibrotic process. The aim of the study is to analyze the health surveillance data, correlating the spirometric finding and its variation over time with the clinical and radiological picture. Methods The study is conducted on 372 patients with asbestosis from occupational exposure diagnosed in the period 2017-2023, as part of the Tuscany Region’s program for former asbestos exposures (DGR 396/2016). The investigation is at the second level of surveillance, which includes chest CT and Respiratory Functionality Testing (RFT). Data are obtained from patients’ medical records and processed through a database. Results Out of 372 patients with asbestosis, 213 had pleural plaques (57.25%). Out of those, there is a progressive worsening of RFTs in a restrictive direction (TLC &amp;lt;80%, FEV1/FVC &amp;gt;70%) in 71 patients (33.3%), with a mean TLC loss of 8.7 ± 5.9 mL over subsequent follow-ups on a yearly basis. The FEV1/FVC ratio also declines, with a mean reduction of 5 ± 2.4%. Out of those 71 patients, 14 (19.7%) also show a mean reduction in DLCO of 6.7 ± 5 mL/min/mmHg. The negative trend in RFTs correlates with the worsening clinical and radiological picture attributable to the occurrence of plaques on a fibrotic framework. Conclusions The health surveillance protocol that we adopted has as objective the ascertainment of pulmonary pleura-parenchymal alterations correlated with occupational exposure, investigating their evolution over time through the analysis of spirometric data, and to optimize the management of the functional disability, with a view to the tertiary prevention of patients with asbestos-related disease. Key messages • The negative trend in asbestosis PFRs correlates with the worsening of the clinical and radiological picture attributable to the appearance of pleural plaques on an interstitial fibrosis. • Health surveillance is essential in order to optimize the management of functional disability, with a view to tertiary prevention of patients with asbestos-related disease.

Geriatric Research – Indian Perspective

Abstract With the rapidly growing older population in India, age-related diseases, disabilities, and socioeconomic issues are also increasing. Providing quality of life to this ever-increasing older population is impossible by any agency or government in the present setup. Geriatric research is a need of the hour in India to provide health care, prevention of disease, and better management of disabilities and maintain the autonomy of our older population.

Impacts on Firm Productivity by Retaining Worker Knowledge and Capacity Through Disability Management Programs

Helping employees return to work following an injury or illness is a moral imperative, and usually a legal requirement, but is it economically beneficial to the firm? While there is intuitive awareness that disability management programs can be economically beneficial, particularly by retaining and resecuring the knowledge and capacity of employees, there is limited evidence to support that claim. The literature lacks insight into the logic and mechanisms through which disability management programs are economically beneficial. To provide such insight, this study undertakes an exploratory analysis of disability management programs concerning productivity as a firm-level performance factor. The data is sourced from a Canadian national database statistically representing more than 650,000 firms. The findings indicate there are differential impacts of disability management programs on firm productivity and this relationship is moderated by business strategy.

Disability inclusion studies in the construction industry: a mixed review approach

People with disabilities are an important part of our society and are acknowledged as a wonderful piece of human variety. However, their involvement in the building business is mostly unknown. This report aims to give a critical assessment of disability inclusion studies in the construction industry and identify areas for further research. The Scopus search engine aided in the literature review search, where 253 publications were discovered using relevant keywords. After carefully reviewing the titles, abstracts, keywords, and full texts of the publications, a total of 55 relevant publications were selected. A scientometric study was undertaken to chart the landscape of disability inclusion studies within the construction industry and identify primary areas of research focus within this domain. The top five countries that are actively researching disability in the construction industry include the UK, the United States, Brazil, Canada, and Australia. The emerging areas in disability inclusion research in the construction industry focused on social value, social innovation, social procurement, employment, disability management, policies, discrimination, and disability management maturity model. The study highlighted the essential knowledge areas crucial for enhancing the integration of persons with disabilities in the construction sector to industry practitioners and other stakeholders.

The Management of Sexual Disability Related to Low Back Pain: A Cross-Sectional Survey of Italian Physiotherapists

The Management of Sexual Disability Related to Low Back Pain: A Cross-Sectional Survey of Italian Physiotherapists

Multimodal Analgesia Approach in Acute Low Back Pain Management: A Phase III Study of a Novel Analgesic Combination of Etoricoxib/Tramadol.

Pain and disability management are crucial for a speedy recovery. Combining analgesics with different mechanisms of action provides greater pain relief with lower doses, promoting efficient multimodal analgesia. This study evaluated the efficacy and safety between two fixed-dose combinations (FDC): etoricoxib/tramadol compared to paracetamol/tramadol for the management of acute low back pain (LBP) in a 7-day treatment. We conducted a phase IIIb, prospective, randomized, and multicenter study in patients with acute LBP treated with etoricoxib 90mg/tramadol 50mg (one packet of granules diluted in 100ml of water, once a day [QD], for 7 days) or paracetamol 975mg/tramadol 112.5mg (one tablet of 325mg/37.5mg, three times a day [TID], for 7 days) to assess the efficacy (in terms of pain and disability improvement) and safety. One hundred and twenty-four patients were randomized to receive either etoricoxib/tramadol QD (n = 61) or paracetamol/tramadol TID (n = 63). From the magnitude of change in pain evaluations, differences were observed between the treatment groups at 3 [p = 0.054, CI 95% -0.648 (-0.010 to 1.306)] and 5days (p = 0.041). The proportion of patients with a 30% reduction in Visual Analogue Scale (VAS) score was statistically significant when comparing the treatment groups on the third day of follow-up [p = 0.008, CI 95% 0.241 (0.061-0.421)]. An improvement in LBP's disability to perform activities of daily routine (Oswestry and Roland-Morris questionnaires) was observed in both treatment groups. A total of 79 adverse events (AEs) (38 [48.1%] with etoricoxib/tramadol and 41 [51.9%] with paracetamol/tramadol) were reported. The most frequent AEs were nausea (17.7%) and dizziness (16.4%). The results show the clinical benefits of etoricoxib/tramadol FDC, such as the sparing effect of tramadol dose per day, early therapeutic response rate compared with paracetamol/tramadol; which translates into faster pain relief, better adherence, less tramadol drug dependency, and a reduction of related AEs incidence. ClinicalTrials.gov identifier, NCT04968158.

A Fixed Combination of Palmitoylethanolamide and Melatonin (PEATONIDE) for the Management of Pain, Sleep, and Disability in Patients with Fibromyalgia: A Pilot Study.

Fibromyalgia is characterized by chronic widespread pain, fatigue, and sleep disturbances. Recent theories attribute fibromyalgia to central sensitization syndromes, suggesting altered nociceptive processing leads to hyperalgesia and allodynia. Standardized effective treatments are currently lacking. Palmitoylethanolamide and melatonin have shown pain-relieving effects in chronic pain conditions, including fibromyalgia, with excellent safety. Our open-label study assessed the impact of a daily combination of 1200 mg of palmitoylethanolamide and 0.2 mg of melatonin on pain, sleep, and quality of life in fibromyalgia patients. Between June 2023 and March 2024, 50 patients (2016 ACR criteria) were treated and evaluated at baseline, 1 month, 3 months, and 4 months (1 month discontinuation). The assessments included VAS for pain, ISI for insomnia, HAQ for health assessments, and a tender points evaluation. The patients, averaging 54.12 years old with a 3:1 female-to-male ratio, showed significant improvements in VAS, ISI, and HAQ scores relative to their own baselines and a reduction in tender points at 1 and 3 months, which was maintained at 4 months. No adverse events were reported. This study is the first to demonstrate the efficacy of a palmitoylethanolamide and melatonin combination as an adjunct therapy in fibromyalgia, highlighting its potential to reduce pain and improve sleep and quality of life.

The evaluation of health, disability and aged care-sector engagement with resources designed to support optimisation of the allied health assistant workforce: a qualitative study

BackgroundAllied health assistants (AHAs) support allied health professionals (AHPs) to meet workforce demands in modern healthcare systems. In an Australian context historically, AHAs have been sub-optimally utilised. Prior research has identified that AHAs and AHPs working in health, disability and aged care sectors, and the Vocational Education and Training (VET) industry, may benefit from access to resources to support the optimisation of the AHA workforce. As a part of a Victorian department of health funded project, several resources were developed in line with workforce recommendations for use in each of the above sectors. Recommendations and resources covered the broad areas of pre-employment training, workforce planning and governance, consumer-centred therapy and supports, recruitment and induction and workplace training and development. This study aimed to evaluate the engagement with these newly designed resources to support optimisation of AHAs in the Victorian context.MethodsSemi-structured interviews were conducted to evaluate engagement with resources, from the perspective of AHAs, AHPs and allied health leaders (AHLs) in the health, aged care or disability sectors, and educators and managers of allied health assistance training. Thematic analysis was conducted using team-based framework analysis.ResultsThematic framework analysis of the interview data identified four themes; Why participants accessed the resources; How participants engaged with the resources; What (if any) changes in practice occurred as a result of engaging with the resources in a participant’s local context, How did participants envision the resources being utilised for AHA workforce optimisation in the future. Responses were mapped to the AHA workforce career pathway at the career preparation, career development and career trajectory tiers.ConclusionsAppetite for AHA workforce development and optimal utilisation is evident across Victoria, Australia. Readily accessible resources that inform AHA role and scope of practice, delegation practice, or improve the ability for an AHA to state their own development needs, were identified as useful by participants. The potential for these resources to assist in the optimal utilisation and development of AHA workforces across the career continuum differs according to the role, sector and geographical location of the resource user. Further study is needed to investigate the transferability of these resources to national and global contexts.

Exploring ICOPE's Impact on Delaying Elderly Disability Management.

The purpose of this study was to explore the initial benefits of introducing the ICOPE (Integrated care for older people) information assessment system for the management of hospitalized elderly patients in a teaching hospital in Eastern Taiwan. The ICOPE information assessment system was set up for case screening and abnormal referral through clinical ICOPE, followed by follow-up and case management. The results showed a total of 3424 screened cases, an average of 311 ICOPE screenings per month, an average of 48 abnormal screenings per month (15%), a referral rate of 79%, a rescreening rate of 91%, and a case management completion rate of 71%. Conclusion: Introducing the ICOPE information evaluation system can quickly screen for potential abnormal disability cases in hospitalized elderly patients, timely referral case management, provide appropriate intervention measures, and improve the quality of life after returning home in old age.