A "Job Coach" model was developed based on sports medicine and rehabilitation principles for athletes, and individual placement and supported employment for people with psychiatric disabilities. This is a biopsychosocial model, emphasising workplace-based intervention. / Background. Occupational musculoskeletal soft tissue injuries represent a major source of work disability. There has been a gradual rise in the occurrence of occupational musculoskeletal injuries of the upper extremity, including both acute injuries and more chronic health problems. Return to work following an occupational injury is a multifactoral process, although traditional clinic-based rehabilitation programmes do not appreciate the importance of contextual factors. / Conclusion. Workplace work hardening programmes are a further development of work rehabilitation programmes. The therapeutic use of actual work facilities and the work environment can effectively facilitate the successful return to work process of the injured worker. More importantly, many of the psychosocial problems associated with separation from the work routine, peer group and/or the employer are minimised by the presence of the Job Coach. The results of this study confirm that workplace-based rehabilitation intervention is more effective than conventional clinic-based rehabilitation programmes in terms of prevention of further work disability, improvement in functional capabilities and decrease in perceived pain and disability. / Keywords. Job coach, workplace-based rehabilitation, rotator cuff injury, work disability, return to work intervention. / Methodology. A randomised controlled trial was conducted on 94 workers recruited from Workers' Compensation insurers. These workers had all sustained occupational rotator cuff injury and had lost more than 90 workdays. The workers were randomly assigned into control or experimental groups. The control group received a traditional work hardening programme and the experimental group received a workplace work hardening programme using the Job Coach model. The return to work outcomes of the two groups were compared. Areas of comparison included return to work rate after training, job retention ability and impact on earning capacity. Other outcome measures included change in active range of motion of the shoulder joint, eight basic functional capacities and the worker's perception of shoulder pain and disability based on the Shoulder Pain and Disability Index (SPADI). / Results. After one-month of the training programme, a higher return to work rate was obtained in the experimental group compared to the control group (71.4% against 37%, chi2=11.095, p=0.001). For job retention ability, 93.5% of the workers in the experimental group were still at work compared to 72.9% of workers in the control group (chi 2=7.031, p=0.008). No obvious salary change was noted between the two groups. / The SPADI was statistically significantly lower in the experimental group than in the control group (p=0.032), meaning that workers in the experimental group had fewer shoulder problems after training. Other significant improvements were noted in active shoulder flexion (p=0.001), arm lift strength (p=0.01), high-near lift strength (p=0.014), dynamic carrying strength (p=0.007) and overhead work tolerance (p=0.032), all of which were found to be statistically significantly higher in the experimental group than in the control group. / Cheng Shu-kei. / "July 2006." / Adviser: Leung Kim Hung. / Source: Dissertation Abstracts International, Volume: 68-03, Section: B, page: 1568. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2006. / Includes bibliographical references (p. 216-238). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstracts in English and Chinese. / School code: 1307.
| Identifer | oai:union.ndltd.org:cuhk.edu.hk/oai:cuhk-dr:cuhk_343869 |
| Date | January 2006 |
| Contributors | Cheng, Andy Shu Kei., Chinese University of Hong Kong Graduate School. Division of Orthopaedics & Traumatology. |
| Source Sets | The Chinese University of Hong Kong |
| Language | English, Chinese |
| Detected Language | English |
| Type | Text, theses |
| Format | electronic resource, microform, microfiche, 1 online resource (xix, 284 p. : ill.) |
| Rights | Use of this resource is governed by the terms and conditions of the Creative Commons “Attribution-NonCommercial-NoDerivatives 4.0 International” License (http://creativecommons.org/licenses/by-nc-nd/4.0/) |
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