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Hung-yi Chuang - One of the best experts on this subject based on the ideXlab platform.
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Vocational rehabilitation for enhancing return-to-work in workers with traumatic upper Limb injuries.
The Cochrane database of systematic reviews, 2017Co-Authors: Heng-lien Lo, Yun-yun Chou, Hung-yi ChuangAbstract:Traumatic upper Limb Injury is a leading cause of work-related disability. After return-to-work (RTW), many survivors of injuries are able to regain a quality of life (QoL) comparable with the normal population. Since RTW plays an important role in economic productivity and regaining health-related QoL, enhancing RTW in workers with traumatic Limb injuries is the primary goal of rehabilitation. Vocational rehabilitation has been commonly employed in the field of occupational safety and health to increase the number of injured people returning to the labour market, prevent illness, increase well-being, and reduce disability. To assess the effects of vocational rehabilitation programmes for enhancing RTW in workers with traumatic upper Limb injuries. This is an update of a Cochrane review previously published in 2013. We updated our searches of the following databases: the Cochrane Central Register of Controlled Trials (CENTRAL; 2017, Issue 9), MEDLINE (to 30 August 2017), EMBASE (to 3 September 2017), CINAHL (to 6 September 2017), and PsycINFO (to 6 September 2017), and we handsearched the references lists of relevant review articles. We aimed to include all randomised controlled trials (RCTs) comparing vocational rehabilitation with an alternative (control) intervention such as standard rehabilitation, a limited form of the vocational rehabilitation intervention (such as advice on RTW, referral information, or liaison with employer), or waiting-list controls. Two authors independently inspected abstracts, and we obtained full papers when necessary. When the two authors disagreed about the inclusion of a study, we resolved disagreements by discussion. A third author arbitrated when necessary. Our updated search identified 466 citations. Based on assessments of their titles and abstracts, we decided to evaluate the full texts of five records; however, none met our inclusion criteria. There is currently no high-quality evidence to support or refute the efficacy of vocational rehabilitation for enhancing RTW in workers with traumatic upper Limb injuries. Since injured people in occupational settings frequently receive vocational rehabilitation with the aim of decreasing work disability, enhancing RTW, increasing productivity, and containing the welfare cost, further high-quality RCTs assessing the efficacy of vocational rehabilitation for workers with traumatic upper Limb Injury are needed to fill this gap in knowledge.
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A threshold regression model to predict return to work after traumatic Limb Injury
Injury-international Journal of The Care of The Injured, 2015Co-Authors: Hung-yi ChuangAbstract:Abstract Objective The study aims to examine the severity of initial impairment and recovery rate of return-to-work (RTW) predictors among workers with traumatic Limb Injury. Methods This 2-year prospective cohort study recruited 1124 workers with traumatic Limb Injury during the first 2 weeks of hospital admission. Baseline data were obtained by questionnaire and chart review. Patient follow-up occurred at 1, 3, 6, 12, 18, and 24 months post Injury. The primary outcome was the time of first RTW. The impact of potential predictors on initial impairment and rate of recovery towards RTW was estimated by threshold regression (TR). Results A total of 846 (75.27%) participants returned to work during the follow-up period. Our model revealed that the initial impairment level in elderly workers and lower Limb injuries were 33% and 35% greater than their counterparts, respectively. Workers with >12 years of education, part-time job, and moderate and higher self-efficacy were less impaired at initial Injury compared with their counterparts. In terms of the rate of recovery leading to RTW, workers with older age, part-time jobs, lower Limbs, or combined injuries had a significantly slower recovery rate, while workers with 9–12 years of education and >12 years of education had a significantly faster recovery rate. Conclusions Our study provides researchers and clinicians with evidence to understand the baseline impairment and rate of recovery towards RTW by explaining the predictors of RTW among workers with traumatic Limb injuries.
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Vocational rehabilitation for enhancing return-to-work in workers with traumatic upper Limb injuries.
The Cochrane database of systematic reviews, 2013Co-Authors: Heng-lien Daniel Lo, Hung-yi ChuangAbstract:Traumatic upper Limb Injury is a leading cause of work-related disability. After return-to-work (RTW), many survivors of injuries are able to regain a quality of life (QoL) comparable with the normal population. Since RTW plays an important role in economic productivity and regaining health-related QoL, enhancing RTW in workers with traumatic Limb injuries is the primary goal of rehabilitation. Vocational rehabilitation has been adapted in the field of occupational safety and health to enhance the number of injured people returning to the labour market, prevent illness, increase well-being, and reduce disability. To assess the effects of vocational rehabilitation programs in enhancing RTW of workers with traumatic upper Limb injuries. We searched OSH UPDATE databases (CISDOC, HSELINE, International Bibliographic, NIOSHTIC, NIOSHTIC-2, RILOSH) (up to 10 December 2012), the Cochrane Central Register of Controlled Trials (CENTRAL) (2012, Issue 11), MEDLINE through PubMed (up to 15 November 2012), EMBASE (up to 28 November 2012), CINAHL (up to 5 May 2013), PsycINFO (up to 7 December 2012), and handsearched the reference lists of relevant review articles. We aimed to include all randomised controlled trials (RCTs) comparing vocational rehabilitation with an alternative (control) intervention such as standard rehabilitation, an incomplete form of the vocational rehabilitation intervention (such as with limited advice on RTW, referral information, or liaison with employer), or waiting-list controls. Two authors independently inspected abstracts and we obtained full papers when necessary. When the two authors disagreed about the inclusion of a study, we resolved disagreements by discussion. A third author arbitrated when necessary. Our search identified 332 citations. Based on assessments of their titles and abstracts, we decided to evaluate the full texts of 15 citations. In the end, none of these 15 citations met our inclusion criteria. There is currently no high-level evidence to support or refute the efficacy of vocational rehabilitation in enhancing RTW in workers with traumatic upper Limb injuries. Since vocational rehabilitation has frequently been provided to injured people in occupational settings with the aim of decreasing work disability, enhancing RTW, increasing productivity, and containing the welfare cost, further high-quality RCTs assessing the efficacy of vocational rehabilitation for workers with traumatic upper Limb Injury are needed to fill this gap in knowledge.
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The Cochrane Library - Vocational rehabilitation for enhancing return-to-work in workers with traumatic upper Limb injuries
Cochrane Database of Systematic Reviews, 2013Co-Authors: Heng-lien Lo, Yun-yun Chou, Hung-yi ChuangAbstract:Background Traumatic upper Limb Injury is a leading cause of work-related disability. After return-to-work (RTW), many survivors of injuries are able to regain a quality of life (QoL) comparable with the normal population. Since RTW plays an important role in economic productivity and regaining health-related QoL, enhancing RTW in workers with traumatic Limb injuries is the primary goal of rehabilitation. Vocational rehabilitation has been adapted in the field of occupational safety and health to enhance the number of injured people returning to the labour market, prevent illness, increase well-being, and reduce disability. Objectives To assess the effects of vocational rehabilitation programs in enhancing RTW of workers with traumatic upper Limb injuries. Search methods We searched OSH UPDATE databases (CISDOC, HSELINE, International Bibliographic, NIOSHTIC, NIOSHTIC-2, RILOSH) (up to 10 December 2012), the Cochrane Central Register of Controlled Trials (CENTRAL) (2012, Issue 11), MEDLINE through PubMed (up to 15 November 2012), EMBASE (up to 28 November 2012), CINAHL (up to 5 May 2013), PsycINFO (up to 7 December 2012), and handsearched the reference lists of relevant review articles. Selection criteria We aimed to include all randomised controlled trials (RCTs) comparing vocational rehabilitation with an alternative (control) intervention such as standard rehabilitation, an incomplete form of the vocational rehabilitation intervention (such as with limited advice on RTW, referral information, or liaison with employer), or waiting-list controls. Data collection and analysis Two authors independently inspected abstracts and we obtained full papers when necessary. When the two authors disagreed about the inclusion of a study, we resolved disagreements by discussion. A third author arbitrated when necessary. Main results Our search identified 332 citations. Based on assessments of their titles and abstracts, we decided to evaluate the full texts of 15 citations. In the end, none of these 15 citations met our inclusion criteria. Authors' conclusions There is currently no high-level evidence to support or refute the efficacy of vocational rehabilitationin enhancing RTW in workers with traumatic upper Limb injuries. Since vocational rehabilitation has frequently been provided to injured people in occupational settings with the aim of decreasing work disability, enhancing RTW, increasing productivity, and containing the welfare cost, further high-quality RCTs assessing the efficacy of vocational rehabilitation for workers with traumatic upper Limb Injury are needed to fill this gap in knowledge.
E. Bruce Barry - One of the best experts on this subject based on the ideXlab platform.
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Shoe-Surface Interaction and the Reduction of Injury in Rugby Union
Sports Medicine, 1998Co-Authors: Peter D Milburn, E. Bruce BarryAbstract:While it is quite clear that footwear can provide protection against lower Limb Injury in running and some court sports, the literature related to footwear design and Injury prevention in most sports played on natural turf is limited. Nowhere is this more apparent than in the design of footwear for rugby union and rugby league. Therefore, in this article, information from other sporting codes will be applied to the design and performance characteristics of footwear and surfaces in an attempt to understand the causes of equipment-related injuries in rugby.A complete understanding of the complex interactions between the leg, foot, footwear and the surface has not yet been achieved and as a consequence, precise footwear design criteria to minimise Injury, while not compromising the performance aspects of shoe design, have yet to be established. The variable surface conditions experienced by players makes it difficult to provide recommendations as to the ideal footwear for all (or any) conditions. Equally, the ground reaction loads experienced by each player (and playing position) vary sufficiently to make generalisations difficult. Also, the foot-fall pattern during weight-bearing is highly individualised and further prohibits making general recommendations about selecting footwear for rugby.
Bengt I Eriksson - One of the best experts on this subject based on the ideXlab platform.
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high incidence of deep venous thrombosis after achilles tendon rupture a prospective study
Knee Surgery Sports Traumatology Arthroscopy, 2009Co-Authors: Katarin Nilssonhelander, Anders Thurin, Jon Karlsson, Bengt I ErikssonAbstract:Deep venous thrombosis (DVT) is common after lower Limb Injury, but the effect of prophylactic treatment has not been documented in large randomised trials or meta-analyses. As a result, evidence-based recommendations have not been established. The purpose of this study was to evaluate the incidence of venous thromboembolism in patients with Achilles tendon rupture. A total of 100 consecutive patients with an acute Achilles tendon rupture were included in a prospective study and randomised to either surgical or non-surgical treatment. At 8 weeks after the initiation of treatment, 95/100 patients were screened for DVT using colour duplex sonography (CDS) with blinded interpretation by two experienced examiners and adjudication in cases of disagreement by a third person. A total of 95 patients (79 male and 16 female) with a median (range) age of 41 (24–63) years were screened for CDS at 8 weeks. Of the 95 patients, 32 had a CDS-verified thrombosis, 5 proximal and 27 distal, whereas 3 had non-fatal pulmonary embolism. Surgical treatment was performed in 49 patients, non-surgical in 46. There were no significant differences in DVT frequency between the two treatment groups. The incidence of asymptomatic and symptomatic deep venous thrombosis is high after Achilles tendon rupture and there is a need to define the possible benefit of thromboprophylaxis.
Caroline F Finch - One of the best experts on this subject based on the ideXlab platform.
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is subsequent lower Limb Injury associated with previous Injury a systematic review and meta analysis
British Journal of Sports Medicine, 2017Co-Authors: L Toohey, Michael K Drew, Jill Cook, Caroline F Finch, Jamie GaidaAbstract:BACKGROUND: Previous Injury is a strong risk factor for recurrent lower Limb Injury in athletic populations, yet the association between previous Injury and a subsequent Injury different in nature or location is rarely considered. OBJECTIVE: To systematically review data on the risk of sustaining a subsequent lower Limb Injury different in nature or location following a previous Injury. METHODS: Eight medical databases were searched. Studies were eligible if they reported lower Limb Injury occurrence following any Injury of a different anatomical site and/or of a different nature, assessed Injury risk, contained athletic human participants and were written in English. Two reviewers independently applied the eligibility criteria and performed the risk of bias assessment. Meta-analysis was conducted using a random effects model. RESULTS: Twelve studies satisfied the eligibility criteria. Previous history of an ACL Injury was associated with an increased risk of subsequent hamstring Injury (three studies, RR=2.25, 95% CI 1.34 to 3.76), but a history of chronic groin Injury was not associated with subsequent hamstring Injury (three studies, RR=1.14, 95% CI 0.29 to 4.51). Previous lower Limb muscular Injury was associated with an increased risk of sustaining a lower Limb muscular Injury at a different site. A history of concussion and a variety of joint injuries were associated with an increased subsequent lower Limb Injury risk. CONCLUSIONS: The fact that previous Injury of any type may increase the risk for a range of lower Limb subsequent injuries must be considered in the development of future tertiary prevention programmes. SYSTEMATIC REVIEW REGISTRATION NUMBER: CRD42016039904 (PROSPERO).
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FROM CONTENT TO CONTEXT: THE DEVELOPMENT OF THE FOOTYFIRST PROGRAM TO PREVENT LOWER Limb INJURIES IN COMMUNITY AUSTRALIAN FOOTBALL
British Journal of Sports Medicine, 2014Co-Authors: Alex Donaldson, Jill Cook, David G. Lloyd, Warren B. Young, G Barbery, Belinda J. Gabbe, Caroline F FinchAbstract:Background Developing Injury prevention programs for community sport is challenging. The Injury issues and interventions must be grounded in science and be both meaningful to, and implementable by, those involved in community sport. Objective This presentation will detail the multi-stage iterative process used to develop FootyFirst, a community-Australian Football (AF) specific lower Limb Injury prevention program. Design The scientific literature, clinical experience, expert and end-user consultations, community trials, theory-informed discussion, and graphic design and editorial expertise, were combined to develop FootyFirst. Setting Community-AF. Results Lower Limb injuries were identified as the major Injury concern and it was established that a combination of balance and control, eccentric hamstring, plyometric and strength exercises could be efficacious in preventing such injuries. The multi-disciplinary research team used evidence from the scientific literature, clinical experience and knowledge of the community-AF context in an iterative process to create and trial the exercises and progressions that were included in the first draft of FootyFirst. This draft was further refined through a Delphi process in which AF-specific lower Limb Injury prevention experts agreed on the appropriateness of including the proposed exercises in FootyFirst. Potential end-user groups (community-AF players, coaches, fitness coaches, sports trainers and administrators) provided feedback about the fit between FootyFirst and the implementation context including potential barriers and facilitators to widespread program adoption and implementation. Trials of FootyFirst were conducted to ensure it could be understood and delivered by community-AF coaches and completed by players. The research team then reviewed the entire program during discussions focused around the Diffusion of Innovations principles of relative advantage, compatibility, complexity, trialability and observability before expert graphic designers and editors were engaged to develop FootyFirst resources. Conclusions The content-to-context process detailed in this presentation was successfully used to develop FootyFirst, an evidence-informed, expert-endorsed, context-specific community-AF lower Limb Injury prevention program.
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Could Targeted Exercise Programmes Prevent Lower Limb Injury in Community Australian Football
Sports Medicine, 2013Co-Authors: Nadine E. Andrew, David G. Lloyd, Belinda J. Gabbe, Jillianne Leigh Cook, Cyril J. Donnelly, Clare Marguerite Mary Nash, Caroline F FinchAbstract:Background Australian football is a popular sport in Australia, at both the community and elite levels. It is a high-speed contact sport with a higher incidence of medically treated injuries when compared with most other organized sports. Hamstring injuries, ligament injuries to the knee or ankle, hip/groin injuries and tendinopathies are particularly common and often result in considerable time lost from sport. Consequently, the prevention of lower Limb injuries is a priority for both community and elite Australian football organizations. There is considerable literature available on exercise programmes aimed at reducing lower Limb injuries in Australian football and other running-related sports. The quality and outcomes of these studies have varied considerably, but indicate that exercise protocols may be an effective means of preventing lower Limb injuries. Despite this, there has been limited high-quality and systematic evaluation of these data.
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Are We Having Fun Yet?
Sports Medicine, 2012Co-Authors: Melanie R. Keats, Carolyn A. Emery, Caroline F FinchAbstract:Sport and recreational activities are the leading cause of Injury in youth, yet there is increasing evidence that many sport-related injuries are preventable. For Injury prevention strategies to be effective, individuals must understand, adopt and adhere to the recommended prevention strategy or programme. Despite the recognized importance of a behavioural approach, the inclusion of behavioural change strategies in sport Injury prevention has been historically neglected. The purpose of this commentary is to outline the rationale for the inclusion and application of behavioural science in reducing the burden of Injury by increasing adherence to proven prevention strategies. In an effort to provide an illustrative example of a behavioural change approach, the authors suggest a specific plan for the implementation of a neuromuscular training strategy to reduce the risk of lower Limb Injury in youth sport. Given the paucity of evidence in the sport Injury prevention setting, and the lack of application of theoretical frameworks to predicting adoption and adherence to Injury preventive exercise recommendations in youth sport, data from the related physical activity promotion domain is utilized to describe how sound, theory-based Injury prevention exercise interventions in youth may be developed. While the question of how to facilitate behavioural change and optimize adherence to preventive exercise recommendations remains an ongoing challenge, the authors detail several strategies based on two prominent behavioural theories to aid the reader in conceptualizing, designing and implementing effective interventions. Despite the minimal application of behavioural theory within the field of sport Injury prevention in youth, behavioural science has the potential to make a significant impact on the understanding and prevention of youth sport Injury. Appropriate evaluation of adherence and maintenance components based on models of behavioural change should be a critical component of future Injury prevention research and practice.
Marianne Jodoin - One of the best experts on this subject based on the ideXlab platform.
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incidence rate of mild traumatic brain Injury among patients who have suffered from an isolated Limb fracture upper Limb fracture patients are more at risk
Injury-international Journal of The Care of The Injured, 2016Co-Authors: Marianne Jodoin, Dominique M Rouleau, Camille Charleboisplante, Stephane Leduc, Benoît Benoît, Georgeyves LaflammeAbstract:Abstract Objectives This study compares the incidence rate of mild traumatic brain Injury (mild TBI) detected at follow-up visits (retrospective diagnosis) in patients suffering from an isolated Limb trauma, with the incidence rate held by the hospital records (prospective diagnosis) of the sampled cohort. This study also seeks to determine which types of fractures present with the highest incidence of mild TBI. Patients and methods Retrospective assessment of mild TBI among orthopaedic monotrauma patients, randomly selected for participation in an Orthopaedic clinic of a Level I Trauma Hospital. Patients in the remission phase of a Limb fracture were recruited between August 2014 and May 2015. No intervention was done (observational study). Main outcome measurements: Standardized semi-structured interviews were conducted with all patients to retrospectively assess for mild TBI at the time of the fracture. Emergency room related medical records of all patients were carefully analyzed to determine whether a prospective mild TBI diagnosis was made following the accident. Results A total of 251 patients were recruited (54% females, Mean age = 49). Study interview revealed a 23.5% incidence rate of mild TBI compared to an incidence rate of 8.8% for prospective diagnosis (χ 2 = 78.47; p 2 = 6.70; p = 0.010). More specifically, patients with a proximal upper Limb Injury were significantly more at risk of sustaining concomitant mild TBI (40.6%; 26/64) compared to distal upper Limb fractures (20.25%; 16/79) (χ 2 = 7.07; p = 0.008). Conclusions Results suggest an important concomitance of mild TBI among orthopaedic trauma patients, the majority of which go undetected during acute care. Patients treated for an upper Limb fracture are particularly at risk of sustaining concomitant mild TBI.