Browsing by Subject "musculoskeletal disorders"

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  • Russo, Fabrizio; De Salvatore, Sergio; Ambrosio, Luca; Vadalà, Gianluca; Fontana, Luca; Papalia, Rocco; Rantanen, Jorma; Iavicoli, Sergio; Denaro, Vincenzo (2021)
    Low back pain (LBP) is currently the leading cause of disability worldwide and the mostcommon reason for workers’ compensation (WC) claims. Studies have demonstrated that receivingWC is associated with a negative prognosis following treatment for a vast range of health conditions.However, the impact of WC on outcomes after spine surgery is still controversial. The aim of thismeta-analysis was to systematically review the literature and analyze the impact of compensationstatus on outcomes after lumbar spine surgery. A systematic search was performed on Medline,Scopus, CINAHL, EMBASE and CENTRAL databases. The review included studies of patientsundergoing lumbar spine surgery in which compensation status was reported. Methodologicalquality was assessed through ROBINS-I and quality of evidence was estimated using the GRADErating. A total of 26 studies with a total of 2668 patients were included in the analysis. WC patientshad higher post-operative pain and disability, as well as lower satisfaction after surgery whencompared to those without WC. Furthermore, WC patients demonstrated to have a delayed return towork. According to our results, compensation status is associated with poor outcomes after lumbarspine surgery. Contextualizing post-operative outcomes in clinical and work-related domains helpsunderstand the multifactorial nature of the phenomenon.
  • Kausto, Johanna; Rosenstrom, Tom Henrik; Ervasti, Jenni; Pietiläinen, Olli; Kaila-Kangas, Leena; Rahkonen, Ossi; Harkko, Jaakko; Väänänen, Ari; Kouvonen, Anne; Lallukka, Tea (2021)
    Objective An intervention was carried out at the occupational healthcare services (OHS) of the City of Helsinki beginning in 2016. We investigated the association between the intervention and employee sick leaves using interrupted time series analysis. Design Register-based cohort study with a quasi-experimental study design. Setting Employees of the City of Helsinki. Participants We analysed individual-level register-based data on all employees who were employed by the city for any length of time between 2013 and 2018 (a total 86 970 employees and 3 014 075 sick leave days). Sick leave days and periods that were OHS-based constituted the intervention time series and the rest of the sick leave days and periods contributed to the comparison time series. Intervention Recommendations provided to physicians on managing pain and prescribing sick leave for low back, shoulder and elbow pain. Outcome measures Number of sick leave days per month and sick leave periods per year. Results For all sick leave days prescribed at OHS, there was no immediate change in sick leave days, whereas a gradual change showing decreasing number of OHS-based sick leave days was detected. On average, the intervention was estimated to have saved 2.5 sick leave days per year per employee. For other sick leave days, there was an immediate increase in the level of sick leave days after the intervention and a subsequent gradual trend showing decreasing number of sick leave days. Conclusions The intervention may have reduced employee sick leaves and therefore it is possible that it had led to direct cost savings. However, further evidence for causal inferences is needed.
  • Ropponen, Annina; Silventoinen, Karri Tapani; Koskenvuo, Markku Juhani; Svedberg, Pia; Kaprio, Jaakko Arthur (2016)
    AIMS: To investigate whether stability or change in body mass index (BMI) predict disability pension (DP) due to musculoskeletal diagnosis (MSD) when controlling for familial confounding. METHODS: Our study cohort consisted of 17,169 Finnish twins born before 1958. Data on BMI and multiple covariates from questionnaires in 1975 and 1981 were included and DPs were collected from the national pension registers until the end of 2004. Cox proportional hazards regression models with Hazard Ratios (HR) and 95% Confidence Intervals (CI) were used for statistical analyses. RESULTS: General DP was granted to 2853 individuals and DP due to MSD to 1143 individuals during the 23-year follow-up. A one-unit increase in BMI in both 1975 (HR 1.08, 95% CI 1.05, 1.10) and 1981 (HR 1.06, 95% CI 1.04, 1.07), as well as the stability of and change in BMI from 1975 to 1981 were all associated with an increased risk of DP. These associations held in the analyses controlling for multiple covariates (age, sex, socioeconomic status, education, marital status, leisure-time physical activity, and musculoskeletal pain), and mainly also familial confounding, that is, genetics and shared environment. HR for stable obesity was 2.28 (95% CI 1.69, 3.08) for DP due to MSD, and 1.91 (95% CI 1.56, 2.34) for general DP in the fully adjusted models. CONCLUSIONS: BMI is an early predictor of general DP and also of DP due to MSD. Owing to the independency of various covariates and potentially also familial confounding, BMI may possibly have a direct effect on the risk of DP.