Table 3 Intervention description, OT elements in the intervention, assessment instruments and general conclusions

Jousset et al., 2004

Functional restoration programme (FRP) including intensive physical training, occupational therapy, psychological support and dietic advices a day, 5 days a week, 5 weeks.

Active individual therapy (AIT): 1 hour treatment sessions, 3 times a week during 5 weeks (programme of exercises to perform alone at home for 50 min. on the 2 remaining weekdays.

Daily for 1.15 hrs.

• Flexibility,

• Endurance,

• Co-ordination,

• Weight lifting,

• Work simulation

• Trunk flexibility by fingertip-floor distance

• Trunk strength by isometric contraction (ITO et al & Biering-Sorensen)

• Lifting: Progressive ISO-inertial lifting evaluation (PILE)

• Level op pain: VASQoL & functional indexes

• French version of Dallas pain questionnaire

• Quebec back pain disability scale

• Hospital anxiety depression scale

• Use of prescript medication

FRP was more efficient then AIT in reducing the number of sick leave days, improving physical condition:

• FRP from 102,3 to 28 days

• AIT 109,8 to 48 days

Joy et al., 2001

Work hardening programme:

• Job-specific work simulations

• Physical conditioning

• Education

Patients who did RTW after work hardening program to patients who did not RTW after work hardening program

• Initial intake evaluation,

• Daily activities schedules,

• Case-management,

• Pain management techniques,

• Individual work simulation activities,

• Discharge planning

• Study specific questionnairepain drawing (indicating where pain was felt)

• 10 point pain level indication scale

• Physical assessment

• Functional abilities testing for 16 physical demands

• Exit-questionnaire

• Improvement scale (pain tolerance, activity tolerance) at exit program

• Determining RTW by contacting patients after discharge (1, 6, 12 and 24 months)

No significant differences due to age, gender, length of injury, days spent in work hardening program or change in pain level

Significant difference in pain tolerance (men: 26,8% vs 42,0%; women: 24,2% vs 39,1%)

No significant difference in activity tolerance

Lambeek et al. (2010)

Care as usual

• medical specialist

• occupational physician

• general practitioner

• and/or allied health professionals

Integrated care

• coordination by clinical occupational physician

• team members:

• medical specialist,

• OT,

• physiotherapist;

• integrated care protocol:

• care-management by occupational physician (from 1 to full sustainable work or to week 12)

• work place intervention (using occupational therapist brainstorm (from week 3 tot week 12)

• graded activity (from week 2 till1 full sustainable work or to max. week 12)

• Assessment patients functional capacity at baseline

• Workplace intervention

• 26 sessions of graded activity

• Questionnaires at baseline and 3,6,9,12 months

• primary outcome (full RTW):

- Self reported sick leave

- Data from dbase of the occupational health service

• Secondary outcome:

- VAS (pain)

- Roland disability questionnaire (functional status)

• Prognostic factors for duration of sick leave

- Job content questionnaire (potential work related psycho-social factors)

-Dutch musculoskeletal questionnaire (data on workload)

The integrated care programme substantially reduced disability due to chronic low back pain in private and working life

Schene et al., 2007

Treatment as usual (TAU) (out-patient psychiatric treatment for depression)

• Clinical management

• antidepressants

• 30 min visits every 2-3 weeks

compared to TAU + Occupational Therapy (OT)

• Diagnostic phase (4 weeks) : five contacts with a detailed occupational history, video observation in a role -played work situation, contact with an occupational physician of the patients employer and a plan for work reintegration

• Therapeutic phase (24 weeks): 24 weekly group sessions and 12 individual sessions3 sub phases: preparation to work reintegration, contacting the place of work and if possible starting to workin individual sessions: further analysis of the relationship between work and depression, exploration of work problems, support and evaluation of work resumption

• Follow-up phase (20 weeks) : three individual visits

• DSM-IV (major depression Episode)

• Beck Depression Inventory (BDI)

• Questionnaire organisation stress (QOS)

• Study specific questionnaires

The addition of OT did not accelerate recovery from depression

The addition of OT accelerates and increases work resumption

The addition of OT did not increase work stress

Sullivan et al., 2006

Compare RWT rates of additionally Progressive goal attainment programme (PGAP) to the results of a historical cohort enrolled in a functional restoration physical therapy intervention.

• Education and reassurance

• Maintaining activity log

• Activities scheduling

• Walking programme

• Increasing activity involvement

• Overcoming psychological obstacles to activity involvement

McGill pain questionnaire, pain rating index (MPQ)

Pain catastrophizing scale (PCS)

Tampa scale for kinesiophobia(TSK)

Pain disability Index (PDI)

A psychosocial risk factor targeted intervention in combination with physical therapy can lead to significant increases in the probability of RTW following whiplash injuries. (75% vs 50%)

The combination of psychosocial intervention with physical therapy may emerge as a viable and cost-effective approach for the prevention of prolonged pain and disability following musculoskeletal injury.

Vanderploeg

et al., 2008

Cognitive-didactic programme (CD): 1,5 to 2,5 hours of protocol specific cognitive-didactic interventions (Individual treatment) with another 2 to 2,5 h daily of OT & physiotherapy

Emphasis on building self-awareness

No real life tasks and settings

Functional experiential rehab therapy (FE) 1,5 to 2,5 hrs of protocol specific functional-experimental treatment with another 2 to 2,5 h daily of OT & physiotherapy.

Focus on developing useful functional abilities or skills

All

Basic activities of daily living, range of motion, mobility

CD:

Training 4 cognitive domains (attention, memory executive functions, pragmatic communication)

Trial and error approach

FE:

Real life performance situations and common tasks

Learning by doing

Functional Independence Measure (FIM)

Disability Rating Scale (DRS)

present state examapathy evaluation scaleneurobehavioral rating scalelife satisfaction (self-rating and clinical interview)

No difference between cognitive-didactic and functional-experiential approaches to TBI rehab on primary 1 year global outcome measures.

However, patients at the cognitive treatment arm had better post treatment cognitive performance.

At 1 year post injury, the overall rates of independent living and employment and/or student status were 58,9% and 37,2% respectively.