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Job Strain in Physical Therapists

Campo, Marc A; Weiser, Sherri; Koenig, Karen L
Background Job stress has been associated with poor outcomes. In focus groups and small-sample surveys, physical therapists have reported high levels of job stress. Studies of job stress in physical therapy with larger samples are needed. Objective The purposes of this study were: (1) to determine the levels of psychological job demands and job control reported by physical therapists in a national sample, (2) to compare those levels with national norms, and (3) to determine whether high demands, low control, or a combination of both (job strain) increases the risk for turnover or work-related pain. Design This was a prospective cohort study with a 1-year follow-up period. METHODS:/b> Participants were randomly selected members of the American Physical Therapy Association (n=882). Exposure assessments included the Job Content Questionnaire (JCQ), a commonly used instrument for evaluation of the psychosocial work environment. OUTCOMES: included job turnover and work-related musculoskeletal disorders. RESULTS: /b> Compared with national averages, the physical therapists reported moderate job demands and high levels of job control. About 16% of the therapists reported changing jobs during follow-up. Risk factors for turnover included high job demands, low job control, job strain, female sex, and younger age. More than one half of the therapists reported work-related pain. Risk factors for work-related pain included low job control and job strain. Limitations The JCQ measures only limited dimensions of the psychosocial work environment. All data were self-reported and subject to associated bias. CONCLUSIONS:/b> Physical therapists' views of their work environments were positive, including moderate levels of demands and high levels of control. Those therapists with high levels of demands and low levels of control, however, were at increased risk for both turnover and work-related pain. Physical therapists should consider the psychosocial work environment, along with other factors, when choosing a job
PMID: 19608632
ISSN: 1538-6724
CID: 101235

Work-related musculoskeletal disorders in physical therapists: a prospective cohort study with 1-year follow-up

Campo, Marc; Weiser, Sherri; Koenig, Karen L; Nordin, Margareta
BACKGROUND: Work-related musculoskeletal disorders (WMSDs) have a significant impact on physical therapists, but few studies have addressed the issue. Research is needed to determine the scope of the problem and the effects of specific risk factors. OBJECTIVES: The objectives of this study were: (1) to determine the 1-year incidence rate of WMSDs in physical therapists and (2) to determine the effects of specific risk factors. DESIGN: This was a prospective cohort study with 1-year follow-up. METHODS: Subjects were randomly selected American Physical Therapy Association members (N=882). Exposure assessment included demographic data, physical risk factors, job strain, and specific physical therapy tasks. The primary outcome was WMSDs, with a severity rating of at least 4/10 and present at least once a month or lasting longer than a week. RESULTS: The response rate to the baseline questionnaire was 67%. Ninety-three percent of the subjects who responded to the baseline questionnaire responded to the follow-up questionnaire. The 1-year incidence rate of WMSDs was 20.7%. Factors that increased the risk for WMSDs included patient transfers, patient repositioning, bent or twisted postures, joint mobilization, soft tissue work, and job strain. LIMITATIONS: The primary limitation of this study was the number of therapists who had a change in their job situation during the follow-up year. CONCLUSIONS: Work-related musculoskeletal disorders are prevalent in physical therapists. Physical therapy exposures, patient handling, and manual therapy, in particular, increase the risk for WMSDs
PMID: 18276935
ISSN: 1538-6724
CID: 78454

Non-specific low back pain

Chapter by: Brunner F; Weiser S; Schmid A; Nordin M
in: Spinal disorders : fundamentals of diagnosis and treatment by Boos N; Aebi M [Eds]
Berlin ; New York : Springer, 2008
pp. 585-598
ISBN: 3540690913
CID: 5098

Nonspecific low back pain

Chapter by: Hiebert R; Weiser S; Campello M; Nordin M
in: Environmental and occupational medicine by Rom WN; Markowitz S [Eds]
Philadelphia : Wolters Kluwer/Lippincott Williams & Wilkins, 2007
pp. 924-936
ISBN: 0781762995
CID: 4809

Self-care techniques for acute episodes of back pain

Chapter by: Weiser S; Campello M; Nordin M; Pietrek M
in: Pain : best practice & research compendium by Breivik H; Shipley M [Eds]
Edinburgh : Elsevier, 2007
pp. 83-92
ISBN: 0080446841
CID: 4808

Psychosocial aspects of work-related musculoskeletal disorders : clinical implications

Chapter by: Weiser S
in: Musculoskeletal disorders in the workplace : principles and practice by Nordin M; Andersson G; Pope M [Eds]
Philadelphia : Mosby Elsevier, 2007
pp. 13-18
ISBN: 0323026222
CID: 5099

Work retention and nonspecific low back pain

Campello, Marco A; Weiser, Sherri R; Nordin, Margareta; Hiebert, Rudi
STUDY DESIGN: A cohort study of patients with nonspecific low back pain (LBP) participated in a 4-week multidisciplinary rehabilitation program. OBJECTIVE: To identify factors that predict work retention 24 months after treatment in patients with nonspecific LBP. SUMMARY OF BACKGROUND DATA: There is evidence that select physical, psychologic, and psychosocial factors are related to positive outcome for work-related nonspecific LBP. However, there is very little information related to work retention following an episode of nonspecific LBP. This is an exploratory study to identify select physical and psychosocial factors related to work retention. METHODS: Patients who returned to work after treatment (n = 67) were followed for 2 years. Physical baseline measures included tests of flexibility, strength, and functional capacity. Psychosocial baseline measures were The Symptoms Checklist 90-R, The Pain Beliefs and Perceptions Inventory, The Oswestry Scale of perceived disability, The Work Stress Inventory, and The Quality of Life Scale. All physical parameters, perceived disability, and quality of life were tested before and after treatment. The dependent variable, work retention, was defined as the number of days that the subject worked during the 2-year follow-up period. Survival analysis was used to establish the predictive model. RESULT: The average time out of work before treatment was 9 months (standard deviation 12.8) for 67 subjects (mean age 40 years [standard deviation 9.6]), including 18 females and 49 males. There were 18 participants (25%) that had interruption of work retention at follow-up. Average work retention was 362 days (range 47-682). Variables that reached a P value of <0.10 in the bivariate analysis were included in the multivariate analysis. They were trunk flexion (hazard ratio [HR = 2.4], 95% confidence interval [CI] 1.24-4.38; P = 0.01), trunk extension (HR = 2.1, 95% CI 1.02-4.16; P = 0.04), the somatization scale from the Symptom Checklist 90 revised (HR = 2.0, 95% CI 1.03-4.05; P = 0.04), and the obsessive-compulsiveness scale from the Symptom Checklist 90 revised (HR = 0.4, 95% CI 0.12-1.15; P = 0.09). Results showed that post-test trunk flexion, somatization, and obsessive compulsiveness predicted work retention (final trunk flexion HR = 2.5 [95% CI 1.26-4.79; P = 0.01], somatization scale HR = 2.5 [95% CI 1.25-4.93; P = 0.01], and obsessive compulsion HR = 0.2 [95% CI 0.07-0.77; P = 0.02]). CONCLUSION: Psychosocial and physical factors are associated with work retention for patients with nonspecific LBP. The predictive value of certain constructs may vary with the time when they are assessed and how outcome is operationalized. Further studies are needed to confirm these findings
PMID: 16845363
ISSN: 1528-1159
CID: 67009

Triage for nonspecific lower-back pain

Weiser, Sherri; Rossignol, M
Unremitting lower-back pain has long been a costly and personally devastating problem in society. Guidelines for the treatment of lower-back pain have provided evidence-based recommendations to help identify patients who will benefit from specific types of treatment in an effort to reduce costs and human suffering. However, there is little evidence that these guidelines are being applied in the daily practice of health care providers. Practical information is required to assist health care providers in triaging patients for specific treatments so that interventions can be targeted only to those who need them. In this way, iatrogenic complications and unnecessary costs can be contained. This chapter provides information on how to triage the patient with nonspecific lower-back pain for optimal care. The recommendations are supported by evidence-based guidelines, and when these are not available, best practice principles. Because appropriate treatment varies depending on the length of time a patient is suffering from lower-back pain, the chapter is divided into recommendations for acute, subacute, chronic and recurrent phases of lower-back pain. LEVEL OF EVIDENCE: Level V (expert opinion). See the Guidelines for Authors for a complete description of the levels of evidence
PMID: 16462439
ISSN: 0009-921x
CID: 67841

Non-specific low back pain : current issues in treatment

Chapter by: Nordin M; Lis A; Weiser S; Campello M
in: The adult and pediatric spine by Frymoyer JW; Wiesel SW [Eds]
Philadelphia : Lippincott Williams & Wilkins, 2004
pp. 307-321
ISBN: 0781735491
CID: 4556

Le centre pilote pour les troubles musculosquelletiques de l'Occupational and Industrial Orthopaedic Center (OIOC) et du National Institute for Occupational Safety and Health (NIOSH)

Nordin, M; Perry, J; Campello, M; Weiser, S; Halpern, M; Hiebert, R; Van, Doorn, JW
ISSN: 1169-8330
CID: 564252