Purpose
Decisions to increase work participation must be informed and timely to improve return to work (RTW). The implementation of research into clinical practice relies on sophisticated yet ...practical approaches such as machine learning (ML). The objective of this study is to explore the evidence of machine learning in vocational rehabilitation and discuss the strengths and areas for improvement in the field.
Methods
We used the PRISMA guidelines and the Arksey and O’Malley framework. We searched Ovid Medline, CINAHL, and PsycINFO; with hand-searching and use of the Web of Science for the final articles. We included studies that are peer-reviewed, published within the last 10 years to consider contemporary material, implemented a form of “machine learning” or “learning health system”, undertaken in a vocational rehabilitation setting, and has employment as a specific outcome.
Results
12 studies were analyzed. The most commonly studied population was musculoskeletal injuries or health conditions. Most of the studies came from Europe and most were retrospective studies. The interventions were not always reported or specified. ML was used to identify different work-related variables that were predictive of return to work. However, ML approaches were varied and no standard or predominant ML approach was evident.
Conclusions
ML offers a potentially beneficial approach to identifying predictors of RTW. While ML uses a complex calculation and estimation, ML complements other elements of evidence-based practice such as the clinician’s expertise, the worker’s preference and values, and contextual factors around RTW in an efficient and timely manner.
(1) To perform a cross-cultural adaptation of Work Rehabilitation Questionnaire to Russian (WORQ-R); (2) to report the psychometric properties of WORQ-R in patients with traumatic spinal cord injury ...(TSCI).
WORQ is designed to evaluate the work functioning of individuals who are engaged in vocational rehabilitation. We performed a formal cross-cultural adaptation of WORQ from English to Russian utilizing a standardized 3-step approach. We examined the psychometric properties of WORQ-R in terms of its reliability and construct validity through the use of classical and modern test theory in the TSCI population.
The adaptation process achieved equivalence between Russian and English versions of WORQ. WORQ-R proved to cover major issues concerning functioning in vocational rehabilitation and was simple to understand. The internal consistency of WORQ-R was good (Cronbach's Alpha = 0.83). Rasch analysis confirmed the unidimensionality of the WORQ-scale and high reliability (PSI = 0.97) based on a testlet solution. WORQ-R score showed a strong negative correlation with the Functional Independence Measure, moderate negative correlation with the Spinal Cord Independence Measure Version III and the SF-36, moderate positive correlation with the Spinal Cord Injury Secondary Conditions Scale.
WORQ-R showed good validity and reliability in persons with TSCI allowing vocational professionals to have comprehensive information on vocational functioning.
IMPLICATIONS FOR REHABILITATION
SCI is a disabling condition that causes impairments in body structure and function leading to activity limitations and participation restrictions.
WORQ is a generic tool that allows for an assessment of work-related aspects of functioning in different populations of persons with disabilities.
This study demonstrates the psychometric properties of the Russian version of WORQ in the SCI population.
WORQ-R is recommended as a tool to describe the biopsychosocial and related vocational background to gain a better understanding of needs among SCI persons in terms of vocational rehabilitation.
Musculoskeletal disorders of the upper limb are common among semi-automated occupational hand transfer tasks. Ten healthy adults were recruited (five males, five females). Surface electromyography ...(EMG) was collected from eight muscles of the right arm: Upper trapezius, supraspinatus, infraspinatus, brachioradialis, extensor carpi radialis, extensor carpi ulnaris, extensor digitorum indicis, and flexor digitorum superficialis. The task consisted of a repetitive transfer of a 1.8-kg part at 2, 3, and 5
s cycle times (CTs), using power and chuck grips, and under precision and non-precision conditions. EMG was quantified using the amplitude probability distribution function (muscle loading) and gaps analyses (muscle rest). For all muscles, static (tenth percentile APDF) loading exceeded 1% and the muscle rest from gaps was below 10% at 2 and 3
s CT. Precision increased loading in forearm muscles, and increased perceived difficulty (
p<0.001). The findings suggest that precision increased the loading by about 43% in the distal musculature under the conditions tested.
This study will be useful in modeling lower risk CT and designing precision jobs (e.g. hand transfer) in semi-automated industries. Muscle loading and rest as physiologic parameters are influenced differently by CT, grip type and precision requirements of a task.
Understanding chronic pain and disability requires a consideration of the lived experience of the patient. There is limited evaluation of the content validity of patient-reported outcome measures ...(PROMs) in chronic pain using a comprehensive biopsychosocial view of the patient's experience. To address this gap, this study aimed to evaluate the content validity of PROMs for patients with chronic pain. A literature review was performed to identify PROMs for patients with chronic pain. Concepts from PROMs were linked to the International Classification of Functioning, Disability, and Health (ICF); the ICF Core Set for Chronic Widespread Pain; and the International Classification of Diseases-11 Functioning Properties of Chronic Pain (FP). Concepts were compared with published "attributes'' of chronic pain. 62 PROMs (1336 items total) were identified and linked to 560 unique second-level ICF categories. The greatest number of items across PROMs were represented in the activities and participation category (44% of all total items), followed by body functions (41%), environmental factors (9%), personal factors (5%), and body structures (0.3%). There was a 41% to 78% match with the Core Set for Chronic Widespread Pain and the International Classification of Diseases-11 FP, respectively. 20% of items reflected the pain-experience attributes with the most items reflecting the concept of "control over pain." Content validity analysis suggests chronic widespread pain patient-reported outcome measures poorly address attributes of living with chronic pain that matter most to patients. Future development or refinement should consider a more comprehensive view of the patients' lived experience.
Work participation remains challenging for people with spinal cord injury (SCI), as reflected in lower employment rates compared to the general population. To promote work participation for people ...with SCI, practitioners and policymakers need a better understanding of the factors associated with sustaining work in the long term. This study aimed to identify such factors.
Scoping review synthesizing quantitative and qualitative research published between 2000 and 2021. The databases searched were PubMed, CINAHL Complete, PsycINFO, Scopus, and Web of Science.
Initially, 1221 articles were identified. Three quantitative studies investigating socio-demographic and injury-related factors and eight qualitative studies exploring mainly personal and environmental facilitators and barriers to working in the long term were retained. The results of the quantitative studies showed the importance of time since injury, age, and education. The qualitative findings emphasized the positive influence of self-advocacy, managing health behaviors, and a supportive work environment. Main barriers were time organization and societal attitudes.
Future interventions should address the identified factors to promote working in the long term of people with SCI. Policymakers should adapt and enforce legal standards that address environmental and social barriers to creating supportive work environments for persons with SCI.
Implications for rehabilitation
People with spinal cord injury (SCI) experience difficulties in maintaining employment.
Personal factors identified as crucial for working in the long term, such as self-advocacy and self-management of health behaviors, should be strengthened by future interventions.
People with SCI should be offered a supportive work environment with work accommodations and flexible working hours to facilitate their labor market participation.
The assessment of work-related functioning is a key process in vocational rehabilitation to identify specific domains of disability that can be considered within return to work strategies. The Work ...Rehabilitation Questionnaire (WORQ) was developed to evaluate work-related functioning based on the International Classification of Functioning, Disability, and Health (ICF) framework and is available in different languages. The aim of this study was to assess the French version of the WORQ using item response theory to further validate the scale. Rasch analysis of WORQ and the WORQ-BRIEF (a brief version of the WORQ) was performed using a calibration sample of 221 persons with musculoskeletal injuries. A four-testlet solution indicated the unidimensionality of WORQ, with no differential item functioning for age, education, physical job demands, and injury severity. Reliability was 0.969 and 0.918 for WORQ and WORQ-BRIEF, respectively. The minimal detectable change was calculated to be 4.2% of its operational range for WORQ and 8.5% for WORQ-BRIEF. Consequently, the French version of WORQ can be considered a good measure of work-related functioning in musculoskeletal conditions. WORQ can be used in rehabilitation practice to comprehensively identify the disability and guide clinical decision making and intervention planning. Further studies are needed to evaluate the psychometric properties of WORQ in other health conditions.
In her editorial for the May issue of PTJ,1 Resnik discussed a topic that has seemed to have eluded our practice to varying extents but has serious implications to how we practice as physical ...therapists- that is, operationalizing functional reporting using the International Classification of Functioning, Disability and Health (ICF).2 The World Health Assembly approved the ICF in 2001 as the universal model and classification system to describe the functioning of individuals with various health conditions; the ICF is universal in that it can be used across health care, geographic, and cultural settings. The section consisted of 2 articles that critically disentangled the issue of how the ICF could be utilized in clinical physical therapist practice and its benefits in guiding patient management.3,4 In that special section, the authors proposed concrete ways in which the ICF can be implemented in clinical practice,3 and aspects of those proposals could be made consistent with Medicare's recent requirement of functional reporting.5 The first proposal was to use a list of ICF categories from the Generic Set6 and, for each category, document the impairment, limitation, or restriction using a global numerical or percentage rating. ...for the Medicare G code relating to "Carrying, moving, and handling objects,"5 the ICF categories d430 (Lifting and carrying objects), d435 (Moving objects with lower extremities), d440 (Fine hand use), and d445 (Hand and arm use) could be assessed to provide the physical therapist with a comprehensive picture of the patient's functioning relevant to that particular G code. ...in this case, the ICF does provide concrete concepts of functioning that are more specific than the Medicare-prescribed G code.
To detail the methodological features of the first International Spinal Cord Injury (InSCI) Community Survey by describing recruitment and data collection procedures, and to report on the recruitment ...results and basic characteristics of participants by country and income setting.
Cross-sectional survey.
Community setting in 22 countries representing all 6 World Health Organization regions.
Individuals (N=12,591) with traumatic or non-traumatic spinal cord injury (SCI) aged over 18 years.
Not applicable.
Recruitment and data collection procedures, recruitment results, and basic sociodemographic and lesion characteristics of participants.
Eight countries used predefined sampling frames and 14 countries applied convenience sampling for recruitment. Most countries recruited participants through specialized rehabilitation facilities, patient organizations, or acute and general hospitals. Modes of approaching potential participants depended on the sampling strategy and multiple response modes were offered to maximize participation. Contact rates ranged from 33% to 98%, cooperation rates ranged from 29% to 90%, and response rates ranged from 23% to 54%. The majority of participants were men (73%), the median age was 52 years (interquartile range, 40-63y), 60% had a partner, 8% reported that they were born in another country than where they were currently residing, and the median length of education was 12 years (interquartile range, 9-15y). Paraplegia was the main diagnosis (63%), traumatic etiologies were the major cause of injury (81%), and the median time since injury (TSI) was 9 years (interquartile range, 4-19y). Compared with participants from lower income settings, participants from higher income settings were over-represented and, in general, were older, more often diagnosed with tetraplegia, had a longer TSI, higher education, and were more often born in a country different than their current residence country.
The successful implementation of the InSCI survey enables the comparison of the situation of individuals with SCI around the world and constitutes a crucial starting point for an international learning experience.
Purpose: Arthritis is associated with lost wages, work disability, and decreased productivity. There is a lack of knowledge regarding contextual factors that influence worker productivity to inform ...rehabilitation. Our study aims to identify the essential contextual factors that need to be considered when measuring worker productivity outcomes in people with arthritis.
Materials and methods: A three-round international Delphi survey was performed. Round 1 (N = 50) elicited a comprehensive list of contextual factors. In Round 2 (N = 27), participants ranked their top ten factors from the list in Round 1. In Round 3 (N = 27), participants ranked their top five factors and their suggested outcome measures.
Results: The key contextual factors identified in the Delphi are (1) type of job (e.g., level of physical demand, manual vs. sedentary), (2) personal factors (e.g., attitude, self-esteem, personal satisfaction, motivation), (3) disease state, (4) financial need, (5) societal incentive (e.g., insurance, government support, return to work transition programs), and (6) age.
Conclusion: Future clinical trials in arthritis measuring worker productivity should consider the type of job (physical demands), personal factors, and disease state (as related to physical function). Contextual factors are not well investigated in the area but are crucial to developing the appropriate rehabilitation interventions.
Implications for rehabilitation
This study identifies key contextual factors affecting worker productivity in people with arthritis: type of job, personal factors, disease state, financial need, societal incentive, and age.
To facilitate proper interpretation of patient outcomes, rehabilitation professionals should consider contextual factors alongside their standard assessment tools.
These findings provide a framework in designing rehabilitation programs and clinical trials on worker productivity in arthritis.
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