Work resumption after occupational osteoarticular injury: interdisciplinary protocol and case record

We describe an interdisciplinary protocol for work resumption after serious occupational osteoarticular injury and subsequent rehabilitation. The outcomes obtained over two years are presented. Between 2010 and 2011, 159 injured patients (55 females, 104 males), aged between 19 and 75 years (average 44.8), were examined by the physiatrist and the occupational physician, to establish their functional capabilities and task features. The frequency, timing and modalities of work resumption were evaluated by telephonic follow-up, at 6 and 12 months after rehabilitation. The majority (66.7%) of the sample were manual workers, with moderate or heavy tasks. A fraction (8.8%) were healthcare operators. Injuries involved one or more of the following: upper limb (42.8%), lower limb (37.7%), cervical/dorsal spine (30.8%), lumbar/sacral spine (10.1%), other sites (10.1%). Associated peripheral nervous system damage was present in 15.1% of cases. Rehabilitation resulted in decreased pain and improved function. After 6 months, 116 out of 143 subjects available for follow-up (81.1%) had returned to work: 104 had returned to their previous tasks, on average after 14.6 days. Nine patients had changed job, 13 had partially changed the previous work tasks (average resumption time: 48.5 days), and 4 had resumed straightaway with temporary (< 3 months) limitations. After 12 months, 120 out of 141 (85.1%) subjects were working, 12 of them with limitations and/or partially changed tasks. The most relevant findings of the study are both the high percentage of patients returning to work (with few task changes), including those performing high-energy requirement jobs, and the short time required. The difficulty of work resumption for those who failed to restart work within 6 months indicates that the beneficial effect of rehabilitation is maximal in the short-medium period. This study highlights the importance of an interdisciplinary rehabilitative approach to facilitate work resumption after osteoarticular injury, adapting the work tasks to the changed physical capabilities.