Journal Of Occupational Rehabilitation[JOURNAL]
Sun
200 papers
Occupational Exoskeletons as a Technological Solution for Musculoskeletal Disorders: A Systematic Review of Barriers and Facilitators for Sustainable Workplace Integration.
van Laar DM, Bieleman HJ, Rijnders CSI … +3 more , Saakes DP, Reneman MF, Roossien CC
J Occup Rehabil · 2026 May · PMID 42098532 · Publisher ↗
PURPOSE: Widespread adoption of occupational exoskeletons (OEX) depends on various human and environmental factors. This systematic review aimed to provide an overview of facilitators and barriers influencing OEX impleme...
PURPOSE: Widespread adoption of occupational exoskeletons (OEX) depends on various human and environmental factors. This systematic review aimed to provide an overview of facilitators and barriers influencing OEX implementation, according to users and interest holders. METHODS: A systematic search of PubMed and EMBASE identified 28 studies on active or passive OEX and opinions on acceptance or rejection during implementation. RESULTS: Facilitators were reported slightly more often than barriers (128 times vs. 110 times), with 70 facilitators and 67 barriers identified. Barriers were most frequently associated with the Device domain (36.4%), followed by the Person/User (24.5%), Work/Job (20.0%), Company/Management (14.5%), and Attitude (4.5%) domains. In contrast, facilitators were primarily linked to the Person/User domain (28.1%), closely followed by the Work/Job domain (26.6%) and then the Device (20.3%), Company/Management (18.8%), and Attitude (6.3%) domains. Studies with short OEX exposure reported fewer barriers than those without actual OEX use or experience (25 vs. 50). Overall risk of bias was moderate across study designs, with common issues including limited reporting, small or convenience samples, and the unavoidable absence of blinding in trials. CONCLUSION: OEX adoption is shaped by multiple factors, some acting as both facilitators and barriers. User-centered strategies (such as training and hands-on familiarization) are critical, as short-term exposure appears to reduce barriers. REGISTRATION: PROSPERO (CRD420251090106).
How Do Self-Employed Workers Navigate Illness? A Gender-Based Analysis of Informal Support Systems.
Khan TH, MacEachen E
J Occup Rehabil · 2026 May · PMID 42096118 · Publisher ↗
PURPOSE: This study examines how solo self-employed (SE) men and women in Ontario, Canada, navigate informal support systems during periods of illness, injury, or income loss. It investigates gendered motivations for ent...
PURPOSE: This study examines how solo self-employed (SE) men and women in Ontario, Canada, navigate informal support systems during periods of illness, injury, or income loss. It investigates gendered motivations for entering self-employment and addresses the research question: How do gender norms shape self-employed workers' access to and use of informal supports during health-related work disruptions? METHODS: A qualitative narrative approach was adopted, guided by an interpretive paradigm and an intersectionality framework. Twenty-four solo self-employed workers who experienced illness or income loss were recruited through social media and interviewed online between January and July 2021. Interviews were transcribed verbatim and analyzed using Riessman's narrative thematic method. Deductive and inductive coding informed the development of analytical themes capturing gendered experiences of informal support. RESULTS: Findings show distinct gendered patterns in motivations for self-employment and in accessing informal support. Women frequently entered this work for flexibility linked to caregiving roles and, when ill, relied heavily on close family and emotionally intimate networks. Men more often pursued self-employment for higher income and autonomy and drew on broader peer or community networks for practical assistance, while avoiding emotional disclosure. Across genders, reliance on personal savings emerged as a central coping mechanism due to limited access to formal income-replacement systems. However, low-income self-employed workers, specially gig workers, struggled to save adequately, exacerbating their vulnerability during illness. CONCLUSION: Informal support systems function as essential but uneven safety nets for solo SE'd workers, with access and usage shaped by gender norms. These findings highlight the need for gender-responsive policy reforms that extend income protection and address structural gaps in social security for the self-employed.
Return to Work and Psychosocial Adaptation Trajectories in Young and Middle-Aged Patients with Stroke: A 12-Month Longitudinal Cohort Study.
Sun X, Pan X, Li J … +5 more , Li Y, Zhong W, Chen L, Zhang Y, Xu L
J Occup Rehabil · 2026 May · PMID 42096117 · Publisher ↗
PURPOSE: Return to work (RTW) is a key outcome of occupational rehabilitation for working-age stroke survivors, yet marked individual differences exist in RTW success and timing. This study aimed to identify longitudinal...
PURPOSE: Return to work (RTW) is a key outcome of occupational rehabilitation for working-age stroke survivors, yet marked individual differences exist in RTW success and timing. This study aimed to identify longitudinal trajectories of psychosocial adaptation among young and middle-aged patients with stroke and to examine their bidirectional associations with RTW outcomes during the first year after discharge. METHODS: In this prospective longitudinal cohort study, 237 stroke survivors aged 18-59 years were assessed at discharge and at 3-, 6-, and 12-month post-discharge. Psychosocial adaptation was measured using the Psychosocial Adaptation to Illness Scale-Self-Report (PAIS-SR). Latent class growth modeling identified distinct adaptation trajectories among patients who had not returned to work at 3 and 6 months (n = 189). Logistic regression and generalized estimating equations examined associations between adaptation trajectories and RTW status and timing. RESULTS: Three psychosocial adaptation trajectories were identified: a High Adaptation-Enhanced group (24.87%); a Medium Adaptation group (40.74%); and a Persistently Low Adaptation group (34.39%). RTW rates at 12 months differed significantly across trajectories (46.81%, 22.08%, and 24.62%, respectively; P = 0.008). Compared with the Persistently Low Adaptation group, patients in the High Adaptation-Enhanced group had higher odds of RTW (OR = 2.70, 95% CI 1.21-6.02). In the full cohort, earlier RTW was associated with significantly better psychosocial adaptation at 12 months. CONCLUSION: Psychosocial adaptation trajectories are a key determinant of successful return to work after stroke, while earlier RTW is associated with better subsequent adaptation. Early identification of patients at risk of poor adaptation and implementation of supported RTW strategies may enhance occupational rehabilitation outcomes.
Telehealth Treatments of Common Psychological Disorders: An Overview and Meta-analysis.
Gerdes R, Roberts R, Jackson TD … +15 more , Premji R, Deibert D, Choi C, Steer KJD, Bani-Fatemi A, Dennett L, Lytvyak E, Ferguson-Pell M, Tsuyuki R, Durand-Moreau Q, Gross DP, Hagtvedt R, Vandermeer B, Nowrouzi-Kia B, Straube S
J Occup Rehabil · 2026 May · PMID 42091825 · Publisher ↗
PURPOSE: The evidence base for telehealth treatments for mental health has grown substantially in the years following the COVID-19 pandemic. We conducted a narrative synthesis and meta-analysis of reviews investigating t...
PURPOSE: The evidence base for telehealth treatments for mental health has grown substantially in the years following the COVID-19 pandemic. We conducted a narrative synthesis and meta-analysis of reviews investigating the efficacy of live, one-to-one telehealth interventions for common mental disorders. METHODS: We conducted a search for systematic reviews of randomized controlled trials or controlled before-and-after studies. Two independent reviewers screened potentially eligible references and extracted data from all eligible reviews. A meta-regression was conducted with reviews containing data suitable for quantitative analysis. A narrative synthesis of results was undertaken for included reviews that did not contain suitable quantitative data. RESULTS: The search yielded 4180 references, from which 11 eligible reviews were identified. Seven systematic reviews with meta-analyses were included in the meta-regression. Only telehealth interventions for depression and anxiety disorders were identified in the eligible literature. A small significant effect was observed for interventions targeting depression and comparing to active control, where SMD = - 0.316, and p = 0.003. CONCLUSIONS: The results of the meta-regression and narrative synthesis indicate that live one-to-one telehealth produces similar reductions in symptom severity across diagnoses and comparator groups. We identified that most of the research on telehealth for common mental disorders includes low-intensity, self-help tools with reduced clinician involvement, highlighting that much of the research conducted in this area aims at providing care at reduced cost, despite the importance of therapeutic alliance in the provision of mental health care. Investigations of telehealth interventions targeting posttraumatic stress disorder in non-military populations are also needed.
Regional Variation in Management Strategies for Occupational Low Back Pain in Australia.
Xia T, Fini MA, Newton F … +3 more , Collie A, Nielsen S, Di Donato M
J Occup Rehabil · 2026 May · PMID 42084752 · Publisher ↗
PURPOSE: Little is known about transitions in physical therapy and pharmaceutical pain management among workers' compensation (WC) claims with lower back pain (LBP). This study examined these transitions within Victoria'...
PURPOSE: Little is known about transitions in physical therapy and pharmaceutical pain management among workers' compensation (WC) claims with lower back pain (LBP). This study examined these transitions within Victoria's WC system-one of 11 in Australia-to better understand treatment pathways and potential geographic variation. METHODS: Treatment transitions were analysed using Markov transition matrixes based on 32,132 accepted LBP claims with two years of medicine and service data from the Victorian WC scheme (01/01/2010-31/12/2017; data censored 31/12/2019). Transitions were assessed within 1, 3, 6, 12, and 24 months post claim. Geographic location was coded as major city/inner regional vs. outer regional/remote. RESULTS: Physical therapy was initiated earliest (median: 77 days post claim; interquartile range [IQR]: 19-217). Opioids and other medications followed, with median initiation at 162 (IQR: 36-412) and 157 (IQR: 77-407) days, respectively. During the acute period, an 11.8% lower proportion of workers from outer regional/remote areas received physical therapies compared to those from major cities/inner regional areas, this gap remained consistent throughout the entire follow-up period. They also showed slightly higher probabilities of receiving only pharmaceutical treatment, particularly during the sub-acute and persistent periods. CONCLUSION: The findings reveal geographic disparities in recommended treatment guidelines. Opioids were more likely used as first-line treatments for WC claims in outer regional/remote areas, while physical therapy was favoured in major cities/inner regional areas. Further research should explore whether accessibility contributes to these disparities. Understanding such disparities is essential for informing targeted interventions, clinician education, and resource distribution.
Barriers and Facilitators to Implementing Early Intervention Programmes in Compensable Settings: A Multi-stakeholder Qualitative Study in Australia.
Sim A, McNeilage AG, Richardson C … +1 more , Ashton-James CE
J Occup Rehabil · 2026 May · PMID 42084751 · Publisher ↗
PURPOSE: This qualitative study aimed to explore the perspectives of researchers, insurance personnel, and regulators on the barriers and facilitators to implementing early intervention programmes in compensable settings...
PURPOSE: This qualitative study aimed to explore the perspectives of researchers, insurance personnel, and regulators on the barriers and facilitators to implementing early intervention programmes in compensable settings in Australia. METHODS: Nineteen participants from across Australia were interviewed using a semi-structured format. Interviews were transcribed verbatim and thematic analysis was conducted. RESULTS: Through thematic analysis, five key themes were constructed: the knowing-doing gap: shared commitment but fragmented implementation; innovation versus inertia: organisational forces that shape implementation; evidence lost in practice: how low-value care undermines early intervention; bound by the system: legislative and bureaucratic barriers to early intervention; and invisible obstacles: why claims don't start when injuries do. These themes reveal that whilst early intervention is widely valued, its implementation is constrained by fragmented definitions, organisational resistance, misaligned clinical practices, legislative complexity, and delays in claim lodgement. CONCLUSION: Findings suggest that achieving timely and effective early intervention requires more than clinical strategies; it demands system-level reform. Coordinated leadership, policy innovation, and streamlined processes are essential to overcome entrenched structural barriers. Initiatives such as public education, provider accreditation, and legislative reform may enhance access to evidence-based care and improve recovery outcomes for claimants.
Self-Management Interventions and Work Participation in Individuals with Musculoskeletal Disorders: A Scoping Review.
Longtin C, Spence LA, Hong QN … +2 more , Hutting N, Décary S
J Occup Rehabil · 2026 Apr · PMID 42060183 · Publisher ↗
PURPOSE: Many individuals with work disability due to musculoskeletal disorders struggle to achieve a sustainable return to work. Although self-management interventions offer promising avenues to support work participati...
PURPOSE: Many individuals with work disability due to musculoskeletal disorders struggle to achieve a sustainable return to work. Although self-management interventions offer promising avenues to support work participation, their content, delivery characteristics and evaluation approaches remain unclear. This scoping review aimed to map the self-management interventions evaluated in relation to work participation among individuals with work disability due to musculoskeletal disorders, including their components, delivery methods and evaluation approaches. METHODS: A scoping review was conducted in 10 databases (Academic Search Complete, AMED, SPORTDiscus, Medline, PsycINFO, CINAHL, Embase, Scopus, Cochrane Library, Physiotherapy Evidence Database) from inception to July 2025. Primary studies involving working-age individuals with musculoskeletal disorders, a self-management intervention and an assessment of work participation were included. RESULTS: Out of 8310 records, 31 studies representing 23 self-management interventions were included with a median of 10 components (range 3-16). Most studies included non-specific musculoskeletal disorders (n = 13, 41.9%) or low back pain (n = 8, 29%). Less than half of interventions included content specific to work (n = 10, 43%), lifestyle changes (n = 9, 39%), resource utilization (n = 8, 35%), and communication skills (n = 7, 30%). Interventions were typically delivered in person (n = 12, 52%), individually (n = 14, 61%), and with clinician involvement (n = 15, 65%), while 43% (n = 10) incorporated digital health. Most studies focused on intervention effectiveness (n = 23, 72%), assessing work ability (n = 10, 30.4%), sick leave and return to work (n = 9, 39.1%), and work disability (n = 7, 30.4%). Fewer studies included process outcomes (n = 14, 45%) or participant views (n = 8, 26%). CONCLUSION: This review revealed considerable heterogeneity in self-management components, delivery and evaluation methods. It identifies key gaps, suggesting the potential value of workplace-integrated self-management interventions to better support work participation.
Generic and Disease-Specific Themes in Occupational Reflections of Patients in Cardiac, Cancer and Orthopedic Rehabilitation: An Interview Study.
Luizink-Dogan M, Mönnich LL, Holmberg C … +2 more , Völler H, Salzwedel A
J Occup Rehabil · 2026 Apr · PMID 42060182 · Publisher ↗
PURPOSE: To explore occupational perspectives of patients with elevated risk of non-return to work (RTW) in cardiac, cancer, and orthopedic rehabilitation. What themes are relevant when patients in medical rehabilitation...
PURPOSE: To explore occupational perspectives of patients with elevated risk of non-return to work (RTW) in cardiac, cancer, and orthopedic rehabilitation. What themes are relevant when patients in medical rehabilitation reflect on their occupational future, and to what extent are identified themes specific to medical specialty? METHODS: Face-to-face interviews were conducted with 51 patients (63% female, median age 55) of elevated risk of non-RTW in post-acute rehabilitation after hospital stay for an acute cardiac (n = 20), cancer (n = 15), or orthopedic disease (n = 16). Six months after rehabilitation discharge, 41 (80%) participants were interviewed again, to analyze the significance and relevance of the collected themes after return to daily life. The transcripts of audio-recorded interviews were analyzed by a combination of flexible pattern matching and thematic analysis. RESULTS: In their occupational reflections, patients considered seven themes related to health (perception of health / health behavior and lifestyle), work (characteristics of professional career/reintegration options/motives for (non) RTW), and personhood (uncertainty about the future/perception of the environment). Disease-specific aspects were found in heart-related anxiety for cardiac patients, perceived uncertainty about the future for cancer patients, and workplace/work characteristics for orthopedic patients. 61% of the participants did not RTW within six months after rehabilitation discharge. CONCLUSION: Occupational reflections of all patients were characterized by the same set of themes, with some themes having more relevance depending on participants' medical specialty. Perceived uncertainty, health issues and expected barriers led to missing plans for future health-management and RTW-strategies and highlight the need for an occupational planning tool.
Are Newly Graduated Physiotherapists in Quebec Prepared for Work Rehabilitation Practice? A Mixed Method Study.
Longtin C, Hong QN, Coutu MF … +9 more , Alpdogan NY, Singer L, Cooper L, Bussières A, Carrière J, Bertrand-Charette M, Perreault K, Hudon A, Wideman TH
J Occup Rehabil · 2026 Apr · PMID 42060181 · Publisher ↗
PURPOSE: Physiotherapists are frontline providers in supporting the return-to-work process of individuals with musculoskeletal disorders. However, many report feeling unprepared for work rehabilitation following entry-le...
PURPOSE: Physiotherapists are frontline providers in supporting the return-to-work process of individuals with musculoskeletal disorders. However, many report feeling unprepared for work rehabilitation following entry-level training. This study explored recent physiotherapy graduates in Quebec, Canada, perceived preparedness to practice in work rehabilitation and its influencing factors. MATERIALS AND METHODS: A convergent mixed methods design grounded in a competency-based framework was used. Recent graduates from physiotherapy programs completed a cross-sectional survey rating their perceived preparedness across seven work rehabilitation competencies. Semi-structured individual interviews explored how their training prepared them for work rehabilitation practice. Quantitative data were analyzed descriptively, and interviews were thematically analyzed. Findings were integrated through a joint display to contextualize preparedness ratings with qualitative insights. RESULTS: Twenty-five recent graduates from five physiotherapy programs across the province of Quebec completed both the survey and the interview. Perceived preparedness was highest for competencies on person-centered care and collaborative treatment planning, and lowest for psychosocial factors management, collaboration with involved actors, compensation system navigation, and return-to-work support. Three overarching themes influenced perceived preparedness: (1) role perceptions in work rehabilitation, (2) enablers such as supportive curriculum elements, and (3) challenges including stigma toward injured workers and limited work rehabilitation-specific training. A fourth theme described strategies to improve work rehabilitation training. CONCLUSIONS: Recent physiotherapy graduates reported varying levels of perceived preparedness for work rehabilitation, with the lowest ratings associated with managing psychosocial factors, collaborating with involved actors, navigating compensation systems, and supporting return to work. These gaps were linked to limited work rehabilitation training, perceived role ambiguity, and exposure to stigma. Future research should develop strategies to improve work rehabilitation training in physiotherapy programs.
Trajectory and Predictors of Return-to-Work Outcomes for People After a Road Traffic Injury: A Prospective Cohort Study.
Abedi M, Aplin T, Gane E … +1 more , Johnston V
J Occup Rehabil · 2026 Apr · PMID 42060180 · Publisher ↗
PURPOSE: Identifying factors influencing work after road traffic injuries (RTI) is important for developing early and appropriate interventions. This study aimed to quantify vocational outcomes up to 12 months after RTIs...
PURPOSE: Identifying factors influencing work after road traffic injuries (RTI) is important for developing early and appropriate interventions. This study aimed to quantify vocational outcomes up to 12 months after RTIs; to explore Return-to-work (RTW) trajectories over this period; and to identify predictors of RTW status and disability days at baseline, 6-, and 12-month post-RTI. METHODS: Individuals aged 18 to 64 years with minor to serious musculoskeletal RTI presenting to two Australian public hospital emergency departments were recruited. Exclusions were severe injury and not being in paid employment pre-injury. Assessment occurred at baseline, six months, and 12 months post-RTI. RESULTS: Sixty-three participants completed the baseline survey. By 12 months, 88% had returned to work, mostly with work modifications, whilst 13% experienced at least one RTW failure. Mean disability days were 48 (SD = 93). Predictors of RTW at baseline were lower injury severity, less pain/disability, and younger age (R = 0.65, p < 0.05); at 6 months, being a casual/part-time employee (R = 0.2, p < 0.05) and at 12 months, higher pre-injury income (R = 0.25, p < 0.05). Predictors of more disability days at baseline included being male, hospital admission, greater injury severity, greater disability, lodging a compensation claim, and higher distress from intrusion (R = 0.53, p < 0.05); at 6 months, older age and lower RTW self-efficacy (R = 0.18, p < 0.05); and at 12 months, older age, lower level of education, greater injury severity, and casual/part-time pre-injury employment (R = 0.29, p < 0.05). CONCLUSION: RTW after RTI is a dynamic, staged process. Early outcomes are primarily health-related, whereas 6-12-month outcomes are shaped by psychosocial factors. Sustained RTW often requires work modifications, underscoring the need for coordinated, systems-based rehabilitation strategies.
Do Gender and Chronic or Episodic Disability Type Moderate the Relationship Between Support Availability, Perceived Workplace Support Towards Disclosure and Job Disruptions?
Jessiman-Perreault G, Smith PM, Thompson AMS … +1 more , Gignac MAM
J Occup Rehabil · 2026 Apr · PMID 42050291 · Publisher ↗
PURPOSE: Whilst absenteeism and presenteeism amongst workers with chronic and episodic disabling conditions are well-studied, less is known about broader job disruptions and their links to gender, disability type, suppor...
PURPOSE: Whilst absenteeism and presenteeism amongst workers with chronic and episodic disabling conditions are well-studied, less is known about broader job disruptions and their links to gender, disability type, support availability, and perceived workplace support towards disclosure. This study examined the prevalence of job disruptions and their association with support availability and support of disclosure, and whether these relationships differ by gender and disability type. METHODS: A cross-sectional survey was conducted in June-July 2022 with 730 employed Canadians living with chronic or episodic conditions causing work limitations. Relationships between support availability, perceived workplace support towards disability disclosure and six types of job disruptions (i.e. work impacts such as interruptions, distractions, and other barriers that create difficulties with work activities and participation) were analyzed using chi-square tests and adjusted logistic regression. Gender (men/women) and disability type (physical, mental/cognitive, both) were tested as moderators. RESULTS: Short-term job disruptions were common, especially amongst workers with both physical and mental/cognitive conditions. Greater support availability was associated with fewer long-term disruptions but more missed meetings. Negative or ambivalent perception of workplace support towards disability disclosure was associated with higher odds of long-term disruptions. Low support availability exacerbated job disruption disparities between disability types. There was no evidence of moderation by gender. CONCLUSION: Support availability and a positive, inclusive workplace with support towards disability disclosure are important factors influencing long-term job disruptions. The findings of this study suggest that tailored supports for those with complex and co-occurring, disabilities and efforts to improve perceptions of the workplace's support towards disability disclosure are important to promote sustained work participation for people with chronic or episodic conditions causing limitations.
Transdiagnostic Symptoms in Electronic Health Records of Sick-Listed Employees.
Muntinghe FOW, Hoekstra T, Laganga AA … +3 more , Ziech MLW, Brouwer S, Roelen CAM
J Occup Rehabil · 2026 Apr · PMID 42036548 · Publisher ↗
PURPOSE: Transdiagnostic symptoms are the subjective physical and mental features that span across various diseases and share commonalities irrespective of the diagnosis. This study investigated which transdiagnostic sym...
PURPOSE: Transdiagnostic symptoms are the subjective physical and mental features that span across various diseases and share commonalities irrespective of the diagnosis. This study investigated which transdiagnostic symptoms are reported in electronic health records of sick-listed employees and how these symptoms are described. Furthermore, differences in transdiagnostic symptoms were studied across diagnostic categories. METHODS: Cross-sectional register-based study of consultation notes recorded in electronic health records of 25,981 employees sick-listed due to mental, musculoskeletal, cardiovascular, neurological, or gastrointestinal disorders between April 2019 and March 2020. Electronic health records were randomly drawn until data saturation, defined as no new transdiagnostic symptoms in 10 consecutive electronic health records, resulting in a final analytic sample of 262 electronic health records. Descriptions of transdiagnostic symptoms were analysed in Atlas-ti using a thematic analysis. RESULTS: A total of 129 unique symptoms were identified in the 262 electronic health records and thematically categorised into seven groups: psychological symptoms, pain, fatigue, sleep symptoms, vegetative symptoms, cognitive symptoms, and physical symptoms. Psychological symptoms were most prevalent (36%), followed by pain (30%), and fatigue (25%). In the majority of the health records, sequences of transdiagnostic symptoms were reported with brief indications of cause, severity, duration and temporal course. Transdiagnostic symptoms varied across diagnostic categories, though pain was highly prevalent in all diagnostic categories. CONCLUSION: Seven thematic groups of transdiagnostic symptoms were identified in electronic health records of sick-listed employees. These seven groups can be used in further studies to identify symptom profiles that are related to poor work outcomes.
Work Ability and Functioning Among Individuals with Persistent Indoor Environment-Related Symptoms or Chronic Fatigue: Nine-Month Follow-Up of a Web-Based Randomized Controlled Trial.
Vuokko A, Immonen M, Lappalainen P … +5 more , Keinonen K, Sainio M, Lappalainen R, Paunio T, Selinheimo S
J Occup Rehabil · 2026 Apr · PMID 42033546 · Publisher ↗
PURPOSE: Persistent physical symptoms (PPS) can significantly impair work ability and daily functioning, exacerbated by comorbid illness worry (IW). This randomized controlled trial (RCT) examined the effectiveness of gu...
PURPOSE: Persistent physical symptoms (PPS) can significantly impair work ability and daily functioning, exacerbated by comorbid illness worry (IW). This randomized controlled trial (RCT) examined the effectiveness of guided internet-based treatment on work ability and daily functioning of working-aged individuals with PPS associated with indoor environment (IE) and/or chronic fatigue (CF) with disability. The intervention was based on acceptance and commitment therapy (ACT) combined with individual case formulation, compared to treatment as usual (TAU). IW's role in moderating effects was explored. METHODS: In this RCT (Clinicaltrials.gov NCT04532827), 103 individuals with PPS linked to IE, CF or both were assigned to a video-based case conceptualization and 10-week internet-based ACT with TAU (iACT + TAU; n = 50) or TAU alone (n = 53). Self-reported work ability and daily functioning were assessed from pre-intervention to 9-month follow-up, examining the potential moderating effect of baseline IW. Analyses used linear mixed models and Type III ANOVA. RESULTS: Of the 103 participants, 62% completed the 9-month follow-up. Baseline demographics showed no significant differences between treatment groups. Significant positive interaction (treatment group and time) effects for work ability were found in the iACT + TAU group at post-measurement (β = 0.41, p = 0.041), 3-month (β = 0.58, p = 0.004), and 9-month (β = 0.47, p = 0.022) follow-ups. Daily functioning improved significantly at 3-month (β = 0.57, p = 0.007), particularly in the work domain (β = 0.67, p = 0.003). IW and PPS group did not moderate outcomes. CONCLUSION: Internet-based ACT with individual case formulation was associated with improved work ability for individuals with PPS associated with IE and CF, providing preliminary support for further examination as a potential frontline treatment.
Indirect Costs Related to Productivity Loss, Work-Related Quality of Life, and Resource Utilization in Workers with Multiple Sclerosis.
Ponzio M, Grange E, Gualco C … +11 more , Pignattelli E, Manacorda T, Grasso MG, Presicce G, Inglese M, Leveraro E, Durando P, Debarbieri N, Persechino B, Battaglia MA, Brichetto G
J Occup Rehabil · 2026 Apr · PMID 42033545 · Publisher ↗
PURPOSE: Multiple sclerosis (MS) often affects individuals during their most productive working years, resulting in reduced work capacity and quality of life. This study aimed to assess work productivity loss, work-relat...
PURPOSE: Multiple sclerosis (MS) often affects individuals during their most productive working years, resulting in reduced work capacity and quality of life. This study aimed to assess work productivity loss, work-related quality of life (WRQoL), and healthcare and social resource utilization among Italian workers with MS and to identify the predictors of productivity-related indirect costs. METHODS: A cross-sectional study was conducted involving 160 employed people with MS (PwMS) in Italy. Work productivity and activity impairment were measured using the Work Productivity and Activity Impairment questionnaire for MS (WPAI:MS), while work-related difficulties were assessed with the MSQ-Job. WRQoL and healthcare and social support utilization were evaluated using validated instruments. Productivity losses were monetized using national wage data. Two-part regression models were applied to identify the predictors of annual indirect costs. RESULTS: Overall, 79.4% of PwMS reported productivity loss, predominantly due to presenteeism (76.9%), with a mean overall work impairment of 40.3%. The mean annual cost of productivity loss was €12,580, 83% of which was attributable to presenteeism. Indirect costs were significantly higher among PwMS reporting work-related difficulties (€13,992 vs €7098; p < 0.001). Lower WRQoL, higher fatigue levels, and greater healthcare needs were associated with increased productivity losses, while higher WRQoL emerged as a protective factor. CONCLUSION: MS-related work impairment generates substantial indirect costs, largely driven by presenteeism. Interventions targeting workplace well-being, fatigue management, and vocational rehabilitation may help reduce productivity losses and improve quality of life among PwMS.
Working with a Chronic Health Condition: Is Choosing Not to Disclose the Same as Hiding Information?
Gignac MAM, Pienkowski M, Bowring J
J Occup Rehabil · 2026 Apr · PMID 42032441 · Publisher ↗
BACKGROUND AND OBJECTIVES: Hiding personal information from others can come at a negative psychological cost. Yet studies on workplace disclosure of a chronic or episodic disability have not differentiated between decisi...
BACKGROUND AND OBJECTIVES: Hiding personal information from others can come at a negative psychological cost. Yet studies on workplace disclosure of a chronic or episodic disability have not differentiated between decisions not to disclose information vs actively hiding information. We examined differences in decisions around nondisclosure and active hiding of health information, and factors associated with these decisions, including workplace support and job impacts. METHODS: An online, cross-sectional survey asked workers with physical and mental health/cognitive conditions creating job limitations (disability) about disclosing and hiding health information from a supervisor. Relationships between disclosure/nondisclosure and hiding/not hiding and their associations with demographic and work context factors, perceptions of disclosure decisions, workplace support, and job outcomes were examined in multinomial regression analyses. RESULTS: Participants were 695 workers (51% men) with physical (40%), mental health/cognitive (25%), or both types of conditions (35%). Participants hiding health information (disclosure-hiding 20.9%; no disclosure-hiding 24.0%) were more likely to have mental health/cognitive conditions, avoidance goals, negative workplace perceptions, and report challenges in decision making than those not hiding information (disclosure-no hiding 37.5%; no disclosure-no hiding 17.6%). Those who had disclosed reported more workplace support, but those in the disclosure-hiding group reported more absenteeism, worse productivity, and more job disruptions. CONCLUSIONS: The findings underscore the complexity of working with a disability and that many workers report hiding information from their supervisor. Understanding reasons for nondisclosure and hiding, and its implications, has the potential to improve workplace support provision for workers with disabilities and improve work inclusivity and sustainability.
Sickness Absence Duration Across Twenty Different Pathologies: A Systematic Review.
Mouton L, Lambreghts C, Godderis L
J Occup Rehabil · 2026 Apr · PMID 42029976 · Publisher ↗
PURPOSE: There is a clear need for a structured synthesis of the literature on sickness absence duration (SAD). This systematic review aims to summarize existing literature on SAD across twenty different pathologies, sup...
PURPOSE: There is a clear need for a structured synthesis of the literature on sickness absence duration (SAD). This systematic review aims to summarize existing literature on SAD across twenty different pathologies, supporting health care practitioners (HCPs) and policymakers in making informed decisions regarding work resumption and rehabilitation duration. METHODS: A systematic review was conducted following PRISMA guidelines, incorporating both scientific and gray literature. Twenty pathologies were selected based on their prevalence in work disability, as identified by disability management experts. These include seven musculoskeletal, six neurologic, three psychiatric, two pulmonary pathologies and one endocrine, gastro-intestinal and dermatological pathology. Articles were sourced from PubMed, Cochrane Library, and CINAHL, while gray literature was obtained from relevant websites chosen by the steering committee. RESULTS: In this review, a total of 4,826 scientific articles and 770 documents were screened, resulting in 69 included studies. The number of identified records per pathology varied widely, ranging from none to ten. Guidelines are presented for epicondylitis lateralis, hip prothesis and medial collateral ligament knee injuries. No information was reported on epilepsy, obsessive compulsive disorder, and Ehlers-Danlos syndrome. For the remaining fifteen conditions observed SAD was reported, ranging from 1.04 days to 11.4 years, with a median of 24 days. CONCLUSION: This study provides an extensive overview of existing data on SAD. However, the evidence is insufficient to support a clear consensus or the development of guideline recommendations. Since there is little information on SAD, future research should establish consistent and reliable SAD, as well as explore the development of peer-comparison feedback mechanisms that could enhance sick leave and return to work guidance for HCPs.
Predicting Emotional Exhaustion with Multimodal Sensor Data During Return-to-Work Trajectories: A 6-Month Longitudinal Study.
Berkemeier L, Kamphuis W, Oldenhuis H … +4 more , Kok R, Aben B, Verdaasdonk R, van Gemert-Pijnen L
J Occup Rehabil · 2026 Apr · PMID 42018118 · Publisher ↗
PURPOSE: Emotional exhaustion is a core component of burnout and impacts return-to-work trajectories following sick leave due to burnout or stress. Previous research identified links between emotional exhaustion and slee...
PURPOSE: Emotional exhaustion is a core component of burnout and impacts return-to-work trajectories following sick leave due to burnout or stress. Previous research identified links between emotional exhaustion and sleep, physical activity, mobility, and smartphone usage, yet little is known about how these associations vary within and between individuals over time. This study examined how emotional exhaustion can be monitored and predicted using multimodal data from smartphones and smart rings during return-to-work trajectories. METHODS: Eighteen employees on sick leave in the Netherlands due to stress or burnout symptoms were recruited via occupational physicians. For six months, participants completed daily Ecological Momentary Assessments (EMAs) of emotional exhaustion and provided multimodal sensor data on sleep and physical activity (Oura ring), mobility, and phone usage patterns (Avicenna app). Between- and within-person associations were examined using correlational analyses and linear mixed models. Subject-dependent Random Forest (RF) models were trained to assess the predictive performance of multimodal features. RESULTS: Subject-dependent RF models achieved an average Spearman's ρ̄ of 0.38 (range: 0.10-0.72). Sleep and physical activity features showed more consistent associations with emotional exhaustion than mobility and smartphone usage patterns, which were more heterogeneous. The strength and direction of associations, as well as the most predictive features, varied substantially between participants. CONCLUSIONS: Multimodal device data can modestly predict emotional exhaustion, with performance varying by individual. Results indicate that emotional exhaustion patterns are highly variable among employees, necessitating individualized approaches to return-to-work counselling. Future research should incorporate longer monitoring periods and examine inter- and intra-individual variability.
Managing Complexity: Manager-Stakeholder Communication, Relational Dynamics, and the Dual Nature of RTW Communication.
Bertolini H, Corbière M, Negrini A … +6 more , Larivière N, Villotti P, Prévost D, Caiada M, Amorim J, O'Hagan F
J Occup Rehabil · 2026 Apr · PMID 42008103 · Publisher ↗
PURPOSE: The return to work (RTW) process of worker absent due to common mental disorders (CMD) or musculoskeletal disorders (MSD) represents a complex challenge that involves multiple stakeholders. The aim of this study...
PURPOSE: The return to work (RTW) process of worker absent due to common mental disorders (CMD) or musculoskeletal disorders (MSD) represents a complex challenge that involves multiple stakeholders. The aim of this study was to examine how managers perceive the factors that facilitate or hinder communication with other stakeholders during the RTW process. METHODS: This qualitative study was based on four focus groups conducted in Canada (Quebec and Ontario) with 18 managers. RESULTS: Thematic analysis identified five themes related to facilitators and seven themes related to communication obstacles. Among the main facilitators, trust, clarity, and collaboration emerged as key elements that support effective coordination and the development of shared solutions. Obstacles, on the other hand, included distrust, ambiguity, and fragmentation, which can compromise the success of the process and increase the risk of tensions or relapses. The manager emerges as a bridging figure, central to the design of workplace accommodations, but whose role depends on the quality of relationships with the employee, colleagues, and other organizational stakeholders, as well as on the institutional support received. CONCLUSION: The findings highlight that strengthening inter-stakeholder communication not only fosters the sustainable reintegration of employees with health conditions but also contributes to the development of more inclusive and resilient organizational environments.
Recovery-Related Return-to-Work Experiences of People with Common Mental Disorders within Australia's Disability-Based Insurance Context.
Green F, Hancock N, Scanlan JN … +1 more , Matthews LR
J Occup Rehabil · 2026 Apr · PMID 42008102 · Publisher ↗
PURPOSE: Common mental disorders are a leading cause of work disability and long-term income protection claims in Australia. Although recovery-oriented approaches are increasingly embedded in mental health care, their re...
PURPOSE: Common mental disorders are a leading cause of work disability and long-term income protection claims in Australia. Although recovery-oriented approaches are increasingly embedded in mental health care, their relevance to return-to-work within disability-based insurance systems remains underexplored. This study explored the mental health recovery-related return-to-work experiences of people with common mental disorders engaged with Australia's income protection insurance system. METHODS: Semi-structured interviews were conducted with 25 adults who had sustained their return-to-work for at least six months following a common mental disorder-related income protection claim. Data collection and analysis occurred iteratively, and data were analysed inductively using constant comparative analysis. RESULTS: Participants' recovery-related return-to-work experiences comprised three overarching processes: (1) an internal and personal process of growth; (2) negotiating and navigating workplace environments and roles; and (3) accessing and engaging with helpful supports. These processes were shaped by (4) broader contextual influences. CONCLUSION: Findings indicate that recovery constructs, widely used in mental health service contexts, also resonate within this specific return-to-work context. However, recovery-related return-to-work is shaped not only by individual recovery processes but also by workplace conditions, relational supports, and broader contextual influences such as financial circumstances and stigma. Supporting sustainable return-to-work for people living with common mental disorders may therefore require approaches that integrate recovery-oriented principles into workplace and system-level practices. Further exploration is needed to understand system-level barriers and enablers influencing the income protection return-to-work workforce's ability to adopt the recovery-oriented supports and practices highlighted by participants.
Early Prognostic Factors for Claim Cost and Claim Duration Following a Work-Related Back Injury in Saskatchewan, Canada.
Bruno P, Passmore S
J Occup Rehabil · 2026 Apr · PMID 41966648 · Publisher ↗
PURPOSE: The objective of the current study was to determine the degree to which individual prognostic factors obtained within the first 3-4 weeks of the initiation of a work-related back injury claim can predict claim c...
PURPOSE: The objective of the current study was to determine the degree to which individual prognostic factors obtained within the first 3-4 weeks of the initiation of a work-related back injury claim can predict claim cost and claim duration. METHODS: Prognostic factor data and outcome data regarding claim cost and duration were obtained from back injury claimants via an online questionnaire and the local workers' compensation board. Regression models were used to determine which of the factors were best able to predict claim cost, claim duration, and chronic work disability. RESULTS: Age, disability, and an accommodation and/or early return-to-work program being offered were included in the three final regression models and were therefore deemed to be best able to predict all three outcomes. Recovery expectations was also included in the final regression model for claim duration and is therefore able to assist in the prediction of this outcome. CONCLUSION: The regression models produced in the current study could be used to formulate equations to estimate claim cost and duration, thereby allowing insurers to identify "high-risk claims" early in the claim process and facilitate more targeted interventions in such cases. As well, whether an accommodation and/or early return-to-work program is offered is highlighted as a modifiable risk factor that could be used by insurers, employers, and workers to reduce claim cost and claim duration.
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