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Resumen: Objetivo: Valoración clínica-funcional de pacientes con lesión de Lisfranc sin causa laboral ni deportiva tratados en nuestro centro. Material y métodos: Se analizaron 13 pacientes con lesión de Lisfranc sin causa laboral ni deportiva, divididos en dos grupos, lesiones de alta energía y de baja energía. Valoración del retorno a la actividad laboral y deportiva previa a la lesión y el uso de calzado y plantillas posteriormente. Se recogen las puntuaciones del test AOFAS y EVA postoperatorio así como la aparición de complicaciones posteriores a la recuperación de la lesión. Resultados: El grupo de alta energía lo formaron siete pacientes que fueron intervenidos en una media de 7.3 días; cuatro presentaron secuelas postquirúrgicas. De estos pacientes, un paciente no pudo reincorporarse a su actividad laboral previa y dos pacientes no pudieron realizar el deporte que practicaban previamente a la lesión. El AOFAS fue de 79.4 y el EVA de 2.8. En el grupo de baja energía encontramos seis pacientes intervenidos en 5.6 días de media. Todos ellos pudieron reincorporarse a su actividad laboral y deportiva previa. El AOFAs fue de 84.8 y el EVA de 1.6. En ninguna de las variables estudiadas se observaron diferencias estadísticamente significativas. Conclusión: Los pacientes con lesión de Lisfranc fuera del ámbito laboral y deportivo presentan buenos resultados clínicos y funcionales.
Abstract: Objective: Clinical and functional evaluation of patients with Lisfranc lesion without work or sport cause and treated in our center. Material and methods: Thirteen patients with Lisfranc lesion without occupational or sports causes were divided into two groups, high-energy and low-energy injuries. Were analyzed the return to work and sports activity prior to the injury and the use of footwear and insoles after the injury. Also were assessed AOFAS and EVA postoperative score and posterior complications after lesion recovery. Results: High-energy group included 7 patients who underwent surgery on an average of 7.3 days. Of the total of patients, 4 presented post-surgical sequelae. Of these patients, one patient was unable to return to their previous work activity and two patients were unable to practice the usual sports activity. The AOFAS was 79.4 and EVA 2.8. In the low energy group, we found six patients operated on 5.6 days on average. All of them were able to return to their previous work and sports activity. The AOFAS were 84.8 and the EVA 1.6. Statistically significant differences were not observed in any of the variables studied. Conclusion: Patients with Lisfranc injury out of laboral or sports background present good clinical and functional results.
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Objective:To compare the expectation and perception of rehabilitation services for patients with work injury with or without early intervention. Methods:From August, 2017 to February, 2018, 350 inpatients with work injury accepted early intervention and non-early intervention were investigated with the modified ServQual scale. Results:There was no significant difference in the expectation between the inpatients accepted early intervention and non-early intervention (t < 1.904, P > 0.05). In both groups, expectation was the highest in assurance and responsiveness dimension, and the lowest in reliability dimension. The perception was higher in the early intervention group than in the non-early intervention group. In both groups, perception was the highest in tangibility, and the lowest in empathy. Conclusion:Early intervention of rehabilitation may improve the perception of services.
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OBJECTIVE: To observe the therapeutic effect of work intensive training on workers with musculoskeletal injury(MSI). METHODS: A convenience sampling method was used to select MSI patients as research subjects. Patients were randomly divided into control group(179 cases) and experimental group(188 cases). On the basis of the conventional comprehensive rehabilitation treatment, the control group received the routine occupational rehabilitation intervention, and the experimental group received the work intensive training intervention. The intervention period was 4 weeks in both groups. We used the Post-Traumatic Stress Disorder(PTSD) Self-Rating Scale, the Fear-Avoidance Beliefs Questionnaire(FABQ) and the General Self-efficacy Scale(GSES) to assess the recovery of MSI patients. The statuses of return to work of patients were followed up by telephone after six months of discharge from hospital. RESULTS: Compared with the same group before intervention, the scores of PTSD, FABQ-P and FABQ-W in the control group and the experimental group decreased, and the score of GSES increased(P<0.01). After the intervention, the scores of PTSD, FABQ-P and FABQ-W in the experimental group were lower than those in the control group(P<0.01), and the score of GSES was higher than those in the control group(P<0.01). The rate of returning to work in the experimental group was higher than that in the control group(80.9% vs 59.2%, P<0.01). CONCLUSION: Work intensive training has curative effect on self-efficacy, physical activity, subjective pain, and post-traumatic stress disorder, and can improve the rate of resuming to work in patients with MSI.
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BACKGROUND: Workers exposed to hazards without adequate protections are at greater risk of injury and illness. Supervisor activities have also been associated with injury risk. We examined the interplay between supervisor safety support and occupational health and safety (OHS) vulnerability on workplace injury and illness. METHODS: A survey was administered to 2,390 workers employed for more than 15 hrs/week in workplaces with at least five employees who had a direct supervisor. We examined the combined effects of hazard exposure with inadequate protection (OHS vulnerability) and supervisor support on workplace injury and illness, using additive interactions in log-binomial regression models. RESULTS: OHS vulnerability and lack of supervisor support independently increased the likelihood of physical injuries at work. Crude and adjusted models showed that the risk of physical injury was at least 3.5 times higher among those experiencing both OHS vulnerability and a lack of supervisor support than individuals without OHS vulnerability and with a supportive direct supervisor.Workers who experienced vulnerability were at less risk if they had a supervisor who was supportive. CONCLUSION: In workplaces where workers experience one or more types of OHS vulnerability, having a supportive supervisor may play an important role in reducing the risk of injury and protecting workers.
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Occupational HealthABSTRACT
Objective To apply the Baltimore Therapeutic Equipment (BTE), a kind of vocational training and evaluation system, in rehabilitaion of patients post traumatic upper extremity injury from work, and to observe the effects. Methods Inpatients from September, 2014 to August, 2015 for rehabilitation of traumatic upper extremity injury from work were selected as control group (n=42), and inpatients from September, 2015 to August, 2016 were selected as intervention group (n=36). Both groups received routine rehabilitation, while the control group received con-ventional work simulation training, and the intervention group received work simulation training with BTE, for four weeks. They were measured the standing lifting strength (elbow), squatting lifting strength, dynamic lifting strength (floor to waist), dynamic lifting strength (floor to shoulder), and grip strength of the injured hand and the healthy hand with BTE, before and after rehabilitation; while they were assessed with Disability of Arm Shoul-der and Hand (DASH). The incidence of return to work was investigated at six months of follow-up. Results The standing lifting strength (elbow) (t=4.290, P<0.001), squatting lifting strength (t=2.645, P=0.010), dynamic lifting strength (floor to waist) (t=2.639, P=0.010), dynamic lifting strength (floor to shoulder) (t=5.361, P<0.001), and grip strength of the injured hand (t=2.320, P=0.023) and the healthy hand (t=3.130, P=0.002) im-proved better in the intervention group than in the control group after rehabilitation. However, there was no sig-nificant difference between two groups in score of DASH (t=-0.851, P=0.398), as well as incidence of return to work (χ2=0.05, P=0.944). Conclusion BTE may help to improve the body function in patients post traumatic upper extremity injury from work. However, vocational rehabilitation should focus on the factors other than body function, to improve their return to work.
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Objective To study anxiety and depression status in patients with industrial hand injury at admission and look into the influencing factors. Method A total of 154 patients who had industrial hand injury were enrolled in the investigation by self-rating anxiety scale (SAS)and self-rating depression scale (SDS)into mental status of patients once at admission. Results The incidence rates of anxiety and depression were 40.9%(63/154)and 37.0%(57/154),respectively.21.4%(33/154)of the patients had both anxiety and depression.The data from SPSS22.0 software and multivariate Logistic regression analysis showed that anxiety and depression were closely related to age,hand function and education.Conclusion The incidences of anxiety and depression in patients with hand injury and work-related injury is significantly higher than that of healthy people, which is closely related to their age, education and hand function.
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Based on the characteristics that most patients in Vocational Rehabilitation Department of Guangdong Provincial Work Injury Rehabilitation Hospital are patients with occupational injuries,the paper analyzes the hospitalized business process,concretely introduces the main functional modules,design framework,safety requirements,database design,etc.of the vocational competency assessment system.The application of this system provides references for rehabilitation doctors and vocational rehabilitation therapists to make training schemes,strengthens patient information management,improves working efficiency and service level.
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@#Objective To observe the effects of multidisciplinary rehabilitation on early heterotopic ossification of patients with traumatic elbow joint injury.Methods 80 work injury patients of early heterotopic ossification after traumatic elbow joint injury were randomly divided into the experiment group(42 cases) and control group(38 cases).The experiment group received multidisciplinary rehabilitation,including physical therapy,occupational therapy,physical factor therapy,traditional Chinese medicine,ward rehabilitation and vocational training.The control group was treated with pain killer and diminish inflammation medicine and median frequency electrical therapy.Range of motion(ROM) of joint and visual analogue scale(VAS) were separately assessed before and after 3 months treatment.Results After 3 months treatment,ROM and VAS of the experiment group were significantly changed compared with admission(P<0.01).The effectiveness of the experiment group was superior to that of the control group(P<0.05).After discharge,39 cases returned to primary work,3 cases changed work in the experiment group,and after 1 year follow-up,no case needed to receive operation.Conclusion In the early stage of heterotopic ossification after traumatic elbow joint injury,multidisciplinary rehabilitation can significantly relax clinical signs,improve functions and make the work injury patients return to work.