The Healthy LifeWorks project: The effect of a comprehensive workplace wellness program on the prevalence and severity of musculoskeletal disorders in a Canadian government department.

OBJECTIVE: The purpose of this study was to determine the effect of a comprehensive workplace wellness program on the prevalence and severity of musculoskeletal disorders in a Canadian government department. METHODS: The Healthy LifeWorks program was developed, implemented, and evaluated over a 4-year period. A total of 233 employees completed the Nordic Musculoskeletal Questionnaire before and after the program to determine the prevalence and severity of musculoskeletal disorders. RESULTS: There was an approximately 10% decrease in the 12-month prevalence of musculoskeletal disorders, ranging from 4% for hip/thigh problems to 12% for lower and upper back problems. The proportion of people reporting that a musculoskeletal disorder interfered with their normal work during the past 12 months decreased from 83% to 46%. CONCLUSIONS: Comprehensive wellness, including educational sessions on posture, ergonomics, and joint health, results in improved musculoskeletal health.

The Healthy LifeWorks Project: a pilot study of the economic analysis of a comprehensive workplace wellness program in a Canadian government department.

OBJECTIVE: To examine the relationship between health risks and absenteeism and drug costs vis-a-vis comprehensive workplace wellness. METHODS: Eleven health risks, and change in drug claims, short-term and general illness calculated across four risk change groups. Wellness score examined using Wilcoxon test and regression model for cost change. RESULTS: The results showed 31% at risk; 9 of 11 risks associated with higher drug costs. Employees moving from low to high risk showed highest relative increase (81%) in drug costs; moving from high to low had lowest (24%). Low-high had highest increase in absenteeism costs (160%). With each risk increase, absenteeism costs increased by $CDN248 per year (P < 0.05) with average decrease of 0.07 risk factors and savings $CDN6979 per year. CONCLUSIONS: Both high-risk reduction and low-risk maintenance are important to contain drug costs. Only low-risk maintenance also avoids absenteeism costs associated with high risks.

Longitudinal changes in exercise capacity after stroke.

OBJECTIVE: To determine if stroke patients without specific aerobic training experience a change in the first 6 months after stroke. DESIGN: Descriptive, longitudinal study with repeated measures of exercise capacity at 1, 2, 3, and 6 months after stroke. SETTING: Exercise testing laboratory in a tertiary care hospital. PARTICIPANTS: Consecutive sample of 25 patients (mean age +/- standard deviation, 64.1+/-13.6 y) 1 month after first ischemic stroke. INTERVENTIONS: Not applicable. Main Outcome Measures Peak oxygen consumption (Vo(2)peak) was measured by open-circuit spirometry during maximal effort treadmill walking with 15% body-weight support. RESULTS: Mean Vo(2)peak increased from 14.8+/-5.3 mL x kg(-1). min(-1) at 1 month to 17.3+/-7.0 mL x kg(-1).min(-1) at 6 months after stroke (P=.003) or from 61.7%+/-16% to 71.3%+/-23% of age- and sex-related normative values for sedentary healthy adults (P=.008). CONCLUSIONS: Despite improvements in Vo(2)peak and other indices of cardiovascular training between 1 and 6 months poststroke, substantial limitations in exercise capacity persisted. Further study is needed to determine the extent to which these limitations can be modified through aerobic conditioning.

Exercise capacity early after stroke.

OBJECTIVE: To evaluate exercise capacity of patients with a poststroke interval of less than 1 month. DESIGN: Prospective, cohort, observational study. SETTING: Exercise testing laboratory in a tertiary care hospital. PARTICIPANTS: Twenty-nine patients (mean age +/- standard deviation, 64.9+/-13.5 y) with a poststroke interval of 26.0+/-8.8 days. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Peak exercise capacity (VO(2)peak) was measured by open-circuit spirometry during maximal effort treadmill walking with 15% body-weight support. RESULTS: Mean VO(2)peak was 14.4+/-5.1 mL. kg(-1). min(-1) or 60%+/-16% of age- and sex-related normative values for sedentary healthy adults. CONCLUSIONS: Exercise capacity approximately 1 month after stroke was compromised. Further research is needed to elucidate the physiologic basis of this low capacity.

Cardiovascular stress during a contemporary stroke rehabilitation program: is the intensity adequate to induce a training effect?

OBJECTIVES: To investigate the level of cardiovascular stress of physical therapy (PT) and occupational therapy (OT) sessions of a contemporary stroke rehabilitation program and to identify therapeutic activities that elicit heart rate responses adequate to induce a training effect. DESIGN: A descriptive, longitudinal study with heart rate and activity monitoring of PT and OT sessions at biweekly intervals, 2 to 14 weeks poststroke. SETTING: An acute inpatient stroke unit and inpatient and outpatient stroke rehabilitation units. PARTICIPANTS: A consecutive sample of 20 patients with ischemic stroke who participated in inpatient and outpatient stroke rehabilitation. INTERVENTION: Observation of routine PT and OT sessions for patients poststroke without influencing the extent and content of the sessions. MAIN OUTCOME MEASURE: Time per session in which heart rate was within the calculated target heart rate zone. RESULTS: Time per PT session spent in target heart rate zone was low (2.8+/-0.9 min), and per OT session was negligible (0.7+/-0.2 min) over the course of rehabilitation. CONCLUSIONS: The PT and OT sessions between 2 and 14 weeks poststroke did not elicit adequate cardiovascular stress to induce a training effect.