Prevention of work disability due to musculoskeletal disorders: the challenge of implementing evidence.
BACKGROUND
The process of returning disabled workers to work presents numerous challenges. In spite of the growing evidence regarding work disability prevention, little uptake of this evidence has been observed. One reason for limited dissemination of evidence is the complexity of the problem, as it is subject to multiple legal, administrative, social, political, and cultural challenges.


OBJECTIVE
A literature review and collection of experts' opinion is presented, on the current evidence for work disability prevention, and barriers to evidence implementation. Recommendations are presented for enhancing implementation of research results.


CONCLUSIONS
The current evidence regarding work disability prevention shows that some clinical interventions (advice to return to modified work and graded activity programs) and some non-clinical interventions (at a service and policy/community level but not at a practice level) are effective in reducing work absenteeism. Implementation of evidence in work disability is a major challenge because intervention recommendations are often imprecise and not yet practical for immediate use, many barriers exist, and many stakeholders are involved. Future studies should involve all relevant stakeholders and aim at developing new strategies that are effective, efficient, and have a potential for successful implementation. These studies should be based upon a clearer conceptualization of the broader context and inter-relationships that determine return to work outcomes.
Loisel
Patrick
P
Disability Prevention Research and Training Center, Université de Sherbrooke, 1111 St-Charles West, Suite 101, Longueuil, J4K 5G4, Québec, Canada. patrick.loisel@usherbrooke.ca
Buchbinder
Rachelle
R
Hazard
Rowland
R
Keller
Robert
R
Scheel
Inger
I
van Tulder
Maurits
M
Webster
Barbara
B
D001294:Attitude to Health; D002170:Canada; D019317:Evidence-Based Medicine; D006284:Health Plan Implementation; D006801:Humans; D009140:Musculoskeletal Diseases / Q000517:prevention & control* / Q000534:rehabilitation; D009784:Occupational Diseases / Q000517:prevention & control* / Q000534:rehabilitation; D009786:Occupational Health Services / Q000458:organization & administration*; D018582:Sick Leave; D014481:United States