Best practices in the rehabilitation of acute musculoskeletal disorders in workers with injuries: an integrative review and analysis of evolving trends.
OBJECTIVE
Strategies for the restoration of function and job performance in workers with musculoskeletal disorders have changed considerably since industrial rehabilitation became a distinct specialization in the 1980s. A rich body of research concerning approaches to medical and rehabilitative management of these disorders exists, resulting in a large number of hybrid approaches worldwide.


METHODS
This integrative review examined the evidence base for best practices in the rehabilitation of acute musculoskeletal workplace injuries, and also mapped the evolution of approaches over the past thirty years. Contextual factors that may have contributed to change were assessed through analysis of changing practice trends and review of descriptive literature over time.


RESULTS
A clear movement away from simplistic, unidimensional approaches towards comprehensive workplace interventions is evident. Economic concerns and growing government and insurance regulation of workplace safety and injury management were the likely drivers of change. While the contributions of various elements of disability management in the workplace were examined, many features of onsite interventions remain to be examined.


CONCLUSIONS
A strong body of research has produced notable advances in management of acute musculoskeletal workplace injury. Research concerning the delivery of workplace-based interventions, the role of workplace environment factors and a range of worker outcomes will further advance knowledge in this field.
Lysaght
Rosemary
R
School of Rehabilitation Therapy, Queen's University, Kingston, ON, Canada. lysaght@queensu.ca
Donnelly
Catherine
C
Luong
Dorothy
D
D016206:Databases, Bibliographic; D006801:Humans; D009140:Musculoskeletal Diseases / Q000534:rehabilitation*; D016273:Occupational Exposure; D016272:Occupational Health; D012046:Rehabilitation / Q000592:standards* / Q000639:trends*