Appendix 4.C - Components of Effective MSD Interventions – L'incapacité et le retour au travail

Table C.1: Interventions encompassing the three target domains for a healthy and sustainable RTW **.

Domain 1: Health	Domain 2: Service Coordination	Domain 3: Work modifications
C.1.1 Programs incorporating physical activity/exercise or back school
Physical activity/exercise ? Endurance or strength training; functional restoration; physical conditioning Physical activity/exercise ? provided in the workplace or developed after a workplace visit and taking into account the workplace Health education Training in work techniques and lifting methods Managing the intensity and duration of physical activity/exercise with or without a workplace visit CBT*?	Involvement of several qualified professionals	Ergonomic assessment
C.1.2 Programs incorporating work modifications
Physical activity/exercise? Education on physical health, relaxation and breaks Psychological health education Activity modification CBT* ?	Contact of qualified personnel with the work environment Early contact with the worker through the workplace RTW coordinator Professional management with active participation of stakeholders, at least with the worker and the employer Meetings with occupational health staff, employee and employer	Adjust the demands of work to match reduced capacity Changes in work location or equipment Work design and work organization Changes in working conditions or the working environment Modifications to ergonomic equipment Redesign of tools or the workstation Supernumerary replacement
C.1.3 Programs integrating multidisciplinary/interdisciplinary rehabilitation Interventions
Activité/exercice physique 🕇, conditionnement physique Éducation : formation à la gestion du stress, la douleur, l’anatomie humaine, école du dos 🕇 Principes cognitivo-comportementaux pour aborder les facteurs psychosociaux, corriger les croyances dysfonctionnelles, enseigner la relaxation	Organizational interventions: job visits, job conditioning, RTW coordinator	Adjust the job demands to match reduced capacity Changes in work location or equipment Work design and work organization Changes in working conditions or the workplace environment Modifications to ergonomic equipment Redesign of tools or the workstation Supernumerary replacement
C.1.4 Programs incorporating occupational interventions with or without educational or clinical interventions
Education on physical health, relaxation and breaks Psychological health education Functional rehabilitation Graded work exposure therapy	Early contact	Ergonomic interventions Changes in the work environment
C.1.5 Programs with integrated social support interventions
Therapeutic education on pain and the importance of being active (encourage activity or modify activity – activity modification)	Improve organizational culture and stakeholder engagement for optimal management of RTW Communication and agreement between stakeholders Communication between stakeholders about work changes and arrangements Contact between qualified professionals and the workplace Structured consultation Coordination efforts by a designated coordinator or RTW team that coordinates services and communication among stakeholders Encourage and support rapid RTW Case Management Involvement of all stakeholders (including employers and qualified professionals) Customized RTW plan	Accommodations (on a temporary basis, if needed) Facilitate RTW through temporary light duty assignments Ergonomic intervention Physical changes in the work environment
C.1.6 Cognitive therapies (cognitive behavioural therapy, behavioural treatment)
Physical activity/exercise? Physical and psychological health education Stress management education, communication skills Medication Cognitive restructuring (to change beliefs and attitudes) CBT* ?	Provision of additional services, as required	Workplace adaptations

*CBT: cognitive behavioral therapy
? This intervention used alone is not effective for a healthy and lasting RTW

** For a given intervention domain (1. Health; 2. Service Coordination; 3. Work modifications), this table may suggest several components. Determine the most appropriate components based on the worker’s assessment and your organization’s context (resources, etc.). Remember that the optimal combination of components, allowing for the best effects, remains unknown. It is the combination of components across at least 2 intervention domains that remains the most important principle to follow (Cullen et al, 2018).

Table C.2 Multi-component interventions encompassing two of the three target domains for healthy and sustainable RTW **

Domain 1: Health	Domain 2: Service Coordination
C.2.1 Health promotion programs
Physical activity/exercise?	Organizational culture of health and wellness Health promotion
C.2.2 Pain management programs
Education on cognitive and behavioral principles	Multidisciplinary/interdisciplinary rehabilitation

🕇 This intervention used alone does not seem to be effective for a healthy and durable RTW

**For a given intervention domain (1. Health; 2. Service Coordination; 3. Work modifications), this table may suggest several components. Determine the most appropriate components based on the worker’s assessment and your organization’s context (resources, etc.). Remember that the optimal combination of components, allowing for the best effects, remains unknown. It is the combination of components across at least 2 intervention domains that remains the most important principle to follow (Cullen et al, 2018).

Tableau C.3 Intervention axée sur la santé **

Domain 1: Health

C.3.1 Prevention intervention

Education on beliefs and attitudes

Note: Although it is recommended that interventions be developed that include at least two out of three domains (Cullen et al., 2018), the case listed here was shown to be effective.

** For a given intervention domain (1. Health; 2. Service Coordination; 3. Work modifications), this table may suggest several components. Determine the most appropriate components based on the worker’s assessment and your organization’s context (resources, etc.). Remember that the optimal combination of components, allowing for the best effects, remains unknown. It is the combination of components across at least 2 intervention domains that remains the most important principle to follow (Cullen et al, 2018).

Référence :

Cullen, K. L., Irvin, E., Collie, A., Clay, F., Gensby, U., Jennings, P. A., . . . Amick, B. C. (2018). Effectiveness of workplace interventions in return-to-work for musculoskeletal, pain-related and mental health conditions: An update of the evidence and messages for practitioners. Journal of Occupational Rehabilitation, 28(1), 1-15. doi: 10.1007/s10926-016-9690-x

Appendix 4.C – Components of Effective MSD Interventions

Table C.1: Interventions encompassing the three target domains for a healthy and sustainable RTW **.

Table C.2 Multi-component interventions encompassing two of the three target domains for healthy and sustainable RTW **

Tableau C.3 Intervention axée sur la santé **