Patrick Loisel | University of Toronto (original) (raw)
Papers by Patrick Loisel
ABSTRACT Résumé non disponible
Work
Therapeutic Return to Work is a work rehabilitation program linking graded work exposure with fun... more Therapeutic Return to Work is a work rehabilitation program linking graded work exposure with functional restoration therapy for chronic low back pain. This study evaluates the impact of the program on stable return to work (RTW) and compares it with the impact on RTW of three frequently used ways of management of back pain (normative comparison). At two year follow-up, 93% of participants of the Therapeutic Return to Work program were working. This rate was higher than in the comparison groups. Although limited by its norm-referenced evaluation design, the results of this study indicate the importance of placing the work site in the center of the of work rehabilitation process. In this program occupational therapists make full use of the client's natural environment.
AIMS: Back muscle capacity is impaired in chronic low back pain (CLBP) patients but no motivation... more AIMS: Back muscle capacity is impaired in chronic low back pain (CLBP) patients but no motivation-free test exists to measure it. The aims of this study were to assess the reliability and criterion validity of EMG indices sensitive to back muscle strength and absolute endurance. We also tested the possibility of using regression equations to predict these outcomes using anthropometric and EMG variables as predictors.
Work
Many work injuries and their associated disabilities are preventable, but effective prevention re... more Many work injuries and their associated disabilities are preventable, but effective prevention requires coordinated action by multiple stakeholders. In trying to achieve coordinated action occupational health practitioners can learn valuable lessons from systems theory, knowledge transfer and action research. Systems theory provides a broad view of the factors leading to injury and disability and a means to refocus stakeholder energies from mutual blaming to effective strategies for system change. Experiences from knowledge transfer will help adopt a stakeholder-centered approach that will facilitate the concrete application of the best and most current occupational health knowledge. Action research is a methodology endorsed by the World Health Organization and the US Centers for Disease Control, which provide methods for successfully engaging stakeholders needed to attain sustainable change. By combining concepts from the three fields we propose MAPAC (Mobilize, Assess, Plan, Act, Check), a five-step framework for developing projects aimed at decreasing occupational injury and disability. Although most practitioners would be familiar with some of the concepts, we believe an explicit framework linked to transferable knowledge from these diverse fields can help design and implement effective programs. We provide examples of model application in workers compensation and in the healthcare workplace.
Physiotherapy Canada, 2004
Handbook of Complex Occupational Disability Claims, 2005
Journal of occupational rehabilitation, 2002
Recent evidence has demonstrated that disability from musculoskeletal disorders is a multifactori... more Recent evidence has demonstrated that disability from musculoskeletal disorders is a multifactorial problem that is not only due to workers' characteristics but also closely related to environmental factors, such as the workplace, the health care system, the compensation system, and the interactions among all stakeholders regarding the disability problem. The Work Disability Diagnosis Interview (WoDDI) was developed following a systematic method in order to help clinicians detect possible disability prognostic factors in subacute or chronic musculoskeletal pain patients. A structured literature review, followed by expert input and a second round of revisions after 4-year's usage led to the current version. The WoDDI is composed of open-ended questions on physical, psychosocial, occupational, and administrative factors, collated into an interview form used at the first encounter with the disabled worker. It enables clinicians to develop a rehabilitation plan and focus on disa...
Journal of Occupational Rehabilitation, 2009
To develop a consensus plan for research and practice to encourage routine clinician screening of... more To develop a consensus plan for research and practice to encourage routine clinician screening of occupational factors associated with long-term back disability. A 3-day conference workshop including 21 leading researchers and clinicians (the "Decade of the Flags Working Group") was held to review the scientific evidence concerning clinical, occupational, and policy factors in back disability and the development of feasible assessment and intervention strategies. The Working Group identified seven workplace variables to include in early screening by clinicians: physical job demands, ability to modify work, job stress, workplace social support or dysfunction, job satisfaction, expectation for resuming work, and fear of re-injury. Five evaluation criteria for screening methods were established: reliability, predictive performance, feasibility, acceptability, and congruence with plausible interventions. An optimal screening method might include a stepped combination of questionnaire, interview, and worksite visit. Future research directions include improving available assessment methods, adopting simpler and more uniform conceptual frameworks, and tying screening results to plausible interventions. There is a clear indication that occupational factors influence back disability, but to expand clinician practices in this area will require that patient screening methods show greater conceptual clarity, feasibility, and linkages to viable options for intervention.
Journal of Occupational Rehabilitation, 2009
Journal of Occupational Rehabilitation, 2009
Introduction The Work Disability Prevention (WDP) Canadian Institutes of Health Research (CIHR) S... more Introduction The Work Disability Prevention (WDP) Canadian Institutes of Health Research (CIHR) Strategic Training Program was developed in 2001 and is a unique program in the world. The main objective of this program is to help future researchers develop transdisciplinary knowledge, skills and attitudes regarding WDP. The purpose of this paper is to present a descriptive portrait of the program's performance over the past 5 years, as well as the trainees' and alumni's perspectives on the WDP CIHR Training Program. Methods Data on the program's performance were collected from documents in the program records. The trainees' opinions on the WDP training program were obtained through focus groups and telephone interviews. The data collected were compiled and divided into themes to summarize the qualitative findings pertaining to each question. Results From 2003 to 2007, five successive summer sessions have been offered, involving 44 high-caliber applicants from nine countries, 34 mentors and collaborators, 29 guest speakers and 15 stakeholders. Overall, trainees appreciated the networking, the opportunity to interact with people from different disciplines and countries, the openness, and the international perspective and uniqueness of the program. The least appreciated aspects concerned mainly the e-learning course, evaluations and information on optional courses. The coordination and logistics were judged appropriate and several topics were suggested to improve the program quality. Conclusion In general, the program implementation went well, with good participation from mentors, speakers and stakeholders; the program was appreciated by the trainees and alumni. This paper underscores the importance of the international perspective, the transdisciplinarity and the scientific networking established through the program.
Joint Bone Spine, 2004
Lateral epicondylitis is the most commonly diagnosed elbow condition and affects about 1-3% of th... more Lateral epicondylitis is the most commonly diagnosed elbow condition and affects about 1-3% of the population at large. It produces a heavy burden of workdays lost and residual impairments. Although many treatment modalities are used, few of them rest on scientific evidence and none has been proven more effective than the others. This paucity of evidence on treatments for lateral epicondylitis may stem from several sources, including the possible self-limiting nature of the condition, the lack of pathophysiological data, the methodological shortcomings of available studies, and the existence of numerous factors influencing the outcome.
Canadian Journal of Occupational Therapy, 1998
... porteuse de sens. En effet, certains auteurs font une distinction entre les activités authent... more ... porteuse de sens. En effet, certains auteurs font une distinction entre les activités authentiques provenant du milieu réel et les activités apocryphes réalisées dans le milieu scolai re (Brown, Collins & Duguid, 1989). Les pre mi ...
Best Practice & Research Clinical Rheumatology, 2010
Low back pain is a leading cause of work disability and constitutes a significant socioeconomic b... more Low back pain is a leading cause of work disability and constitutes a significant socioeconomic burden worldwide. In an attempt to stem the serious consequences of long-term disability, a new approach for back pain in primary care is being disseminated. It mainly focusses on identifying the relationship between pain/disability and work, recognising important workplace and psychosocial issues, providing patients reassuring messages about activity, facilitating the return to work process and engaging other resources as needed. This article examines current expert opinion and available evidence on work issues for effective back pain management. In general, return to work, if safe, is beneficial for recovery and well-being. Some cases might require physicians to actively communicate with employers, claims managers and others in order to achieve safe and sustained return to work, while in most instances, simple efforts to identify and discuss work issues directly with the patient can lead to better work outcomes.
Archives of Physical Medicine and Rehabilitation, 2002
Larivière C, Arsenault AB, Gravel D, Gagnon D, Loisel P, Vadeboncoeur R. Electromyographic assess... more Larivière C, Arsenault AB, Gravel D, Gagnon D, Loisel P, Vadeboncoeur R. Electromyographic assessment of back muscle weakness and muscle composition: reliability and validity issues. Arch Phys Med Rehabil 2002;83:1206-14.
Revista Latino-Americana de Enfermagem, 2012
The Work Disability Diagnosis Interview (WoDDI) is a structured interview guide developed by the ... more The Work Disability Diagnosis Interview (WoDDI) is a structured interview guide developed by the University of Sherbrooke, Canada to help clinicians detect the most important work-related disability predictors and to identify one or more causes of prolonged absenteeism. This methodological study aims for the cross-cultural adaptation of the WoDDI for the Brazilian context. The method followed international guidelines for studies of this kind, including the following steps: initial translation, synthesis of translations, back translation, evaluation by an expert committee and testing of the penultimate version. These steps allowed obtaining conceptual, semantic, idiomatic, experiential and operational equivalences, in addition to content validity. The results showed that the translated WoDDI is adapted to the Brazilian context and can be used after training.
Applied Ergonomics, 2001
This paper describes a participatory ergonomics program aimed at early return to regular work of ... more This paper describes a participatory ergonomics program aimed at early return to regular work of workers suffering from subacute occupational back pain and assesses the perceptions of the participants on the implementation of ergonomic solutions in the workplace. The participatory ergonomics program was used in the rehabilitation of workers suffering from subacute back pain for more than 6 weeks, a program that was associated with an increased rate of return to work. The perceptions of the participatory ergonomics participants were assessed 6 months after completion of the ergonomic intervention through a questionnaire sent to employer representatives, union representatives and injured workers of participating workplaces. About half of the ergonomic solutions were implemented according to the perception of the participants, with a substantial agreement between respondents.
Canadian Journal of Occupational Therapy
Functional capacity evaluations are used to quantify and qualify the physical abilities of an ind... more Functional capacity evaluations are used to quantify and qualify the physical abilities of an individual in relation to the physical requirements of an occupation. One major observation associated with functional capacity evaluations is a lack of evidence on their psychometric properties. This article presents the results of a study on the test-retest reliability of a functional capacity evaluation tool: the Physical Work Performance Evaluation (PWPE). The PWPE is an instrument for evaluating the physical work capacities of individuals with physical limitations resulting from a health problem. The PWPE was administered twice to a convenience sample of 30 workers in good health. In the section on 'Dynamic Strength', the tasks demonstrate a good test-retest reliability (0.79 < ICC < 0.91). The three sections and the global score of the PWPE demonstrate a moderate stability (0.43 < kappa > 0.52). The PWPE score should be interpreted with caution and further studies on its psychometric properties will be necessary to clarify its clinical utility.
Canadian Journal of Occupational Therapy
ABSTRACT
Revue d Épidémiologie et de Santé Publique
Return to work is considered as a major effectiveness criterion for interventions dedicated to su... more Return to work is considered as a major effectiveness criterion for interventions dedicated to subacute or chronic low-back-pain sufferers. Moreover, return to work, beyond the economic and social Issues, is regarded more and more as having a therapeutic dimension. This review aims to describe the various interventions which are effective in returning patients to work. The presentation is based on existing reviews supplemented by a selection of recent studies. "Cognitive-behavioral therapy", "reassurance" and "back exercises" are some suggested approaches. Some of these techniques are geared specifically towards work. Others, such as "back schools" or "multidisciplinary interventions" combine different approaches. Promoting return to work at an appropriate stage (subacute stage) could help low-back-pain sufferers to avoid prolonged disability.
ABSTRACT Résumé non disponible
Work
Therapeutic Return to Work is a work rehabilitation program linking graded work exposure with fun... more Therapeutic Return to Work is a work rehabilitation program linking graded work exposure with functional restoration therapy for chronic low back pain. This study evaluates the impact of the program on stable return to work (RTW) and compares it with the impact on RTW of three frequently used ways of management of back pain (normative comparison). At two year follow-up, 93% of participants of the Therapeutic Return to Work program were working. This rate was higher than in the comparison groups. Although limited by its norm-referenced evaluation design, the results of this study indicate the importance of placing the work site in the center of the of work rehabilitation process. In this program occupational therapists make full use of the client's natural environment.
AIMS: Back muscle capacity is impaired in chronic low back pain (CLBP) patients but no motivation... more AIMS: Back muscle capacity is impaired in chronic low back pain (CLBP) patients but no motivation-free test exists to measure it. The aims of this study were to assess the reliability and criterion validity of EMG indices sensitive to back muscle strength and absolute endurance. We also tested the possibility of using regression equations to predict these outcomes using anthropometric and EMG variables as predictors.
Work
Many work injuries and their associated disabilities are preventable, but effective prevention re... more Many work injuries and their associated disabilities are preventable, but effective prevention requires coordinated action by multiple stakeholders. In trying to achieve coordinated action occupational health practitioners can learn valuable lessons from systems theory, knowledge transfer and action research. Systems theory provides a broad view of the factors leading to injury and disability and a means to refocus stakeholder energies from mutual blaming to effective strategies for system change. Experiences from knowledge transfer will help adopt a stakeholder-centered approach that will facilitate the concrete application of the best and most current occupational health knowledge. Action research is a methodology endorsed by the World Health Organization and the US Centers for Disease Control, which provide methods for successfully engaging stakeholders needed to attain sustainable change. By combining concepts from the three fields we propose MAPAC (Mobilize, Assess, Plan, Act, Check), a five-step framework for developing projects aimed at decreasing occupational injury and disability. Although most practitioners would be familiar with some of the concepts, we believe an explicit framework linked to transferable knowledge from these diverse fields can help design and implement effective programs. We provide examples of model application in workers compensation and in the healthcare workplace.
Physiotherapy Canada, 2004
Handbook of Complex Occupational Disability Claims, 2005
Journal of occupational rehabilitation, 2002
Recent evidence has demonstrated that disability from musculoskeletal disorders is a multifactori... more Recent evidence has demonstrated that disability from musculoskeletal disorders is a multifactorial problem that is not only due to workers' characteristics but also closely related to environmental factors, such as the workplace, the health care system, the compensation system, and the interactions among all stakeholders regarding the disability problem. The Work Disability Diagnosis Interview (WoDDI) was developed following a systematic method in order to help clinicians detect possible disability prognostic factors in subacute or chronic musculoskeletal pain patients. A structured literature review, followed by expert input and a second round of revisions after 4-year's usage led to the current version. The WoDDI is composed of open-ended questions on physical, psychosocial, occupational, and administrative factors, collated into an interview form used at the first encounter with the disabled worker. It enables clinicians to develop a rehabilitation plan and focus on disa...
Journal of Occupational Rehabilitation, 2009
To develop a consensus plan for research and practice to encourage routine clinician screening of... more To develop a consensus plan for research and practice to encourage routine clinician screening of occupational factors associated with long-term back disability. A 3-day conference workshop including 21 leading researchers and clinicians (the "Decade of the Flags Working Group") was held to review the scientific evidence concerning clinical, occupational, and policy factors in back disability and the development of feasible assessment and intervention strategies. The Working Group identified seven workplace variables to include in early screening by clinicians: physical job demands, ability to modify work, job stress, workplace social support or dysfunction, job satisfaction, expectation for resuming work, and fear of re-injury. Five evaluation criteria for screening methods were established: reliability, predictive performance, feasibility, acceptability, and congruence with plausible interventions. An optimal screening method might include a stepped combination of questionnaire, interview, and worksite visit. Future research directions include improving available assessment methods, adopting simpler and more uniform conceptual frameworks, and tying screening results to plausible interventions. There is a clear indication that occupational factors influence back disability, but to expand clinician practices in this area will require that patient screening methods show greater conceptual clarity, feasibility, and linkages to viable options for intervention.
Journal of Occupational Rehabilitation, 2009
Journal of Occupational Rehabilitation, 2009
Introduction The Work Disability Prevention (WDP) Canadian Institutes of Health Research (CIHR) S... more Introduction The Work Disability Prevention (WDP) Canadian Institutes of Health Research (CIHR) Strategic Training Program was developed in 2001 and is a unique program in the world. The main objective of this program is to help future researchers develop transdisciplinary knowledge, skills and attitudes regarding WDP. The purpose of this paper is to present a descriptive portrait of the program's performance over the past 5 years, as well as the trainees' and alumni's perspectives on the WDP CIHR Training Program. Methods Data on the program's performance were collected from documents in the program records. The trainees' opinions on the WDP training program were obtained through focus groups and telephone interviews. The data collected were compiled and divided into themes to summarize the qualitative findings pertaining to each question. Results From 2003 to 2007, five successive summer sessions have been offered, involving 44 high-caliber applicants from nine countries, 34 mentors and collaborators, 29 guest speakers and 15 stakeholders. Overall, trainees appreciated the networking, the opportunity to interact with people from different disciplines and countries, the openness, and the international perspective and uniqueness of the program. The least appreciated aspects concerned mainly the e-learning course, evaluations and information on optional courses. The coordination and logistics were judged appropriate and several topics were suggested to improve the program quality. Conclusion In general, the program implementation went well, with good participation from mentors, speakers and stakeholders; the program was appreciated by the trainees and alumni. This paper underscores the importance of the international perspective, the transdisciplinarity and the scientific networking established through the program.
Joint Bone Spine, 2004
Lateral epicondylitis is the most commonly diagnosed elbow condition and affects about 1-3% of th... more Lateral epicondylitis is the most commonly diagnosed elbow condition and affects about 1-3% of the population at large. It produces a heavy burden of workdays lost and residual impairments. Although many treatment modalities are used, few of them rest on scientific evidence and none has been proven more effective than the others. This paucity of evidence on treatments for lateral epicondylitis may stem from several sources, including the possible self-limiting nature of the condition, the lack of pathophysiological data, the methodological shortcomings of available studies, and the existence of numerous factors influencing the outcome.
Canadian Journal of Occupational Therapy, 1998
... porteuse de sens. En effet, certains auteurs font une distinction entre les activités authent... more ... porteuse de sens. En effet, certains auteurs font une distinction entre les activités authentiques provenant du milieu réel et les activités apocryphes réalisées dans le milieu scolai re (Brown, Collins & Duguid, 1989). Les pre mi ...
Best Practice & Research Clinical Rheumatology, 2010
Low back pain is a leading cause of work disability and constitutes a significant socioeconomic b... more Low back pain is a leading cause of work disability and constitutes a significant socioeconomic burden worldwide. In an attempt to stem the serious consequences of long-term disability, a new approach for back pain in primary care is being disseminated. It mainly focusses on identifying the relationship between pain/disability and work, recognising important workplace and psychosocial issues, providing patients reassuring messages about activity, facilitating the return to work process and engaging other resources as needed. This article examines current expert opinion and available evidence on work issues for effective back pain management. In general, return to work, if safe, is beneficial for recovery and well-being. Some cases might require physicians to actively communicate with employers, claims managers and others in order to achieve safe and sustained return to work, while in most instances, simple efforts to identify and discuss work issues directly with the patient can lead to better work outcomes.
Archives of Physical Medicine and Rehabilitation, 2002
Larivière C, Arsenault AB, Gravel D, Gagnon D, Loisel P, Vadeboncoeur R. Electromyographic assess... more Larivière C, Arsenault AB, Gravel D, Gagnon D, Loisel P, Vadeboncoeur R. Electromyographic assessment of back muscle weakness and muscle composition: reliability and validity issues. Arch Phys Med Rehabil 2002;83:1206-14.
Revista Latino-Americana de Enfermagem, 2012
The Work Disability Diagnosis Interview (WoDDI) is a structured interview guide developed by the ... more The Work Disability Diagnosis Interview (WoDDI) is a structured interview guide developed by the University of Sherbrooke, Canada to help clinicians detect the most important work-related disability predictors and to identify one or more causes of prolonged absenteeism. This methodological study aims for the cross-cultural adaptation of the WoDDI for the Brazilian context. The method followed international guidelines for studies of this kind, including the following steps: initial translation, synthesis of translations, back translation, evaluation by an expert committee and testing of the penultimate version. These steps allowed obtaining conceptual, semantic, idiomatic, experiential and operational equivalences, in addition to content validity. The results showed that the translated WoDDI is adapted to the Brazilian context and can be used after training.
Applied Ergonomics, 2001
This paper describes a participatory ergonomics program aimed at early return to regular work of ... more This paper describes a participatory ergonomics program aimed at early return to regular work of workers suffering from subacute occupational back pain and assesses the perceptions of the participants on the implementation of ergonomic solutions in the workplace. The participatory ergonomics program was used in the rehabilitation of workers suffering from subacute back pain for more than 6 weeks, a program that was associated with an increased rate of return to work. The perceptions of the participatory ergonomics participants were assessed 6 months after completion of the ergonomic intervention through a questionnaire sent to employer representatives, union representatives and injured workers of participating workplaces. About half of the ergonomic solutions were implemented according to the perception of the participants, with a substantial agreement between respondents.
Canadian Journal of Occupational Therapy
Functional capacity evaluations are used to quantify and qualify the physical abilities of an ind... more Functional capacity evaluations are used to quantify and qualify the physical abilities of an individual in relation to the physical requirements of an occupation. One major observation associated with functional capacity evaluations is a lack of evidence on their psychometric properties. This article presents the results of a study on the test-retest reliability of a functional capacity evaluation tool: the Physical Work Performance Evaluation (PWPE). The PWPE is an instrument for evaluating the physical work capacities of individuals with physical limitations resulting from a health problem. The PWPE was administered twice to a convenience sample of 30 workers in good health. In the section on 'Dynamic Strength', the tasks demonstrate a good test-retest reliability (0.79 < ICC < 0.91). The three sections and the global score of the PWPE demonstrate a moderate stability (0.43 < kappa > 0.52). The PWPE score should be interpreted with caution and further studies on its psychometric properties will be necessary to clarify its clinical utility.
Canadian Journal of Occupational Therapy
ABSTRACT
Revue d Épidémiologie et de Santé Publique
Return to work is considered as a major effectiveness criterion for interventions dedicated to su... more Return to work is considered as a major effectiveness criterion for interventions dedicated to subacute or chronic low-back-pain sufferers. Moreover, return to work, beyond the economic and social Issues, is regarded more and more as having a therapeutic dimension. This review aims to describe the various interventions which are effective in returning patients to work. The presentation is based on existing reviews supplemented by a selection of recent studies. "Cognitive-behavioral therapy", "reassurance" and "back exercises" are some suggested approaches. Some of these techniques are geared specifically towards work. Others, such as "back schools" or "multidisciplinary interventions" combine different approaches. Promoting return to work at an appropriate stage (subacute stage) could help low-back-pain sufferers to avoid prolonged disability.