Objective: To describe the prevalence of comorbidity and its relationship with demographic and cl... more Objective: To describe the prevalence of comorbidity and its relationship with demographic and clinical characteristics in persons wearing a prosthesis after lower-limb amputation. Design: Cross-sectional study. Subjects/patients: Persons wearing a prosthesis after lower-limb amputation (n = 171; mean age 65 years (standard deviation 12); 72% men) at the end of outpatient rehabilitation treatment. Methods: Comorbidity was assessed with the Functional Comorbidity Index: a list of 18 items addressing the presence of specific comorbid conditions impacting on functional status. Comorbidities in medical records were assessed independently by 2 assessors. Associations with demographic and clinical characteristics were analysed using linear or logistic regression. Results: The median (interquartile range) number of comorbidities was 3 (2; 4). Three or more comorbidities were present in 103 of 171 (60%) participants. Diabetes was present in 71 (41%), cardiac disease in 60 (35%), and lumbago/degenerative disc disease in 39 (23%) participants. The prevalence of comorbidities was higher in women and those with vascular cause of amputation. Conclusion: There is a high prevalence of comorbidity at the end of outpatient rehabilitation treatment in persons wearing a prosthesis after a lower-limb amputation, especially in women and those with vascular cause of amputation.
This is an open access article under the terms of the Creat ive Commo ns Attri bution-NonCo mmerc... more This is an open access article under the terms of the Creat ive Commo ns Attri bution-NonCo mmerc ial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
Myodesis or myoplasty in trans-femoral amputations. What is the best option? An explorative study... more Myodesis or myoplasty in trans-femoral amputations. What is the best option? An explorative study. Medical Hypotheses,
The Journal of Hand Surgery: Journal of the British Society for Surgery of the Hand, 2000
This retrospective study assessed the long-term outcome of brachial plexus neuropathy in 16 patie... more This retrospective study assessed the long-term outcome of brachial plexus neuropathy in 16 patients. The mean follow up was 8 years. Nine patients complained of persistent pain and muscle weakness, four had continuing problems with various activities of daily living and 11 had trouble with some housekeeping activities. Furthermore, eight of the patients had to change their occupation.
Journal of the American Medical Directors Association, 2012
Elderly people with a lower limb amputation impose a heavy burden on health resources, requiring ... more Elderly people with a lower limb amputation impose a heavy burden on health resources, requiring extensive rehabilitation and long term care. Mobility is key to regaining independence; however, the impact of multiple comorbidities in this patient group can make regaining mobility a particularly challenging task. An evidence-based prognosis for mobility is needed for rehabilitation and long term care planning. This systematic review summarizes the prosthetic and nonprosthetic mobility outcomes achieved by elderly people with a lower limb amputation, to determine whether an accurate prognosis for mobility can be made. MEDLINE, EMBASE, and CINAHL were searched for studies published before May 2010 in English, German, Dutch, or French, using keywords and synonyms for elderly, mobility, rehabilitation, and amputation. Mobility focused on actual movement (moving from one place to another) and was limited to long-term measurements, 6 months after amputation or 3 months after discharge from rehabilitation. The 15 included studies featured a diversity of objective outcome measures and mobility grades that proved difficult to compare meaningfully. In general, studies that included selected populations of prosthetic walkers showed that advanced prosthetic mobility skills can be achieved by the elderly person with a lower limb amputation, including outdoor/community walking. Studies that included all subjects undergoing a lower limb amputation reported that less than half of the elderly population achieved a household level of prosthetic mobility. The predominant findings from the included studies were incomplete reporting of study populations and poor reporting of the reliability of the mobility measures used. The strength of conclusions from this review was therefore limited and the prognosis for mobility in elderly people after lower limb amputation remains unclear. Further research into mobility outcomes of this population is needed to provide evidence that enables more informed choices in rehabilitation and long term care.
Journal of Rehabilitation Medicine – Clinical Communications, 2021
This is an open access article under the CC BY-NC license. www.medicaljournals.se/jrm-cc Foundati... more This is an open access article under the CC BY-NC license. www.medicaljournals.se/jrm-cc Foundation of Rehabilitation Information
Journal of hand surgery (Edinburgh, Scotland), 2002
We read with interest the publication by Zyluk (2001), and wish to comment on some of the author’... more We read with interest the publication by Zyluk (2001), and wish to comment on some of the author’s results. In his introduction Zyluk failed to refer to the publications of Geertzen et al. (Geertzen et al., 1998a, b and c) which concern the long-term functional outcome after RSD (mean follow-up time was 5.5 years; 3–9 years; sd=0.8). Thus such studies do exist. In these publications the relationship between impairments resulting from RSD of the upper extremity, and disabilities and health related quality of life are described. In the section ‘‘patients and methods’’, Zyluk (2001) describes the clinical criteria on which his diagnosis of RSD was based. Additionally, he describes plain X-rays and the three-bone scintigraphy as further diagnostic tools. In the literature there are no data concerning whether these additional diagnostic tools aid the diagnosis of RSD (Schürmann et al., 1999, Stanton-Hicks, 2000). Furthermore, Zyluk (2001) fails to clarify the additional value of these tools. The International Association for the Study of Pain does not consider these tools as necessary for the diagnosis (Merskey and Bogduk, 1994). The physical complaints perceived by our patients 5–9 years after RSD are shown in Table 1 (Geertzen et al., 1998a). Thus, in contrast with Zyluk’s finding, our results suggest that the outcome of RSD is far from good. In our study 12 patients (18.3%) required occasional analgesics or psycho-pharmacons. We used a standardized physical examination, which included active range of motion measurements with a goniometer. Muscle strength (full fist grip, three-point grip and pinch grip) was measured with a hand-held dynamometer and sensibility was measured with a discriminator. Finally circumferences of the wrist and index finger (oedema) were measured with a Gulick measuring tape (Geertzen et al., 1998a). We found significant differences in muscle strength between the affected and unaffected side. The active range of motion was significantly larger on the unaffected side, however all mean active movements were within the ranges needed to perform ADL, such as eating and dressing (Geertzen et al., 1998a). Another aim of our study was to evaluate to the health related Quality of Life, using the RAND-36 and to describe the long-term changes in occupation of RSD patients. The results showed that our RSD patients experience significantly more pain than control-groups and that there are considerable changes in occupation within our RSD-patients. In total RSD 17 patients (26.2%) had to change occupation and four were unemployed due to RSD. Nineteen RSD (29.1%) patients had to stop their work for 12 months or more (Geertzen et al., 1998b). In summary we do not support the findings of Zyluk of an overall good long-term outcome after RSD.
Take-down policy If you believe that this document breaches copyright please contact us providing... more Take-down policy If you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediately and investigate your claim.
Introduction The objective of this study was to analyze the relationship of general and specific ... more Introduction The objective of this study was to analyze the relationship of general and specific self-efficacy (SE) beliefs with functional capacity evaluation (FCE) performances in patients with chronic non-specific low back pain (CLBP), while controlling for influence of gender, age, and self-reported pain intensity, self-esteem, disability, psychosocial distress and health status. Methods Included were 92 patients with CLBP referred to an outpatient university based multidisciplinary pain rehabilitation program in The Netherlands. All patients underwent an FCE. General SE was measured with the ALCOS questionnaire prior to the FCE, specific SE was measured with a self-constructed standardized question during the FCE. Paired samples t-tests were used to tests differences between predicted and actual performances. Pearson and Spearman rank correlation coefficients were used to express the strength of the relationships between SE and performances. Multivariate analyses were used to test the influence of control variables on the relationships between SE (general or specific) and performances. Results Performances were consistently higher than patients' self-predictions. Differences between predictions and performances were significant in male lifting low, male carrying, and female carrying. With exception of the association between specific SE and lifting in males (r = 0.55, P \\ 0.05), all other correlations between general and specific SE and FCE performances were non-significant. Multivariable regression analyses showed that the relative contribution of SE measures over gender was little or none. Conclusions The contribution of specific SE to the prediction of FCE performances is moderate in one instance, and insignificant in most instances (both specific and general SE). Because of the consistency of the differences between prediction (specific SE) and performances, and depending on the level of accuracy needed, future research may deliberate the use of predicted material handling capacities at group level and correct for a systematic underprediction.
Background: Functional Capacity Evaluations (FCEs) are evaluations designed to measure capacity t... more Background: Functional Capacity Evaluations (FCEs) are evaluations designed to measure capacity to perform activities and are used to make recommendations for participation in work. Normative values of healthy working subjects' performances are unavailable, thus patients' performances cannot be compared to those values. Objective: To establish normative values for FCE of healthy working subjects. Methods: Healthy subjects working in over 180 professions performed an FCE consisting of 12 work-related tests. Subjects were classified into categories based on physical demands according to the Dictionary of Occupational Titles (DOT). Means, ranges, standard deviations, percentiles were calculated and a regression analyses for outcome of the 12 tests was performed. Results: Normative FCE values of 701 healthy working subjects (448 male, 253 female) were established for 4 physical demand categories. Conclusion: The normative values enable comparison of patients' performances to these values. If the patients' performances exceed the lowest scores in his/her corresponding demand category, the patients' capacity is very likely to be sufficient to defy the work load. Further, clinicians can make more precise return to work recommendations and set goals for rehabilitation programs. Comparisons to normative values are useful for the fields of rehabilitation, occupational and insurance medicine. Further research is needed to test validity of the normative references with respect to work place assessments and return to work recommendations.
Introduction The problem of inconsistent terminology in functional capacity evaluation (FCE) has ... more Introduction The problem of inconsistent terminology in functional capacity evaluation (FCE) has been widely addressed in the international literature. Many different terms seem to be used interchangeably while other terms appear to be interpreted differently. This may seriously hinder FCE research and clinical use. To gain consensus in operational definitions in FCE and conceptual framework to classify terminology used in FCE. Methods A Delphi Survey with FCE experts was conducted which consisted of three rounds of questioning, using semi and full structured questions. The expert group was formed from international experts in FCE. Experts were selected if they met any of the following criteria: at least one international publication as first author and one as co-author in the field of FCE; or an individual who had developed an FCE that was subject of investigation in at least one publication in international literature. Consensus of definitions was considered when 75% or more of all experts agreed with a definition. Results In total, 22 international experts from 6 different countries in Australia, Europe and North America, working in different health related sectors, participated in this study. Conclusion Consensus concerning conceptual framework of FCE was met in 9 out of 20 statements. Consensus on definitions was met in 10 out of 19 definitions. Experts agreed to use the ICF as a conceptual framework in which terminology of FCE should be classified and agreed to use pre-defined terms of the ICF. No consensus was reached about the definition of FCE, for which two potential eligible definitions remained. Consensus was reached in many terms used in FCE. For future research, it was recommended that researchers use these terms, use the ICF as a conceptual framework and clearly state which definition for FCE is used because no definition of FCE was consented.
Objective: To determine the consequences of using different external criteria on responsiveness o... more Objective: To determine the consequences of using different external criteria on responsiveness of the Roland–Morris Disability Questionnaire (RMDQ) in patients with chronic low back pain. Design: Questionnaire measures before and after rehabilitation treatment. Setting: Rehabilitation centre. Subjects: Patients with nonspecific chronic low back pain, referred for treatment. Main measures: The RMDQ was used to assess self-reported functional status. The used external criteria were: (1) global perceived effect of change in complaints; (2) global perceived effect of change in ability to take care of oneself; (3) change in rating of pain intensity; (4) smallest real difference. Standardized response means, pooled effect sizes and receiver operating curves were calculated to determine respon siveness and to enable comparison of effect sizes with the thresholds of Cohen. Results: Standardized response means ranged from 1.33 to 3.45, pooled effect sizes ranged from 1.50 to 2.81, and areas...
Take-down policy If you believe that this document breaches copyright please contact us providing... more Take-down policy If you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediately and investigate your claim.
Background: Many people with chronic nonspecific musculoskeletal pain (CMP) have decreased work a... more Background: Many people with chronic nonspecific musculoskeletal pain (CMP) have decreased work ability. The majority, however, stays at work despite their pain. Knowledge about workers who stay at work despite chronic pain is limited, narrowing our views on work participation. The aim of this study was to explore why people with CMP stay at work despite pain (motivators) and how they manage to maintain working (success factors). Methods: A semi-structured interview was conducted among 21 subjects who stay at work despite CMP. Participants were included through purposeful sampling. Interviews were audio-recorded, transcribed verbatim, and imported into computer software Atlas.ti. Data was analyzed by means of thematic analysis. The interviews consisted of open questions such as: "Why are you working with pain?" or "How do you manage working while having pain?" Results: A total of 16 motivators and 52 success factors emerged in the interviews. Motivators were categorized into four themes: work as value, work as therapy, work as income generator, and work as responsibility. Success factors were categorized into five themes: personal characteristics, adjustment latitude, coping with pain, use of healthcare services, and pain beliefs.
Objective: To describe the prevalence of comorbidity and its relationship with demographic and cl... more Objective: To describe the prevalence of comorbidity and its relationship with demographic and clinical characteristics in persons wearing a prosthesis after lower-limb amputation. Design: Cross-sectional study. Subjects/patients: Persons wearing a prosthesis after lower-limb amputation (n = 171; mean age 65 years (standard deviation 12); 72% men) at the end of outpatient rehabilitation treatment. Methods: Comorbidity was assessed with the Functional Comorbidity Index: a list of 18 items addressing the presence of specific comorbid conditions impacting on functional status. Comorbidities in medical records were assessed independently by 2 assessors. Associations with demographic and clinical characteristics were analysed using linear or logistic regression. Results: The median (interquartile range) number of comorbidities was 3 (2; 4). Three or more comorbidities were present in 103 of 171 (60%) participants. Diabetes was present in 71 (41%), cardiac disease in 60 (35%), and lumbago/degenerative disc disease in 39 (23%) participants. The prevalence of comorbidities was higher in women and those with vascular cause of amputation. Conclusion: There is a high prevalence of comorbidity at the end of outpatient rehabilitation treatment in persons wearing a prosthesis after a lower-limb amputation, especially in women and those with vascular cause of amputation.
This is an open access article under the terms of the Creat ive Commo ns Attri bution-NonCo mmerc... more This is an open access article under the terms of the Creat ive Commo ns Attri bution-NonCo mmerc ial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
Myodesis or myoplasty in trans-femoral amputations. What is the best option? An explorative study... more Myodesis or myoplasty in trans-femoral amputations. What is the best option? An explorative study. Medical Hypotheses,
The Journal of Hand Surgery: Journal of the British Society for Surgery of the Hand, 2000
This retrospective study assessed the long-term outcome of brachial plexus neuropathy in 16 patie... more This retrospective study assessed the long-term outcome of brachial plexus neuropathy in 16 patients. The mean follow up was 8 years. Nine patients complained of persistent pain and muscle weakness, four had continuing problems with various activities of daily living and 11 had trouble with some housekeeping activities. Furthermore, eight of the patients had to change their occupation.
Journal of the American Medical Directors Association, 2012
Elderly people with a lower limb amputation impose a heavy burden on health resources, requiring ... more Elderly people with a lower limb amputation impose a heavy burden on health resources, requiring extensive rehabilitation and long term care. Mobility is key to regaining independence; however, the impact of multiple comorbidities in this patient group can make regaining mobility a particularly challenging task. An evidence-based prognosis for mobility is needed for rehabilitation and long term care planning. This systematic review summarizes the prosthetic and nonprosthetic mobility outcomes achieved by elderly people with a lower limb amputation, to determine whether an accurate prognosis for mobility can be made. MEDLINE, EMBASE, and CINAHL were searched for studies published before May 2010 in English, German, Dutch, or French, using keywords and synonyms for elderly, mobility, rehabilitation, and amputation. Mobility focused on actual movement (moving from one place to another) and was limited to long-term measurements, 6 months after amputation or 3 months after discharge from rehabilitation. The 15 included studies featured a diversity of objective outcome measures and mobility grades that proved difficult to compare meaningfully. In general, studies that included selected populations of prosthetic walkers showed that advanced prosthetic mobility skills can be achieved by the elderly person with a lower limb amputation, including outdoor/community walking. Studies that included all subjects undergoing a lower limb amputation reported that less than half of the elderly population achieved a household level of prosthetic mobility. The predominant findings from the included studies were incomplete reporting of study populations and poor reporting of the reliability of the mobility measures used. The strength of conclusions from this review was therefore limited and the prognosis for mobility in elderly people after lower limb amputation remains unclear. Further research into mobility outcomes of this population is needed to provide evidence that enables more informed choices in rehabilitation and long term care.
Journal of Rehabilitation Medicine – Clinical Communications, 2021
This is an open access article under the CC BY-NC license. www.medicaljournals.se/jrm-cc Foundati... more This is an open access article under the CC BY-NC license. www.medicaljournals.se/jrm-cc Foundation of Rehabilitation Information
Journal of hand surgery (Edinburgh, Scotland), 2002
We read with interest the publication by Zyluk (2001), and wish to comment on some of the author’... more We read with interest the publication by Zyluk (2001), and wish to comment on some of the author’s results. In his introduction Zyluk failed to refer to the publications of Geertzen et al. (Geertzen et al., 1998a, b and c) which concern the long-term functional outcome after RSD (mean follow-up time was 5.5 years; 3–9 years; sd=0.8). Thus such studies do exist. In these publications the relationship between impairments resulting from RSD of the upper extremity, and disabilities and health related quality of life are described. In the section ‘‘patients and methods’’, Zyluk (2001) describes the clinical criteria on which his diagnosis of RSD was based. Additionally, he describes plain X-rays and the three-bone scintigraphy as further diagnostic tools. In the literature there are no data concerning whether these additional diagnostic tools aid the diagnosis of RSD (Schürmann et al., 1999, Stanton-Hicks, 2000). Furthermore, Zyluk (2001) fails to clarify the additional value of these tools. The International Association for the Study of Pain does not consider these tools as necessary for the diagnosis (Merskey and Bogduk, 1994). The physical complaints perceived by our patients 5–9 years after RSD are shown in Table 1 (Geertzen et al., 1998a). Thus, in contrast with Zyluk’s finding, our results suggest that the outcome of RSD is far from good. In our study 12 patients (18.3%) required occasional analgesics or psycho-pharmacons. We used a standardized physical examination, which included active range of motion measurements with a goniometer. Muscle strength (full fist grip, three-point grip and pinch grip) was measured with a hand-held dynamometer and sensibility was measured with a discriminator. Finally circumferences of the wrist and index finger (oedema) were measured with a Gulick measuring tape (Geertzen et al., 1998a). We found significant differences in muscle strength between the affected and unaffected side. The active range of motion was significantly larger on the unaffected side, however all mean active movements were within the ranges needed to perform ADL, such as eating and dressing (Geertzen et al., 1998a). Another aim of our study was to evaluate to the health related Quality of Life, using the RAND-36 and to describe the long-term changes in occupation of RSD patients. The results showed that our RSD patients experience significantly more pain than control-groups and that there are considerable changes in occupation within our RSD-patients. In total RSD 17 patients (26.2%) had to change occupation and four were unemployed due to RSD. Nineteen RSD (29.1%) patients had to stop their work for 12 months or more (Geertzen et al., 1998b). In summary we do not support the findings of Zyluk of an overall good long-term outcome after RSD.
Take-down policy If you believe that this document breaches copyright please contact us providing... more Take-down policy If you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediately and investigate your claim.
Introduction The objective of this study was to analyze the relationship of general and specific ... more Introduction The objective of this study was to analyze the relationship of general and specific self-efficacy (SE) beliefs with functional capacity evaluation (FCE) performances in patients with chronic non-specific low back pain (CLBP), while controlling for influence of gender, age, and self-reported pain intensity, self-esteem, disability, psychosocial distress and health status. Methods Included were 92 patients with CLBP referred to an outpatient university based multidisciplinary pain rehabilitation program in The Netherlands. All patients underwent an FCE. General SE was measured with the ALCOS questionnaire prior to the FCE, specific SE was measured with a self-constructed standardized question during the FCE. Paired samples t-tests were used to tests differences between predicted and actual performances. Pearson and Spearman rank correlation coefficients were used to express the strength of the relationships between SE and performances. Multivariate analyses were used to test the influence of control variables on the relationships between SE (general or specific) and performances. Results Performances were consistently higher than patients' self-predictions. Differences between predictions and performances were significant in male lifting low, male carrying, and female carrying. With exception of the association between specific SE and lifting in males (r = 0.55, P \\ 0.05), all other correlations between general and specific SE and FCE performances were non-significant. Multivariable regression analyses showed that the relative contribution of SE measures over gender was little or none. Conclusions The contribution of specific SE to the prediction of FCE performances is moderate in one instance, and insignificant in most instances (both specific and general SE). Because of the consistency of the differences between prediction (specific SE) and performances, and depending on the level of accuracy needed, future research may deliberate the use of predicted material handling capacities at group level and correct for a systematic underprediction.
Background: Functional Capacity Evaluations (FCEs) are evaluations designed to measure capacity t... more Background: Functional Capacity Evaluations (FCEs) are evaluations designed to measure capacity to perform activities and are used to make recommendations for participation in work. Normative values of healthy working subjects' performances are unavailable, thus patients' performances cannot be compared to those values. Objective: To establish normative values for FCE of healthy working subjects. Methods: Healthy subjects working in over 180 professions performed an FCE consisting of 12 work-related tests. Subjects were classified into categories based on physical demands according to the Dictionary of Occupational Titles (DOT). Means, ranges, standard deviations, percentiles were calculated and a regression analyses for outcome of the 12 tests was performed. Results: Normative FCE values of 701 healthy working subjects (448 male, 253 female) were established for 4 physical demand categories. Conclusion: The normative values enable comparison of patients' performances to these values. If the patients' performances exceed the lowest scores in his/her corresponding demand category, the patients' capacity is very likely to be sufficient to defy the work load. Further, clinicians can make more precise return to work recommendations and set goals for rehabilitation programs. Comparisons to normative values are useful for the fields of rehabilitation, occupational and insurance medicine. Further research is needed to test validity of the normative references with respect to work place assessments and return to work recommendations.
Introduction The problem of inconsistent terminology in functional capacity evaluation (FCE) has ... more Introduction The problem of inconsistent terminology in functional capacity evaluation (FCE) has been widely addressed in the international literature. Many different terms seem to be used interchangeably while other terms appear to be interpreted differently. This may seriously hinder FCE research and clinical use. To gain consensus in operational definitions in FCE and conceptual framework to classify terminology used in FCE. Methods A Delphi Survey with FCE experts was conducted which consisted of three rounds of questioning, using semi and full structured questions. The expert group was formed from international experts in FCE. Experts were selected if they met any of the following criteria: at least one international publication as first author and one as co-author in the field of FCE; or an individual who had developed an FCE that was subject of investigation in at least one publication in international literature. Consensus of definitions was considered when 75% or more of all experts agreed with a definition. Results In total, 22 international experts from 6 different countries in Australia, Europe and North America, working in different health related sectors, participated in this study. Conclusion Consensus concerning conceptual framework of FCE was met in 9 out of 20 statements. Consensus on definitions was met in 10 out of 19 definitions. Experts agreed to use the ICF as a conceptual framework in which terminology of FCE should be classified and agreed to use pre-defined terms of the ICF. No consensus was reached about the definition of FCE, for which two potential eligible definitions remained. Consensus was reached in many terms used in FCE. For future research, it was recommended that researchers use these terms, use the ICF as a conceptual framework and clearly state which definition for FCE is used because no definition of FCE was consented.
Objective: To determine the consequences of using different external criteria on responsiveness o... more Objective: To determine the consequences of using different external criteria on responsiveness of the Roland–Morris Disability Questionnaire (RMDQ) in patients with chronic low back pain. Design: Questionnaire measures before and after rehabilitation treatment. Setting: Rehabilitation centre. Subjects: Patients with nonspecific chronic low back pain, referred for treatment. Main measures: The RMDQ was used to assess self-reported functional status. The used external criteria were: (1) global perceived effect of change in complaints; (2) global perceived effect of change in ability to take care of oneself; (3) change in rating of pain intensity; (4) smallest real difference. Standardized response means, pooled effect sizes and receiver operating curves were calculated to determine respon siveness and to enable comparison of effect sizes with the thresholds of Cohen. Results: Standardized response means ranged from 1.33 to 3.45, pooled effect sizes ranged from 1.50 to 2.81, and areas...
Take-down policy If you believe that this document breaches copyright please contact us providing... more Take-down policy If you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediately and investigate your claim.
Background: Many people with chronic nonspecific musculoskeletal pain (CMP) have decreased work a... more Background: Many people with chronic nonspecific musculoskeletal pain (CMP) have decreased work ability. The majority, however, stays at work despite their pain. Knowledge about workers who stay at work despite chronic pain is limited, narrowing our views on work participation. The aim of this study was to explore why people with CMP stay at work despite pain (motivators) and how they manage to maintain working (success factors). Methods: A semi-structured interview was conducted among 21 subjects who stay at work despite CMP. Participants were included through purposeful sampling. Interviews were audio-recorded, transcribed verbatim, and imported into computer software Atlas.ti. Data was analyzed by means of thematic analysis. The interviews consisted of open questions such as: "Why are you working with pain?" or "How do you manage working while having pain?" Results: A total of 16 motivators and 52 success factors emerged in the interviews. Motivators were categorized into four themes: work as value, work as therapy, work as income generator, and work as responsibility. Success factors were categorized into five themes: personal characteristics, adjustment latitude, coping with pain, use of healthcare services, and pain beliefs.
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