In addition to the different experts participating in the P4W Consortium, a Panel with external experts of recognized prestige in the field has been created in order to advise, review and improve the different educational materials and results generated throughout the project.

Prevent4Work External Experts

Biography

Professor Szeto joins the Tung Wah College in January 2018, as the inaugural programme leader for the proposed new programme in Physiotherapy which is under preparation at present.
She graduated from BSc (Physiotherapy) in University of Toronto, Canada in 1982. She has had extensive clinical experience in physiotherapy working in Canada, Hong Kong and Australia over 30 years.
She taught in the undergraduate and postgraduate physiotherapy programmes in the Department of Rehabilitation Sciences, the Hong Kong Polytechnic University for over 20 years. She has had extensive experience in physiotherapy curriculum planning and coordination of clinical education.
She has published over 50 papers in internationally renowned journals and is a member of the editorial board for the journals, Applied Ergonomics and Musculoskeletal Science & Practice.

Education:

PhD (Physiotherapy), Curtin University of Technology, Australia
Master of Applied Sciences, Curtin University of Technology, Australia
Post-grad Diploma in Sports Physiotherapy, Curtin University of Technology, Australia
BSc(PT), University of Toronto, Canada

Professional Qualifications / Memberships:

Registered Physiotherapist in Hong Kong and Australia
Member of Hong Kong Ergonomic Society
Member of Australian Physiotherapy Association
Member of the Hong Kong Physiotherapy Association
Member of the Hong Kong Physiotherapy Union

Teaching Areas:

Musculoskeletal physiotherapy, ergonomics, electrotherapy, biomechanics, occupational health, health care management

Research Interests:

Occupational health, ergonomics, musculoskeletal disorders, biomechanics, pain, motor control

Overview

Dr Venerina Johnston is a researcher and Associate Professor in Physiotherapy at The University of Queensland. She has qualifications in physiotherapy, occupational health and safety and work disability prevention. Her research interests are in the prevention of work-related musculoskeletal problems and the prevention of work disability following a compensable injury. Venerina has a rich background in occupational rehabilitation and injury management from the perspective of the insurer, provider and employer.

Research Interests

  • Primary prevention of musculoskeleletal injuries in the workplace
    There is a debate over the source of neck pain in office workers. This debate is focused on two main areas (1) what is the source of pain and (2) can asymptomatic and symptomatic workers be differentiated on any physical measures? This research project is focused on understanding the source of pain to help target interventions for the prevention of neck pain in office workers.
  • Prevention of neck problems in office workers
    Various interventions have been trialled to address painful neck disorders in office workers. As the workplace is becoming the arena for many health initiatives, my research is exploring interventions which can be implemented at the workplace and the impact on presenteeism and absenteeism of these interventions. We are currently testing the impact of an exercise plus ergonomic intervention to impact productivity and neck pain in office workers in Brisbane. Please contact me if your organisation is interested in participating.
  • Upskilling supervisors to facilitate a return to work after a musculoskeletal and mental disorder
    It is recognised that line supervisors play a pivotal role in the return-to-work process. However, the specific knowledge, skills and behaviours necessary for supervisors to assist workers return to work after a compensable injury or illness have not been identified in the Australian setting. This project identified the needs of supervisors who are required to support staff returning to work after a mental health disorder or musculoskeletal injury. The results have provided the evidence base for the development of a training program specific to the Australian culture and compensation environment. A training program is currently undergoing pilot testing. The long-term benefits of such a training program will be the prevention of work disability and a reduction in the duration and costs associated with compensable injuries. Please contact me if your organisation is interested in participating or if you would like to undertake a PhD to complete this project.
  • Self-managing return to work following a compensbile musculoskeletal injury
    This study explores whether adding self-management training to vocational rehabilitation had an impact on work readiness, health efficacy and pain. We developed and tested a new model for the occupational rehabilitation of workers with chronic compensated musculoskeletal disorders by adding self-management training to the usual care. Self-management programs have been shown to be effective for chronic conditions in particular diabetes, heart disease, asthma and arthritis, but is new in the field of work disability. This project was funded by an Australian Research Council linkage grant.

Qualifications

  • Diploma in Workplace Disability Prevention, Université de Sherbrooke
  • Graduate Certificate in Management, University of Southern Queensland
  • Doctor of Philosophy, The University of Queensland
  • Bachelor of Physiotherapy, The University of Queensland


Kieran O’Sullivan graduated as a Physiotherapist from University College Dublin in 1999. He completed an MSc in Manipulative Therapy at Curtin University of Technology, Perth, Western Australia and his PhD, on persistent low back pain, at the University of Limerick – where he has worked since 2005. In 2008 he was awarded specialist member status by the Irish Society of Chartered Physiotherapists. In 2016, he took a 3-year career break from the University of Limerick to set up a Spinal Pain Centre of Excellence at Aspetar, Qatar. In August 2019, he returned to the University of Limerick.

His research interest is musculoskeletal pain and injury, particularly persistent spinal pain. He has published one book, six book chapters and over 140 journal articles. He has obtained over 4m euros in research funding. His research group disseminates its research through www.pain-ed.com, which is an online platform providing advice and information from both patients and clinical researchers on managing musculoskeletal pain.


Dr. David Høyrup Christiansen is a senior researcher and associate professor at the Department of Occupational Medicine, University Research Clinic and Department of Clinical Medicine, Aarhus University in Denmark.

He is as physiotherapist, Master of Health Science and a PhD in Clinical Medicine. He has 10 years of clinical experience in rehabilitation of patients with chronic musculoskeletal pain, before moving on to full time research.

His key interests are prevention, prognosis and effect of interventions of musculoskeletal pain, and evaluation of outcome measurement instruments.

He has been the principal investigator on several large scale observational and randomised interventional studies and published widely in peer-review journals in the musculoskeletal field.

Throughout his career he has had a strong focus on knowledge translation and ensuring research reaches the end-users and makes a difference.

Interviews with Prevent4Work External Experts


Question 1. What do you think about Prevent 4 Work and what do you think about the topic of the project? Although the project is in its first year of development, what is most striking about it and why did you decide to join it?

MSDs are a huge issue in the occupational setting, with massive costs for the people affected, and society. Given my own research focvusses on MSDs, and the quality of the people involved in the project, accepting an invitation to join as an external expert was easy.

Q2. The traditional approach has been focused on a bio-mechanical and anatomical understanding of why pain arise, leading to a focus on movement. Recent evidence suggests that many other factors may be responsible for such pains. In your opinion, which factors are relevant and what has been underestimated in the previous approach?

In just this past month, 2 systematic reviews (https://www.ncbi.nlm.nih.gov/pubmed/31775556 and https://www.ncbi.nlm.nih.gov/pubmed/31730537 – i am an author on the latter) further highlighted that many of the traditional views we have held about why people develop MSDs such as back pain are on shaky ground. There is no doubt at all in my mind that (i) we have overly focussed on what the late, great Max Zusman described as the SAB (structural-anatomical-biomechanical) model; and (ii) even when we consider those SAB factors, we have likely not looked at them sensibly either. For example, when we look at lifting, it is clearly a provocative factor for many people with LBP – but it is not the only factor, and it doesn’t mean that avoiding it, or doing it in a very ‘cautious’ manner is necessarily correct.

In terms of what factors are relevant, I think it would be hard to think of factors across the biopsychosocial spectrum that are totally irrelevant. To state the obvious, the specific factors might vary between individuals, and between different contexts (e.g. job demands, job security, prevailing compensation and social welfare policies within a company or country etc), but they can encompass physical, lifestyle, psychological, social, and so on…

Q3. Within the frame of MSDs, a lot of attention is paid to the workplace; however, recent guidelines point towards education on self-management strategies and promote an active and healthy lifestyle. Do you think that strategies focused on prevention and management of WMSDs should consider a broader scope when addressing the problem?

It is hard, and perhaps would leave employers at risk of being considered negligent, to NOT consider the workplace. But it is only one part of the person’s life, and when considering the workplace we have to look at the whole environment – not just the physical ergonomics, but the job security, job satisfaction, stress, etc… however, neither employer legislation nor health provider policies support such an approach – in most EU countries, avoiding MSDs by better designing office spaces received far more attention (in prevention of MSDs) than the aforementioned job security, satisfaction, stress etc…

Q4. How do you think the current model could be improved?

The steps above cover where I think the focus should be – consider the whole person, both inside and outside of work, and see what is impairing their health. It is not about ignoring physical or patho-anatomical factors, but better weighting their (modest) contribution to pain/MSDs. This is Not just about education of patients, employers, employees…..this is about meaningful policy/practice changes that support people/employers do the things that are most likely to help reduce the impact of MSDs.

Q5. What elements do you think are most relevant when developing these types of disorders?

I am reluctant to place the ‘blame’ on any one aspect – as in the aforementioned social factors are clearly important, physical health (enough fitness, strength for the job and life in general), lifestyle (sleep, stress, diet), mental health, etc… I appreciate this does not make prevention and management easy, as we likely have to screen for these factors broadly – and then target care in a way that is feasible for the person concerned, and scaleable for employers/society.

Q6. Do you think there are missing topics or contents within educational programs in relation to prevention of work-related musculoskeletal disorders?

I think the prevailing SAB model is overly dominant. I think we need to reduce (albeit not remove) the focus on physical risk factors for MSDs, and when we actually discuss these factors we should consider the adaptability/robustness of the body to loading once it is progressed gradually, rather than (almost always) discussing the frailty/vulnerability of the body. This reduced focus on physical risk factors can then offer time and space to examine broader bio-psycho-social constructs which have at least as much evidence to support their role.

Finally, we need to be very careful that when we talk about prevention of MSDs that we do not try to give people the impression that all pain is preventable, or that if someone gets a pain at work sometime that someone must be to blame for this rare/awful thing happening. Intermittent aches and pains like back pain are – in the words of nortin hadler – a predicament of life. In other words, back pain is – like tiredness, sadness, constipation – something that most of us will get every so often in our life and while this is unpleasant it is relatively normal, and should not be considered a very bad / dangerous thing, once it starts to settle. If we set the aim as trying to prevent every ache and pain, we would fail and perhaps make people feel even more scared about the robustness of their body and their health. What we are trying to prevent instead is severe and/or ongoing pain that has a big impact of a person’s overall life-including their ability to work.


Question 1. What do you think about Prevent 4 Work and what do you think about the topic of the project? Although the project is in its first year of development, what is most striking about it and why did you decide to join it?

The Prevent4Work is an interesting project. Preventing Work-Related Musculoskeletal Disorders (WMSD) are highly important and establishing a network to develop new educational programmes and E-health solutions has the potential to impact occupational health in Europe. The involvement of experts and relevant stakeholders are crucial. The abovementioned are the reasons why I joined the project. However it should be noted I have only been involved from WP3 Risk Assessment Questionnaire.

Q2. The traditional approach has been focused on a bio-mechanical and anatomical understanding of why pain arise, leading to a focus on movement. Recent evidence suggests that many other factors may be responsible for such pains. In your opinion, which factors are relevant and what has been underestimated in the previous approach?

The biomechanical and anatomical understanding of MSD is to narrow, as well as only focusing on the individual perspective. WMSD seems also to be influenced by aspects on group and organisational level. Including such factors may help us understand the development and prevention of WMSD better.

Q3. Within the frame of MSDs, a lot of attention is paid to the workplace; however, recent guidelines point towards education on self-management strategies and promote an active and healthy lifestyle. Do you think that strategies focused on prevention and management of WMSDs should consider a broader scope when addressing the problem?

In line with above mention the workplace may need to give greater attention to satisfaction of employees and organizational factors, such as management commitment, supportive environment and personal appreciation of risk. These factors have found to be associated with presence of WMSD. Therefore these factors could be a part of the puzzle, and calls for further exploration. Despite setting the tone for many years in other research areas, such as occupational safety (i.e. safety climate), workplace culture has been sparsely investigated for WMSD.

Q4. How do you think the current model could be improved?

I have only been involved since WP 3 Risk Assessment Questionnaire, so it is difficult to answer. But it seems well structured and organised; however I look forward to learn more about the next phases.

Q5. What elements do you think are most relevant when developing these types of disorders?

The development of WMSD is multifactorial – and should be approached as such – physical, psychological, social, and cultural factors

Q6. Do you think there are missing topics or contents within educational programs in relation to prevention of work-related musculoskeletal disorders?

As mentioned in 2 and 3, we need to be very aware for the organizational factors and work culture, both within countries (different industries/business) and between countries. One-size seldom fits all.