Factors of success and of failure in the process of returning to work after surgery for a work-related degenerative shoulder injury

Among musculoskeletal disorders (MSDs) of the upper limb, work-related degenerative injuries to the tendons of the rotator cuff muscles, which stabilise the shoulder, are frequent, and particularly costly and disabling. Going back to work after such damage to the shoulder, and even more so after a surgical operation, constitutes a crucial step in the success of a process of returning to work, and in preventing occupational exclusion. It transpires that going back to work has a large number of determinants and that those determinants are partially elucidated. In order to improve the chances of returning to work, it would appear important to describe the prognostic factors contributing to a favourable outcome and to an unfavourable outcome for this process.
The proposed study, which is a longitudinal epidemiological study on 120 employees, will be conducted in collaboration with the Institut Régional de Réadaptation (IRR, Regional Institute for Rehabilitation) of Nancy. In particular, it will aim to identify the underlying workings of the complex processes of returning to work, contributing to success or to failure of the process of returning to work, in terms of:
the extent to which the functional capacities are consistent with the constraints related to the work;
the expectations of the employee as regards recovering and returning to work;
information on the coordination of all of the players in the process of returning to work (occupational health services, healthcare practitioners and care staff, national health insurance medical officers, disability players, etc.);
re-induction into the company (compliance with the recommendations of the healthcare players, adapting working time and work content, occupational relations, etc.);
and, where applicable, preparing for retraining with the relevant players.

The study will comprise five stages for collecting objective and subjective data on the numerous aspects involved in the outcome of the process of returning to work for employees suffering from work-related shoulder injuries.

The tools (questionnaires, functional tests, etc.) that are the most relevant for identifying the factors of success or of failure of a process of returning to work will be recommended. All of these items (prognostic factors and tools) will be the subject of scientific presentations and publications, and of awareness-raising messages intended for occupational health services, national health insurance medical officers, healthcare practitioners and care staff, and employers at occupational days or during training actions.