A new guide to help clinicians plan a progressive return to work for workers absent due to musculoskeletal disorders

Introduction
For people facing work disability situations, exposure to work is the core element of a successful RTW program. For clinicians in this field, however, the appropriate progression in tasks and production demands still requires planning based on their experience and intuition. Objective: To develop a guide that will help clinicians structure a progressive RTW using the ergonomics concept of margin of manoeuvre.

Methods
Fifty-two indicators of the margin of manoeuvre were defined on the basis of prior research. In this study, a literature search and discussion with experts (n=4) helped select the 35 most significant indicators. Starting from this shorter list, another literature review and expert group meetings (n=4) allowed retrieval of appropriate tools to assess each indicator.

Results
A first version of the guide for assessing the margin of manoeuvre needed for workers absent due to musculoskeletal disorders (MM Guide) has been written and approved by the expert committee. The guide includes questions from the following questionnaires: Organizational Policies and Practices Questionnaire, Job Content Questionnaire, Risk Factor Questionnaire, Work Role Functioning Questionnaire, and others. The MM Guide is to be used by trained professionals, within RTW programs.

Discussion
For the first time, a guide allows the dynamic integration of both individual capacities and work demands in the context of RTW programs. The next step will involve the pilot testing of the Guide with three clinicians. Barriers and facilitators will be discussed, and a new version of the Guide will be produced. The revised Guide will help both clinicians in their professional practice and workers with MSDs to achieve a safer, more productive return to work.