Approaches to worker rehabilitation by occupational and physical therapists in the United States: factors impacting practice.

Work-related rehabilitation services have changed in nature and scope since their inception in the late 1970s. A review of the literature reveals a large body of published data concerning the various approaches used by therapists in this practice area, but a limited number of comparison studies documenting the value of one approach over the other. This national survey of physical and occupational therapists in the US was conducted in 2002, and examined the prevailing trends in service provision, and factors that determine the nature of services provided to clients. Results indicate that services continue the move to onsite service provision and an emphasis on prevention, but that select services, such as onsite job analysis and comprehensive, inter-disciplinary programs are being used to a limited degree. Research that examines the relative contributions of selected work-related services to successful and efficient return to work outcomes is necessary to identify best practice approaches. Therapists and insurance providers should work more closely in exchange of data that will ensure optimal program design and funding.