Rehabilitation that works--vocational outcomes following rehabilitation for occupational musculoskeletal pain.
OBJECTIVE
To describe the short term vocational outcome for accident compensation claimaints with disabling musculoskeletal pain following a comprehensive, interdisciplinary rehabilitation programme.


METHODS
A telephone follow-up audit of clients who had undertaken a rehabilitation programme characterised by a cognitive-behavioural approach with self-management, reconditioning, vocational rehabilitation and psychological pain management.


RESULTS
Of 62 clients who had undergone a rehabilitation programme, we obtained follow-up information on 49 (79%). These were predominantly male, aged in their mid 30s, manual workers with low back pain and a median sick leave of twelve months. At a median of five months a vocational success was achieved in 75%: working full time (47%), part time (12%) or actively looking for work (16%). Of those in work, 48% went back to the same job, 7% went back to the same job but with a different employer and 15% went to a different job that used the same skills. Logistic regression analysis showed that duration of work disability was the major predictor of vocational success (OR 0.36, 95% CI 0.18 to 0.78, for a difference of twelve months).


CONCLUSIONS
Despite the uncontrolled nature of these results, it is likely that the rehabilitation programme had a significant impact in getting compensation claimants back to work. Only a minority require substantive retraining and early intervention is associated with a better outcome.
Taylor
W
W
Specialist Rehabilitation Services, Hutt Valley Health, Lower Hutt and Rehabilitation Teaching and Research Unit, Wellington School of Medicine. medwjt@leeds.ac.uk
Simpson
R
R
Gow
D
D
McNaughton
H
H
D000328:Adult; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D009140:Musculoskeletal Diseases / Q000534:rehabilitation*; D009784:Occupational Diseases / Q000534:rehabilitation*; D010146:Pain / Q000534:rehabilitation*; D012050:Rehabilitation, Vocational