title: Quality of life and maintenance of improvements after early multimodal rehabilitation: a 5-year follow-up.
abstract: OBJECTIVE
  There is a paucity of long-term evaluations on rehabilitation of musculoskeletal disorders, e.g., neck, shoulder or back pain. The aim of this study was to assess quality of life and the effect of early multimodal rehabilitation on 91 patients with musculoskeletal pain and disability at a 5-year follow-up.
  
  
  METHODS
  The follow-up assessment, which included questions on pain, function, quality of life, perceived health, sick leave and psychosomatic symptoms, was performed 5 years after the assessment of baseline status.
  
  
  RESULTS
  Improvements in pain, perceived health and psychosomatic symptoms were maintained at the 5-year follow-up. In addition, improvements in function, quality of life, and level of acceptable pain were significant in comparison to baseline. At the time of the baseline assessment all patients were on sick leave (13% were on partial sick leave). At the 5-year follow-up, 58% of the patients were at work part or full time. The results show that those working differed significantly from those not working at the 5-year follow-up on almost all variables, indicating that those working enjoy better health. The most salient prognostic factors for return to work were perceived health and educational level at the time of the baseline evaluation.
  
  
  CONCLUSIONS
  These results show that treatment improved quality of life and the effects were basically maintained at 5 years. Work capacity as reflected in return to work increased greatly (81%) at a 1-year follow-up and was substantial (58%) at the 5-year follow-up. Moreover, perceived health and educational levels were important prognostic factors. Finally, the fact that patients working reported better health underscores the probable importance of return to work. Our results imply that it may be feasible to obtain long-term benefits from such a primary care-based intervention.
authors.affiliation: Centre for Clinical Research, Uppsala University-Västerås Hospital, Sweden. anders.westman@ltv.se
authors.forename: A
authors.initials: A
authors.lastname: Westman
authors.forename: S J
authors.initials: SJ
authors.lastname: Linton
authors.forename: T
authors.initials: T
authors.lastname: Theorell
authors.forename: J
authors.initials: J
authors.lastname: Ohrvik
authors.forename: P
authors.initials: P
authors.lastname: Wahlén
authors.forename: J
authors.initials: J
authors.lastname: Leppert
mesh_terms: D000328:Adult; D016009:Chi-Square Distribution; D003131:Combined Modality Therapy; D004185:Disability Evaluation; D006233:Persons with Disabilities / Q000523:psychology* / Q000534:rehabilitation*; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000523:psychology / Q000534:rehabilitation*; D010146:Pain / Q000523:psychology / Q000534:rehabilitation; D010147:Pain Measurement; D017060:Patient Satisfaction; D026761:Physical Therapy Specialty / Q000379:methods; D015397:Program Evaluation; D011788:Quality of Life