Effectiveness of early part-time sick leave in musculoskeletal disorders.
BACKGROUND
The importance of staying active instead of bed rest has been acknowledged in the management of musculoskeletal disorders (MSDs). This emphasizes the potential benefits of adjusting work to fit the employee's remaining work ability. Despite part-time sick leave being an official option in many countries, its effectiveness has not been studied yet. We have designed a randomized controlled study to assess the health effects of early part-time sick leave compared to conventional full-day sick leave. Our hypothesis is that if work time is temporarily reduced and work load adjusted at the early stages of disability, employees with MSDs will have less disability days and faster return to regular work duties than employees on a conventional sick leave.


METHODS
The study population will consist of 600 employees, who seek medical advice from an occupational physician due to musculoskeletal pain. The inclusion requires that they have not been on a sick leave for longer than 14 days prior to the visit. Based on the physician's judgement, the severity of the symptoms must indicate a need for conventional sick leave, but the employee is considered to be able to work part-time without any additional risk. Half of the employees are randomly allocated to part-time sick leave group and their work time is reduced by 40-60%, whereas in the control group work load is totally eliminated with conventional sick leave. The main outcomes are the number of days from the initial visit to return to regular work activities, and the total number of sick leave days during 12 and 24 months of follow-up. The costs and benefits as well as the feasibility of early part-time sick leave will also be evaluated.


CONCLUSIONS
This is the first randomised trial to our knowledge on the effectiveness of early part-time sick leave compared to conventional full-time sick leave in the management of MSDs. The data collection continues until 2011, but preliminary results on the feasibility of part-time sick leave will be available already in 2008. The increased knowledge will assist in better decision making process regarding the management of disability related to MSDs.


BACKGROUND
International Standard Randomised Controlled Trial Number Register, register number ISRCTN30911719.
Martimo
Kari-Pekka
KP
Team of Musculoskeletal Disorders, Centre of Expertise of Health and Work Ability, Finnish Institute of Occupational Health, Topeliuksenkatu 41 a A, 00250 Helsinki, Finland. kari-pekka.martimo@ttl.fi
Kaila-Kangas
Leena
L
Kausto
Johanna
J
Takala
Esa-Pekka
EP
Ketola
Ritva
R
Riihimäki
Hilkka
H
Luukkonen
Ritva
R
Karppinen
Jaro
J
Miranda
Helena
H
Viikari-Juntura
Eira
E
D002985:Clinical Protocols; D006801:Humans; D009140:Musculoskeletal Diseases / Q000453:epidemiology / Q000534:rehabilitation*; D012107:Research Design; D018582:Sick Leave; D013997:Time Factors; D016526:Workload