title: Outpatient rehabilitation of workers with musculoskeletal disorders using structured workplace description.
abstract: OBJECTIVE
  In most industrialized countries musculoskeletal disorders contribute considerably (25%) to illness induced work absence. A special interest to reduce worker absences exists in highly specialized industries such as jet manufacturing, where specific knowledge is hard to replace. We investigated the reduction and sustainability in sick leave days by a workplace oriented outpatient rehabilitation program based on structured information exchange between occupational physicians and therapists.
  
  
  METHODS
  Sick leave days reduction and return-to-work-ratios were analysed for 79 male blue collar workers with musculoskeletal disease, who voluntarily participated in an outpatient rehabilitation treatment between 2002 and 2005. During rehabilitation therapy standardized workplace descriptions were given to the therapists and individual return-to-work (rtw) schemes were implemented. Therapy lasted from 3 to 4 weeks followed by workplace reintegration. Off-work-time was calculated from 0 to 6 years before and 0 to 3 years after rehabilitation from insurance and industrial medical reports.
  
  
  RESULTS
  A total of 97% of the patients returned to their original job at the workplace, usually directly after the rehabilitation. Average sick leave days per year were reduced from 48.8 +/- 32.8 days before to 34.2 +/- 37.3 days after the rehabilitation. The therapy interrupted an increase in sick leave days over the years stabilizing absence at a low level for at least 2 years. Duration of illness related work absence was the only significant predictor for sick leave reduction (P < 0.05). Other common risk factors for musculoskeletal diseases like smoking or body mass index did not significantly influence the therapeutic effect.
  
  
  CONCLUSIONS
  Our results support evidence that information exchange for workplace description and rehabilitation therapist may help to reduce sick leave days and achieve very high rtw-ratio. However it is important to observe the effects of this shared information for longer intervals.
authors.affiliation: Institute of Occupational Medicine, University of Luebeck, Ratzeburger Allee 160, Luebeck, Germany. info.contact@uni-luebeck.de
authors.forename: Stephan W
authors.initials: SW
authors.lastname: Weiler
authors.forename: Kay Peter
authors.initials: KP
authors.lastname: Foeh
authors.forename: Anke
authors.initials: A
authors.lastname: van Mark
authors.forename: Rene
authors.initials: R
authors.lastname: Touissant
authors.forename: Nina
authors.initials: N
authors.lastname: Sonntag
authors.forename: Annette
authors.initials: A
authors.lastname: Gaessler
authors.forename: Johannes
authors.initials: J
authors.lastname: Schulze
authors.forename: Richard
authors.initials: R
authors.lastname: Kessel
mesh_terms: D000041:Absenteeism; D000328:Adult; D000401:Aircraft; D000553:Ambulatory Care / Q000379:methods*; D015992:Body Mass Index; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007587:Job Description; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000534:rehabilitation*; D009784:Occupational Diseases / Q000534:rehabilitation*; D009788:Occupational Therapy; D012307:Risk Factors; D018582:Sick Leave / Q000706:statistics & numerical data*; D012907:Smoking / Q000453:epidemiology; D017132:Workplace