What factors predict full or partial return to work among sickness absentees with spinal pain participating in rehabilitation?
OBJECTIVE
To identify the factors that predict full or partial return to work among long-term (> or =90 days) sickness absentees due to spinal pain who begin a multidisciplinary rehabilitation programme.


METHODS
In a prospective cohort study, 312 patients with neck, thoracic and/or lumbar pain, aged 20-64, participated in a 4-week multidisciplinary rehabilitation programme in Sweden. Questionnaire data at inclusion were used. Factors included in logistic regressions were as follows: age, gender, type of work, pain location, pain intensity (visual analogue scale), activity limitations [Disability Rating Index (DRI)], health-related quality of life (SF-36), pain-related fear of movement (Tampa Scale of Kinesiophobia), motivation (Self Motivation Inventory), sickness absence at baseline and number of sick-leave days during the previous 2 years. Outcome factor was increased versus not increased working time at follow-up 6 months later.


RESULTS
Most patients (68%) reported two or three pain locations. At baseline, 56% were full-time sickness absent and 23% at follow-up; 61% had increased their working time. Predictors for increased working time were age below 40 years, low activity limitation (DRI < 50), low SF-36 bodily pain (> 30) and high SF-36 social functioning (> 60). Number of sick-leave days during the previous 2 years (md 360; range 90-730) had no influence.


CONCLUSIONS
Even patients with long previous sick leave can increase working time after a multidisciplinary rehabilitation programme, especially if they are younger, have lower levels of activity limitations and pain and better social functioning. To include information on part-time work is useful when evaluating work ability following rehabilitation programmes.
Elfving
Britt
B
Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden. Britt.Elfving@ki.se
Asell
Malin
M
Ropponen
Annina
A
Alexanderson
Kristina
K
D000328:Adult; D000367:Age Factors; D001416:Back Pain / Q000534:rehabilitation*; D004185:Disability Evaluation; D004651:Employment; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019547:Neck Pain / Q000534:rehabilitation; D011446:Prospective Studies; D011788:Quality of Life; D018582:Sick Leave; D012944:Social Support; D055815:Young Adult