title: Two-year outcome of a multidisciplinary vocational rehabilitation programme focused on range of motion of the neck and back.
abstract: OBJECTIVE
  To investigate whether improvement of range of motion (ROM) in persons with musculoskeletal disorders, mainly neck and back pain, was associated with a favourable development regarding physical disability, pain, and health-related quality of life (QoL), and whether such development differed between sick-listed and non-sick-listed persons during and up to 2 years after a multidisciplinary rehabilitation programme.
  
  
  METHODS
  Ten persons with full-time sick leave (Group I) and 49 with part-time or no sick leave (Group II) at the end of a previous study participated. It was shown in that study that Group I had higher pain rating and higher subjective physical disability than Group II, with little or no improvement during and after rehabilitation. In the present study, all participants were evaluated with neck and back mobility tests: Disability Rating Index (DRI); Pain Intensity Rating on a visual analogue scale (VAS); and Global Self-Efficacy Index (GSI).
  
  
  RESULTS
  Cervical and thoracolumbar spine ROM were lower in Group I than in Group II from the start of rehabilitation to a 2-year follow-up. Only Group II showed a temporal improvement in ROM. No changes in DRI, VAS or GSI were found in parallel with corresponding temporal changes in any of the ROM.
  
  
  CONCLUSIONS
  Group II but not Group I improved in active ROM during rehabilitation; further, in Group I active ROM in the cervical and thoracolumbar spine did not improve during the 2-year follow-up. Improvement of ROM showed no correlation with physical disability, pain or QoL.
authors.affiliation: Strömsund Health Centre, Jämtland County Council, Strömsund, Sweden. rita.sjostrom@jll.se
authors.forename: Rita
authors.initials: R
authors.lastname: Sjöström
authors.forename: Ragnar
authors.initials: R
authors.lastname: Asplund
authors.forename: Marie
authors.initials: M
authors.lastname: Alricsson
mesh_terms: D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000534:rehabilitation*; D008297:Male; D019547:Neck Pain / Q000534:rehabilitation*; D011446:Prospective Studies; D011788:Quality of Life; D016059:Range of Motion, Articular; D012050:Rehabilitation, Vocational / Q000379:methods*; D018582:Sick Leave; D018709:Statistics, Nonparametric; D013548:Sweden; D016896:Treatment Outcome