Short-term goal attainment of in-patient rehabilitation in Germany and long-term risk of early retirement in patients with musculoskeletal diseases: results from a prospective 5-year follow-up study.
OBJECTIVE
Occupational consequences of musculoskeletal disorders (MSDs) are consistently found in epidemiological studies. The aim of this study was to evaluate the prognostic value of various short-term rehabilitation outcome parameters on early retirement in Germany.


METHODS
In a prospective multi-centre cohort study of self-rated patient status, physician chosen therapy goals and attainment were measured by means of standardized questionnaires at the beginning and end of medical rehabilitation. Information with regard to disability was collected by self-report over a 5-year follow-up period.


RESULTS
We included 1268 MSD patients aged 45-57 who underwent a 3-week, multidisciplinary, in-patient rehabilitation programme in 10 rehabilitation centres in Southern Germany between January and December 2001. During follow-up (mean duration: 3.9 years) 117 (9%) patients received a disability pension. After adjustment for sex, age and patient outcomes, risk for early retirement was significantly increased for patients with only partial success with respect for the therapy goals pain reduction (HR 1.95), improvement in spine motility (HR 1.6) and improvement of muscle strength (HR 2.3). Patients who did not have the therapy goal were at the same risk as patients with full goal achievement.


CONCLUSIONS
Clinicians' rating of short-term therapy outcome might be of prognostic relevance of MSD patients' long-term employment status.
Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany.
Ralf
R
Neuner
Stefanie
S
Braig
Maria
M
Weyermann
Rainer
R
Kaluscha
Gert
G
Krischak
D000328:Adult; D000367:Age Factors; D004185:Disability Evaluation; D004651:Employment / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D005858:Germany; D006040:Goals; D006801:Humans; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000534:rehabilitation*; D010415:Pensions / Q000706:statistics & numerical data; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012047:Rehabilitation Centers; D012050:Rehabilitation, Vocational / Q000379:methods*; D012179:Retirement / Q000523:psychology* / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D014938:Work Capacity Evaluation