Effects of intensified work-related multidisciplinary rehabilitation on occupational participation: a randomized-controlled trial in patients with chronic musculoskeletal disorders.
This study examined the effects of work-related multidisciplinary rehabilitation (MR) on occupational participation in patients with chronic musculoskeletal disorders. A randomized-controlled trial was carried out. The sample included patients with chronic musculoskeletal disorders and severe restrictions of work ability (n=222). Participants in the intervention group received a work-related rehabilitation programme following a comprehensive functional capacity evaluation (FCE MR). Controls completed a conventional MR. The analysis was based on 1-year follow-up data. The primary outcome was stable occupational participation (SOP), defined as employment with at most 6 months of sick leave after rehabilitation. The secondary outcomes were the duration of sick leave, employment status and the Pain Disability Index. We included 102 patients in our analysis (intervention: n=55, control: n=47). Despite randomization there were group differences. Adjusting these differences, patients of the FCE MR had 3.5 times higher odds of SOP [95% confidence interval (CI): 1.2-9.8, P=0.018]. However, there was neither a significant difference in the duration of sick leave between both groups (b=-8.0 weeks, 95% CI: -17.4 to 1.4, P=0.095) nor higher odds of employment in favour of the FCE MR after 1 year (odds ratio=2.3, 95% CI: 0.9-5.8, P=0.088). Participants in the FCE MR reported less pain-related disabilities (b=-6.5, 95% CI: -12.6 to -0.4, P=0.038). The study had a limitation in terms of group balance. However, the findings indicate that the work-related FCE MR was more effective for SOP, but did not significantly affect employment rate and sick leave duration.
aGerman Federal Pension Insurance (GFPI), Department of Rehabilitation, Berlin bDepartment for Rehabilitation Medicine, Medical School Hanover, Hanover, Germany.
Marco
M
Streibelt
Matthias
M
Bethge
D000328:Adult; D002908:Chronic Disease; D003131:Combined Modality Therapy; D003299:Cooperative Behavior; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D005858:Germany; D006801:Humans; D033183:Interdisciplinary Communication; D008297:Male; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000175:diagnosis / Q000534:rehabilitation*; D010147:Pain Measurement; D012047:Rehabilitation Centers; D012050:Rehabilitation, Vocational / Q000379:methods*; D018582:Sick Leave