title: The effect of work-focused rehabilitation among patients with neck and back pain: a randomized controlled trial.
abstract: METHODS
  Multicenter randomized trial with patients listed as sick for 1 to 12 months due to neck or back pain and referred to secondary care.
  
  
  OBJECTIVE
  To compare the return-to-work (RTW) rate among patients offered work-focused rehabilitation or multidisciplinary rehabilitation.
  
  
  BACKGROUND
  A growing number of studies have focused on the RTW processes associated with patients with back pain. Many studies have combined a workplace focus with multidisciplinary treatments; however, this focus has not been evaluated in Norway among patients with neck and back pain thus far.
  
  
  METHODS
  A total of 405 patients who were referred to the spine clinics at 2 university hospitals in Norway were randomly assigned into work-focused and control intervention groups. The existing treatments at each hospital were used as the control interventions, which entailed either a comprehensive multidisciplinary intervention or a brief multidisciplinary intervention. The RTW rates and proportions were compared at 12 months.
  
  
  RESULTS
  During the first 12 months after inclusion, 142 (70%) participants in the work-focused rehabilitation group and 152 (75%) participants in the control group returned to work. The median time to RTW was 161 days in the work-focused group and 158 days in the control group. A comparison of the work-focused and control interventions revealed a relative RTW probability (hazard ratio) of 0.94 (95% confidence interval = 0.75-1.17) after adjusting for age, sex, and education.
  
  
  CONCLUSIONS
  The results suggest that a focus on the workplace in specialist care does not substantially alter the RTW rate compared with standard multidisciplinary treatments.
authors.affiliation: *Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Ulleval, Oslo, Norway †Faculty of Medicine, Department of Neuroscience, Norwegian University of Science and Technology (NTNU), Trondheim, Norway ‡Department of Physical Medicine and Rehabilitation, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway §Copenhagen Centre for Back Research (COPEBACK), Centre for Rheumatology and Spine Diseases, Glostrup Hospital, University of Copenhagen, Denmark ¶Faculty of Medicine, University of Oslo, Oslo, Norway ‖Department of Biostatistics and Epidemiology, Oslo University Hospital, Ulleval, Oslo, Norway **National Institute of Occupational Health, Oslo, Norway; and ††Lovisenberg Hospital, Oslo, Norway.
authors.forename: Kjersti
authors.initials: K
authors.lastname: Myhre
authors.forename: Gunn Hege
authors.initials: GH
authors.lastname: Marchand
authors.forename: Gunnar
authors.initials: G
authors.lastname: Leivseth
authors.forename: Anne
authors.initials: A
authors.lastname: Keller
authors.forename: Erik
authors.initials: E
authors.lastname: Bautz-Holter
authors.forename: Leiv
authors.initials: L
authors.lastname: Sandvik
authors.forename: Bjørn
authors.initials: B
authors.lastname: Lau
authors.forename: Cecilie
authors.initials: C
authors.lastname: Røe
mesh_terms: D000328:Adult; D001416:Back Pain / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019547:Neck Pain / Q000534:rehabilitation*; D011446:Prospective Studies; D012046:Rehabilitation / Q000379:methods; D062707:Return to Work; D018582:Sick Leave; D013997:Time Factors