title: Work-related medical rehabilitation in patients with musculoskeletal disorders: the protocol of a propensity score matched effectiveness study (EVA-WMR, DRKS00009780).
abstract: Musculoskeletal disorders are one of the most important causes of work disability. Various rehabilitation services and return-to-work programs have been developed in order to reduce sickness absence and increase sustainable return-to-work. As the effects of conventional medical rehabilitation programs on sickness absence duration were shown to be slight, work-related medical rehabilitation programs have been developed and tested. While such studies proved the efficacy of work-related medical rehabilitation compared with conventional medical rehabilitation in well-conducted randomized controlled trials, its effectiveness under real-life conditions has yet to be proved.
  
  
  
  The cohort study will be performed under real-life conditions with two parallel groups. Participants will receive either a conventional or a work-related medical rehabilitation program. Propensity score matching will be used to identify controls that are comparable to treated work-related medical rehabilitation patients. Over a period of three months, about 18,000 insured patients with permission to undergo a musculoskeletal rehabilitation program will be contacted. Of these, 15,000 will receive a conventional and 3,000 a work-related medical rehabilitation. We expect a participation rate of 40 % at baseline. Patients will be aged 18 to 65 years and have chronic musculoskeletal disorders, usually back pain. The control group will receive a conventional medical rehabilitation program without any explicit focus on work, work ability and return to work in diagnostics and therapy. The intervention group will receive a work-related medical rehabilitation program that in addition to common rehabilitation treatments contains 11 to 25 h of work-related treatment modules. Follow-up data will be assessed three and ten months after patients' discharge from the rehabilitation center. Additionally, department characteristics will be assessed and administrative data records used. The primary outcomes are sick leave duration, stable return to work and subjective work ability. Secondary outcomes cover several dimensions of health, functioning and coping strategies.
  
  
  
  This study will determine the relative effectiveness of a complex, newly implemented work-related rehabilitation strategy for patients with musculoskeletal disorders.
  
  
  
  German Clinical Trials Register ( DRKS00009780 , February 10, 2016).
authors.affiliation: University of Applied Sciences Würzburg-Schweinfurt, Faculty of Applied Social Sciences, Münzstraße 12, Würzburg, 97070, Germany.
authors.forename: Silke
authors.initials: S
authors.lastname: Neuderth
authors.affiliation: Institute of Social Medicine and Epidemiology, University of Lübeck, Ratzeburger Allee 160, Lübeck, 23562, Germany.
authors.forename: Betje
authors.initials: B
authors.lastname: Schwarz
authors.affiliation: Department of Medical Psychology and Psychotherapy, Medical Sociology and Rehabilitation Sciences, University of Würzburg, Klinikstraße 3, Würzburg, 97070, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Gerlich
authors.affiliation: Department of Medical Psychology and Psychotherapy, Medical Sociology and Rehabilitation Sciences, University of Würzburg, Klinikstraße 3, Würzburg, 97070, Germany. m.schuler@uni-wuerzburg.de.
authors.forename: Michael
authors.identifier: 0000-0001-6502-9232
authors.initials: M
authors.lastname: Schuler
authors.affiliation: Institute of Social Medicine and Epidemiology, University of Lübeck, Ratzeburger Allee 160, Lübeck, 23562, Germany.
authors.forename: Miriam
authors.initials: M
authors.lastname: Markus
authors.affiliation: Institute of Social Medicine and Epidemiology, University of Lübeck, Ratzeburger Allee 160, Lübeck, 23562, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Bethge
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001416:Back Pain; D002908:Chronic Disease; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000534:rehabilitation*; D057216:Propensity Score; D012107:Research Design; D062707:Return to Work; D018582:Sick Leave; D014937:Work; D055815:Young Adult
keywords: Effectiveness; Propensity score matching; Return to work; Work ability; Work-related medical rehabilitation