Return to work helps maintain treatment gains in the rehabilitation of whiplash injury.
This study examined the relation between return to work and the maintenance of treatment gains made over the course of a rehabilitation intervention. The study sample consisted of 110 individuals who had sustained whiplash injuries in rear collision motor vehicle accidents and were work-disabled at the time of enrolment in the study. Participants completed pre- and post-treatment measures of pain severity, disability, cervical range of motion, depression, posttraumatic stress symptoms, and catastrophizing. Pain severity was assessed again at 1-year follow-up. At 1-year follow-up, 73 participants had returned to work and 37 remained work-disabled. Analyses revealed that participants who returned to work were more likely to maintain treatment gains (77.5%) than participants who remained work-disabled (48%), χ = 6.3, P < 0.01. The results of a regression analysis revealed that the relation between return to work and the maintenance of treatment gains remained significant (β = 0.30, P < 0.01), even when controlling for potential confounders such as pain severity, restricted range of motion, depression, and pain catastrophizing. The Discussion addresses the processes by which prolonged work-disability might contribute to the failure to maintain treatment gains. Important knowledge gaps still remain concerning the individual, workplace, and system variables that might play a role in whether or not the gains made in the rehabilitation of whiplash injury are maintained. Clinical implications of the findings are also addressed.
Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Australia.|Department of Psychology, McGill University, Montreal, Canada.
Michael
M
Sullivan
Recover Injury Research Centre, The University of Queensland, Brisbane, Australia.
Heather
H
Adams
Department of Psychology, McGill University, Montreal, Canada.
Pascal
P
Thibault
Department of Psychology, McGill University, Montreal, Canada.
Emily
E
Moore
Department of Psychology, McGill University, Montreal, Canada.
Junie S
JS
Carriere
Occupational Health and Safety, Research Institute Robert-Sauvé, Montreal, Canada.
Christian
C
Larivière
D000063:Accidents, Traffic; D000328:Adult; D058443:Catastrophization / Q000209:etiology / Q000523:psychology; D003863:Depression / Q000209:etiology; D004185:Disability Evaluation; D006233:Persons with Disabilities; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology / Q000523:psychology* / Q000534:rehabilitation*; D010147:Pain Measurement; D011569:Psychiatric Status Rating Scales; D016059:Range of Motion, Articular / Q000502:physiology; D012050:Rehabilitation, Vocational / Q000379:methods* / Q000523:psychology; D012189:Retrospective Studies; D062707:Return to Work; D057566:Self Report; D014911:Whiplash Injuries / Q000150:complications / Q000209:etiology / Q000523:psychology* / Q000534:rehabilitation*; D055815:Young Adult