title: [Rehabilitation and work participation].
abstract: Work participation is increasingly seen as a primary outcome of rehabilitation measures. Randomised controlled trials from several different countries and the reviews and meta-analyses based on them show that multidisciplinary rehabilitation programmes improve work participation, return-to-work rates, and reduce sickness absence in patients with back pain, depression, and cancer. In Germany, such programmes were implemented as work-related medical rehabilitation. This intervention targets patients with poor work ability and an increased risk of permanent work disability. Randomised controlled trials have confirmed a reduction of sickness absence and increased rates of sustainable work participation in favour of work-related medical rehabilitation as compared to common medical rehabilitation. Dissemination of these programmes and translation of research evidence into practice progresses. An additional important strategy to support returning to work following rehabilitation is graded return to work. There is emerging evidence of sustainable employment effects in favour of graded return to work. A direct involvement of the workplace and a closer cooperation with employers and occupational health physicians may further improve the outcomes of rehabilitation programmes. Strategies that synergistically integrate safety, health promotion and rehabilitation may achieve more favourable outcomes than separated actions.
authors.affiliation: Institut für Sozialmedizin und Epidemiologie, Universität zu Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Deutschland. matthias.bethge@uksh.de.
authors.forename: Matthias
authors.initials: M
authors.lastname: Bethge
mesh_terms: D006233:Persons with Disabilities / Q000534:rehabilitation* / Q000706:statistics & numerical data*; D019317:Evidence-Based Medicine; D005858:Germany / Q000453:epidemiology; D006801:Humans; D009784:Occupational Diseases / Q000453:epidemiology* / Q000534:rehabilitation*; D012050:Rehabilitation, Vocational / Q000706:statistics & numerical data*; D062707:Return to Work / Q000706:statistics & numerical data*; D018582:Sick Leave / Q000706:statistics & numerical data*; D016896:Treatment Outcome; D017132:Workplace / Q000706:statistics & numerical data
keywords: Evidence; Participation; Rehabilitation; Return to work; Review