Effects of intensified work-related multidisciplinary rehabilitation on occupational participation: a randomized-controlled trial in patients with chronic musculoskeletal disorders

Abstract

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.