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The Effect of Work-Focused Rehabilitation Among Patients With Neck and Back Pain

2014; Lippincott Williams & Wilkins; Volume: 39; Issue: 24 Linguagem: Inglês

10.1097/brs.0000000000000610

1528-1159

Kjersti Myhre, Gunn Hege Marchand, Gunnar Leivseth, Anne Keller, Erik Bautz‐Holter, Leiv Sandvik, Bjørn Lau, Cecilie Røe,

Spine and Intervertebral Disc Pathology

Multicenter randomized trial with patients listed as sick for 1 to 12 months due to neck or back pain and referred to secondary care.To compare the return-to-work (RTW) rate among patients offered work-focused rehabilitation or multidisciplinary rehabilitation.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.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.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.The results suggest that a focus on the workplace in specialist care does not substantially alter the RTW rate compared with standard multidisciplinary treatments.