Email updates

Keep up to date with the latest news and content from BMC Musculoskeletal Disorders and BioMed Central.

Open Access Research article

Promoting work ability in a structured national rehabilitation program in patients with musculoskeletal disorders: outcomes and predictors in a prospective cohort study

Kjerstin G E Stigmar12356*, Ingemar F Petersson45, Anna Jöud45 and Birgitta E M Grahn23456

Author affiliations

1 Kommunhälsan Occupational Health Services, Box 1222, Växjö S 351 12, Sweden

2 Department of Health Sciences, Division of Physiotherapy, Lund University, Lund, Sweden

3 Research and Development Kronoberg, Box 1223, Växjö, S 351 12, Sweden

4 Department of Orthopedics, Clinical Sciences Lund, Lund University, WHO Collaborating Centre for Evidence-Based Healthcare in Musculoskeletal Disorders, Lund, Sweden

5 EPI-centrum, County Council of Skåne, Lund, Sweden

6 FoU-Kronoberg, Box 1223, Växjö, S 351 12, Sweden

For all author emails, please log on.

Citation and License

BMC Musculoskeletal Disorders 2013, 14:57  doi:10.1186/1471-2474-14-57

Published: 6 February 2013

Abstract

Background

Musculoskeletal disorders (MSDs) are a major reason for impaired work productivity and sick leave. In 2009, a national rehabilitation program was introduced in Sweden to promote work ability, and patients with MSDs were offered multimodal rehabilitation. The aim of this study was to analyse the effect of this program on health related quality of life, function, sick leave and work ability.

Methods

We conducted a prospective, observational cohort study including 406 patients with MSDs attending multimodal rehabilitation. Changes over time and differences between groups were analysed concerning function, health related quality of life, work ability and sick leave. Regression analyses were used to study the outcome variables health related quality of life (measured with EQ-5D), and sick leave.

Results

Functional ability and health related quality of life improved after rehabilitation. Patients with no sick leave/disability pension the year before rehabilitation, improved health related quality of life more than patients with sick leave/disability pension the year before rehabilitation (p = 0.044). During a period of −/+ four months from rehabilitation start, patients with EQ-5D ≥ 0.5 at rehabilitation start, reduced their net sick leave days with 0.5 days and patients with EQ-5D <0.5 at rehabilitation start, increased net sick leave days with 1.5 days (p = 0.019). Factors negatively associated with sick leave at follow-up were earlier episodes of sick leave/disability pension, problems with exercise tolerance functions and mobility after rehabilitation. Higher age was associated with not being on sick leave at follow-up and reaching an EQ-5D ≥ 0.5 at follow-up. Severe pain after rehabilitation, problems with exercise tolerance functions, born outside of Sweden and full-time sick leave/disability pension the year before rehabilitation were all associated with an EQ-5D level < 0.5 at follow-up.

Conclusions

Patients with MSDs participating in a national work promoting rehabilitation program significantly improved their health related quality of life and functional ability, especially those with no sick leave. This shows that vocational rehabilitation programs in a primary health care setting are effective. The findings of this study can also be valuable for more appropriate patient selection for rehabilitation programs for MSDs.

Keywords:
Sick leave; Musculoskeletal pain; Multimodal rehabilitation; Health related quality of life; Function