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

Abstract

BackgroundMusculoskeletal 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.MethodsWe 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.ResultsFunctional 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.ConclusionsPatients 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.

Can the STarT Back Tool predict health-related quality of life and work ability after an acute/subacute episode with back or neck pain? A psychometric validation study in primary care

“…The EQ-5D was applied to measure HRQoL because it has been found to have good prediction of return to work and the cut-off ≥0.6 on EQ-5D has been proposed to be a limit for having sufficient capacity to work for patients with BP and NP 39. Another cut-off has been used in a study of patients with musculoskeletal pain taking part in a national rehabilitation programme in Sweden where ≥0.5 on EQ-5D at start showed reduced sick leave days after the rehabilitation 53. Our population had a median EQ-5D score of 0.80, which is just below the mean scores for a Swedish normal population (0.84) 54.…”

Productivity at work and quality of life in patients with rheumatoid arthritis

“…Prolonging work participation reflects an important contribution to fulfilling societal roles. It has been suggested that becoming permanently work-disabled is associated with a poorer quality of life in general [ 13 - 15 ]. Since patients who experience at-work productivity loss are prone to develop sick leave and permanent work disability in the future, we hypothesize that at-work productivity loss is associated with a low quality of life.…”

An assessment of the work ability, disability and quality of life of working people of pre-retirement and retirement age in Poland – a cross-sectional pilot study

“…To a large extent, it is related to the people of pre-retirement and retirement age was associated with the occurrence of musculoskeletal diseases and pain. In fact, musculoskeletal disorders are the main reason for reduced work efficiency and sick leaves in many developed countries [20]. Musculoskeletal diseases occur in younger and older employees, but in the latter group they cause a significant reduction in work ability over time [21].…”