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Health-related effects of early part-time sick leave due to musculoskeletal disorders: a randomized controlled trial
Shiri R, Kausto J, Martimo K-P, Kaila-Kangas L, Takala E-P, Viikari-Juntura E
Scandinavian Journal of Work, Environment & Health 2013 Jan;39(1):37-45
clinical trial
4/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: No; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: Previously we reported that early part-time sick leave enhances return to work (RTW) among employees with musculoskeletal disorders (MSD). This paper assesses the health-related effects of this intervention. METHODS: Patients aged 18 to 60 years who were unable to perform their regular work due to MSD were randomized to part- or full-time sick leave groups. In the former, workload was reduced by halving working time. Using validated questionnaires, we assessed pain intensity and interference with work and sleep, region-specific disability due to MSD, self-rated general health, health-related quality of life (measured via EuroQol), productivity loss, depression, and sleep disturbance at baseline, 1, 3, 8, 12, and 52 weeks. We analyzed the repeated measures data (171 to 356 observations) with the generalized estimating equation approach. RESULTS: The intervention (part-time sick leave) and control (full-time sick leave) groups did not differ with regard to pain intensity, pain interference with work and sleep, region-specific disability, productivity loss, depression, or sleep disturbance. The intervention group reported better self-rated general health (adjusted p = 0.07) and health-related quality of life (adjusted p = 0.02) than the control group. In subgroup analyses, the intervention was more effective among the patients whose current problem began occurring < 6 weeks before baseline and those with <= 30% productivity loss at baseline. CONCLUSIONS: Our findings showed that part-time sick leave did not exacerbate pain-related symptoms and functional disability, but improved self-rated general health and health-related quality of life in the early stage of work disability due to MSD.

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