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The effect of work-focused rehabilitation among patients with neck and back pain: a randomised controlled trial [with consumer summary] |
Myhre K, Marchand GH, Leivseth G, Keller A, Bautz-Holter E, Sandvik L, Lau B, Roe C |
Spine 2014 Nov 15;39(24):1999-2006 |
clinical trial |
6/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed* |
STUDY DESIGN: Multicentre randomised trial with patients sick-listed between 1 and 12 months due to neck or back pain and referred to secondary care. OBJECTIVE: To compare the return-to-work (RTW) rate among patients offered work-focused rehabilitation or multidisciplinary rehabilitation. SUMMARY OF BACKGROUND DATA: A growing number of studies has 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. METHODS: A total of 405 patients who were referred to the spine clinics at two 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. RESULTS: 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; HR) of 0.94 (95% CIs 0.75 to 1.17) after adjusting for age, gender, and education. CONCLUSION: The results suggest that a focus on the workplace in specialist care does not substantially alter the RTW rate compared with standard multidisciplinary treatments. LEVEL OF EVIDENCE: 2.
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