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| Return to work after early part-time sick leave due to musculoskeletal disorders: a randomized controlled trial |
| Viikari-Juntura E, Kausto J, Shiri R, Kaila-Kangas L, Takala E-P, Karppinen J, Miranda H, Luukkonen R, Martimo K-P |
| Scandinavian Journal of Work, Environment & Health 2012 Mar;38(2):134-143 |
| clinical trial |
| 5/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: No; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; 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* |
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OBJECTIVES: The purpose of this study was to assess the effects of early part-time sick leave on return to work (RTW) and sickness absence among patients with musculoskeletal disorders. METHODS: A randomized controlled trial was conducted in six occupational health units of medium- and large-size enterprises. Patients aged 18 to 60 years with musculoskeletal disorders (n = 63) unable to perform their regular work were randomly allocated to part- or full-time sick leave. In the former group, workload was reduced by restricting work time by about a half. Remaining work tasks were modified when necessary, as specified in a "fit note" from the physician. The main outcomes were time to return to regular work activities and sickness absence during 12-month follow-up. RESULTS: Time to RTW sustained for >= 4 weeks was shorter in the intervention group (median 12 versus 20 days, p = 0.10). Hazard ratio of RTW adjusted for age was 1.60 (95% confidence interval (95% CI) 0.98 to 2.63) and 1.76 (95% CI 1.21 to 2.56) after further adjustment for pain interference with sleep and previous sickness absence at baseline. Total sickness absence during the 12-month follow-up was about 20% lower in the intervention than the control group. Compliance with the intervention was high with no discontinuations of part-time sick leave due to musculoskeletal reasons. CONCLUSIONS: Early part-time sick leave may provide a faster and more sustainable return to regular duties than full-time sick leave among patients with musculoskeletal disorders. This is the first study to show that work participation can be safely increased with early part-time sick leave.
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