Take Home Messages:

Early prediction of workers at risk of being off work for long periods can help tailor treatment approaches.

The results of a brief questionnaire, the Orebro Musculoskeletal Pain Questionnaire, correctly predicted the discharge assessment of whether workers could return to work after a rehabilitation program 85% of the time. 

Why the research matters:

Prolonged time off work due to injury or illness is detrimental to both the worker and the employer.

While most workers with muscular injuries return to work within 4 weeks, a significant number of people experience long tem pain problems and associated disability.  

The longer someone is away from work, the more psychological factors begin to influence pain and disability. For some people, a treatment plan only addressing physical issues will not prove effective.

Therefore it is important to indentify early people whose pain and disability are likely to be influenced by psychological factors, so that treatment is not only targeted at the physical aspects of their conditions.  This allows a more effective treatment plan to be created and may facilitate an earlier return to work.

What the research involved:

The Orebro Musculoskeletal Pain Questionnaire (OMPQ) is completed by the worker and assesses pain,

• Avoidance of physical activity;
• Depression;
• The degree to which the daily functioning of the worker is impaired;
• Work satisfaction; and
• The worker’s age and gender.

A high score indicates the worker is at greater risk of remaining off work.

The OMPQ was completed by 200 injured workers, identified via claims to the Workplace Health, Safety and Compensation Commission in Canada, prior to beginning a 6 week “work conditioning” treatment.

Pre-treatment scores from the questionnaire were used to predict a score which would separate where the worker would be assessed as “fit to return to work” or “unfit to return to work” at the end of treatment.   This was determined to be 147, using a variety of statistical methods.

Treatment involved education on how the body moves, physiotherapy, management of symptoms by the worker, exercises, and activities depending on the worker’s line of work.

The questionnaire was then used on a second group of participants, on this occasion 211 workers. At the end of the 6 week treatment a physiotherapist assessed whether the worker was fit to return to work.

Summary of research findings:

The OMPQ scores assessed at the beginning of the treatment program accurately predicted the assessment of 85% of workers as “fit” or “unfit” to return to work upon the completion of treatment.

This was based on a cut off score of 147.

The questionnaire has a reasonable chance of identifying high risk cases early. Identification of cases where the person is likely to be determined as unfit for work at the end of a physiotherapy program could be supported with psychosocial interventions, to address important factors influencing the outcome.

Original research:

Predicting treatment failure in the subacute injury phase using the Orebro Musculoskeletal Pain Questionnaire: an observational prospective study in a workers' compensation system.

Margison DA, French DJ.

J Occup Environ Med. 2007 Jan;49(1):59-67.

Link to PubMed abstract