Take Home Messages

A more involved approach to the case management and rehabilitation of workers with musculoskeletal disorders - including an individual assessment of disability, functioning and barriers to return to work, and the development of a personalised work rehabilitation plan - leads to less time off work and is associated with significant economic savings compared to conventional management.

Why the research matters

In Denmark, the large impact of work disability on the individual worker and society has prompted the development of a new "coordinated and tailored work rehabilitation" approach to assisting injured workers in returning to work.  Facilitating return to work is beneficial for both the individual and the economy.

What the research involved

This study, conducted in Denmark, compared the effects of “coordinated and tailored work rehabilitation” with conventional case management on return to work following sick leave due to musculoskeletal disorders.

“Coordinated and tailored work rehabilitation” involved:

• Assessing the worker’s level of disability, functioning and barriers to returning to work; and
• Developing an individual work rehabilitation plan.

Conventional case management involves:

• The regular reassessment of the worker’s eligibility for sickness benefits by a case manager; and
• Potential liaison between the case manager and the worker’s employer.

119 workers on sick leave for 4-12 weeks due to musculoskeletal injuries participated in the study. 68 workers received "coordinated and tailored work rehabilitation", while 51 workers acted as the control group and received conventional case management. The workers were followed over a twelve month period.

The study looked at how many hours in total the participant was absent from work due to sickness over the twelve month study period.  The study also looked at work status as well as pain intensity and functional disability.  These factors were measured at the beginning of the study, and then again after three and twelve months.

Summary of research findings

The study found:

• The number of hours that workers were absent due to sickness was significantly lower in workers who underwent coordinated and tailored work rehabilitation compared to those who received standard case management; and
   
• Providing workers with coordinated and tailored work rehabilitation saved approximately US $ 10,666 per person over the twelve month period compared to conventional case management.

Original research

Coordinated and tailored work rehabilitation: a randomized controlled trial with economic evaluation undertaken with workers on sick leave due to musculoskeletal disorders.
Bültmann U, Sherson D, Olsen J, Hansen CL, Lund T, Kilsgaard J.
J Occup Rehabil. 2009 Mar;19(1):81-93. Epub 2009 Jan 24.

Link to PubMed abstract