Multidisciplinary rehab program shows benefits beyond the short term
Take Home Messages:
A multidisciplinary rehabilitation program can:
- Decrease sick leave;
- Improve quality of life;
- Increase the likelihood of return to work; and
- Decrease anxiety, depression and stress.
These positive effects may last for two years.
Men and women respond to chronic pain and rehabilitation programs differently. Rehabilitation programs should take this into consideration.
Why the research matters:
Musculoskeletal disorders are widespread and the most common cause of sick leave in developed countries. They impair function and reduce quality of life.
People with chronic pain have associated increases in rates of anxiety, substance abuse/dependence and personality disorders. They are five times more likely to become depressed.
Multidisciplinary rehabilitation is expected to improve quality of life and function more effectively than traditional rehabilitation programs, however to date the effectiveness of multidisciplinary programs is untested.
What the research involved:
The study aimed to evaluate the results of a rehabilitation program involving various care providers over a two year period in Sweden.
The research focused on 60 people with musculoskeletal problems, primarily back and neck pain. Outcomes assessed include mental and physical health, function, quality of life and return to work.
The rehabilitation program involved 4 hours per day, 5 days a week, for a 7 week period. It consisted of the following measures, all tailored to the individual:
- Physical activity in several forms;
- Relaxation;
- Theoretical and practical education;
- Individual guidance;
- Education in ergonomics, coping with pain and stress handling;
- Discussions of behavioural changes in work and lifestyle; and
- Counselling with a psychologist.
Participants were assessed before, during and after the intervention for function, anxiety, depression and stress.
Summary of research findings:
At the two year follow up to the multidisciplinary rehabilitation program:
- Full time sick leave was reduced by 37% in women and 25% in men;
- More men had resumed full time work;
- More women were receiving part time sickness benefit;
- Women had more difficulty than men in returning to labour focused jobs;
- Quality of life was improved in men and women;
- Depression, anxiety and self experienced stress were less than at the start of the program; and
- Women were more stressed by their higher unpaid workload and greater responsibilities related to home and family.
The authors note differences in the experiences of the men and women in the study, and their different responses to rehabilitation. They suggest further research to potentially tailor rehabilitation programs accordingly.
Original Research
Back to work - evaluation of a multidisciplinary rehabilitation programme with emphasis on musculoskeletal disorders. A two-year follow-up.
Sjöström, Rita, Alricsson, Marie and Asplund, Ragnar(2007)
Disability & Rehabilitation,30:9,649 — 655