Experiences of participating in return-to-work group programmes for people with musculoskeletal disorders: A focus group study.

PURPOSE: The present study aimed to explore the experiences of individuals with musculoskeletal disorders (MSDs) who had participated in return-to-work group programmes (RTW-GPs) and to assess whether the programmes had had an impact on their work disability. METHOD: Three focus group interviews and one individual interview were conducted involving 17 women (mean age = 47) with MSDs who had completed RTW-GPs. All interviews were audio-recorded, transcribed verbatim and analysed using thematic analyses. RESULTS: Participant experiences were categorised into three main themes: changed way of thinking, the importance of being able to work, and a changed lifestyle. The respondents said that participation in the RTW-GPs had enabled them to shift their focus from problems to opportunities. They had become more aware of strategies to enhance their energy levels and continue working. Several participants had reduced their work hours to achieve a better balance between work and daily life. Many participants had also changed their lifestyle habits, which had led to weight reduction, more energy and less pain. CONCLUSION: The study participants had attained a heightened awareness of what they could do to continue working. Many participants had introduced changes in their daily lives, with consequences for employment, social life and lifestyle. The findings suggest that RTW-GPs can help people with MSDs to remain in employment and prevent absenteeism.

A three-week multidisciplinary in-patient rehabilitation programme had positive long-term effects in patients with ankylosing spondylitis: randomized controlled trial.

OBJECTIVE: To evaluate the mean overall effects over a 1-year period of a multidisciplinary in-patient rehabilitation programme for patients with ankylosing spondylitis. DESIGN: Observer-blinded, randomized controlled trial, with assessments made after 4 and 12 months. PATIENTS: Forty-six patients received a 3-week in-patient rehabilitation programme and 49 patients received treatment as usual. METHODS: Primary outcomes were disease activity measured with the Bath Ankylosing Spondylitis Disease Activity Scale (BASDAI), and function measured with the Bath Ankylosing Spondylitis Functional Index (BASFI). Secondary outcomes included well-being, spinal and hip mobility, and health-related quality of life measured with the Medical Outcome Study Short Form-36. Overall treatment effects were estimated with Mixed models repeated measures analyses. RESULTS: Significant overall treatment effects in favour of the rehabilitation group were found in the BASDAI score (mean difference over the 1-year period -10.0, 95% confidence interval: -3.7 to -16.3), in well-being (-7.3, 95% confidence interval: -1.0 to -14.7), and in the Medical Outcome Study Short Form-36 variables social functioning, role physical, role mental and bodily pain (mean differences ranging from 5.8 (pain) to 10.7 (role physical)). CONCLUSION: A 3-week in-patient rehabilitation programme had positive overall effects on disease activity, pain, function and well-being, and should be considered an important complement to medical disease management in persons with ankylosing spondylitis.

Effect of an intensive hand exercise programme in patients with rheumatoid arthritis.

The aim of this study was to test the effect of an intensive hand exercise programme in patients with rheumatoid arthritis (RA). Designed as a clinical controlled trial, the first 30 participants received a conservative exercise programme (CEP), while the next 30 received an intensive exercise programme (IEP). Outcomes were assessed at baseline, and after 2 and 14 weeks. Hand strength, measured as grip strength and pinch strength, was the primary outcome variable. Secondary outcomes were joint mobility, hand pain, and functional ability. After two weeks, there were significant differences between the groups in favour of the IEP in pinch strength in the dominant hand (p = 0.01), as well as grip and pinch strength in the non-dominant hand (p = 0.04 and 0.05, respectively). After 14 weeks, there was a significant difference between the two groups in grip strength in the non-dominant hand (p = 0.04), again in favour of the IEP. There was a trend towards increased pain in the CEP group and towards decreased pain in the IEP group, with significant differences between the groups in several measures of pain after 2 and 14 weeks. However, there were few significant differences between the two groups regarding joint mobility and functional ability. The results indicate that, compared with a traditional programme, an intensive hand exercise programme is well tolerated and more effective in improving hand function in patients with RA.