RESUMEN
PURPOSE: Vocational rehabilitation (VR) is an intervention to improve return to work for patients with chronic musculoskeletal pain (CMP). However, a systematic overview of characteristics of referred patients or eligible for VR is lacking, which hinders comparability across studies. Objectives were (1) to describe characteristics of patients with CMP referred to and eligible for VR and (2) to identify factors that contribute to VR eligibility. METHODS: This study used a multicenter, cross-sectional design. Data of self-reported questionnaires were obtained between 2013 and 2019 from care as usual of eight Dutch VR centers. Descriptive statistics were performed to describe sociodemographic, pain-related, and work-related characteristics. Logistic regression analysis was used to identify factors contributing to VR eligibility. RESULTS: Data sets of n = 2970 referred patients were included. The mean age was 46 years and 60% were female. Low back (43%), neck (37%), and shoulder pain (34%) were most reported. 82% Worked in paid employment. The absenteeism rate was 85%, and 44% was partially absent. After multidisciplinary screening, 62.2% were eligible for VR. Persons most likely to be eligible for VR (OR < 1.20) were those having back or neck pain, whereas least eligible (OR < 0.80) were persons having pain in hand/fingers or pain in other regions, unemployed workers, and those referred by a 'other' medical specialists. All other factors contributed little or none to the model. CONCLUSIONS: An extensive description of sociodemographic, pain-related, and work-related characteristics is presented for patients eligible for VR. Especially having back/neck pain and being an employee were associated with higher chance of eligibility for VR.
RESUMEN
STUDY DESIGN: Systematic review of randomized controlled trials. OBJECTIVES: To determine the long-term effect of multidisciplinary back training on the work participation of patients with nonspecific chronic low back pain. SUMMARY OF BACKGROUND DATA: Chronic low back pain is influenced by multiple factors. Multidisciplinary back training represents one of the options to take this multiplicity into account. So far, only evidence of the short-term effectiveness of this approach in terms of work participation is available. METHODS: Electronic databases were searched and the references of various articles were screened for relevant publications. Ten studies met the inclusion criteria. All included studies were evaluated for their methodologic quality. RESULTS: Five of the studies had a low methodologic quality. All high-quality studies found a positive effect on at least one of the 4 outcome measures used. Based on our criteria, effectiveness was found for the outcome measures of work participation and quality of life. No effectiveness was found for experienced pain and functional status. The intensity of the intervention seems to have no substantial influence on the effectiveness of the intervention. CONCLUSION: In the long-term, multidisciplinary back training has a positive effect on work participation in patients with nonspecific chronic low back pain.