Abstract
Purpose To evaluate effects on somatic and mental health of a multicomponent inpatient occupational rehabilitation program compared to a less comprehensive outpatient program in individuals on sick leave for musculoskeletal complaints or mental health disorders. Methods A randomized clinical trial with parallel groups. Participants were individuals on sick-leave for 2–12 months with a sick-leave diagnosis within the musculoskeletal, psychological or general and unspecified chapters of ICPC-2. Potential participants were identified in the Social Security System Registry. The multicomponent inpatient program (4 + 4 days) consisted of Acceptance and Commitment Therapy, physical training and work-related problem-solving including creating a return to work plan and a workplace visit if considered relevant. The comparative outpatient program consisted primarily of ACT (6 sessions during 6 weeks). Self-reported health-related quality of life, subjective health complaints, pain and anxiety and depression symptoms were assessed up to 12 months after the program. Results 168 individuals were randomized to the multicomponent inpatient program (n = 92) or the outpatient program (n = 76). Linear mixed models showed no statistically significant differences between the programs, except for slightly more reduced pain after the outpatient program. Conclusions This study presents no support that a 4 + 4 days multicomponent inpatient rehabilitation program is superior to a less comprehensive outpatient program, in improving health outcomes.
Highlights
Musculoskeletal and mental health disorders are the two leading causes of sickness absence in Norway [1]
In a recent study with 12 months of follow-up we found no difference between the programs on number of sickness absence days and return to work
We conducted a randomized clinical trial with parallel groups, comparing an inpatient multicomponent program (4 ? 4 days) with a single-component program (6 sessions during 6 weeks) for individuals on sickleave due to musculoskeletal, unspecific, or common mental health disorders
Summary
Musculoskeletal and mental health disorders are the two leading causes of sickness absence in Norway [1]. Five percent of the gross domestic product is spent on disability and sickness benefits, and this is by far the highest level in the OECD countries [2]. Most occupational rehabilitation programs described in the scientific literature are directed towards specific diagnostic groups, mainly musculoskeletal disorders [3, 4]. Effects reported in the literature are ambiguous. Jensen et al [5] did not find added effects on return to work or pain reduction of multidisciplinary occupational rehabilitation compared to a brief intervention program for subjects with low back pain. Lambeek et al [6] and Loisel et al [7] reported that multidisciplinary occupational rehabilitation led to
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