Presentation M P3

M P3 (Poster Presentation):
Do Extended Occupational Rehabilitation Programs Result in Better Return to Work Outcomes?

Presented by: Riikka Niemeläinen

Authors

Koponen MJ1, Haws C1, Niemeläinen ER1, Gross DP1,2

  1. WCB-Alberta/ Millard Health, Edmonton, Canada
  2. University of Alberta, Edmonton, Canada

Abstract

Background

The optimal duration of rehabilitation programs for injured workers with musculoskeletal conditions is unknown. The Alberta Worker’s Compensation Board (WCB–Alberta) offers functional rehabilitation programs with typical duration of 4 to 6 weeks, with durations over 6 weeks requiring approval from a manager. Program extensions can be burdensome for workers and are expensive, and it is unknown whether longer programs result in improved outcomes. We studied whether claimants with extended (> 6 weeks) rehabilitation programs differ from those with shorter durations in terms of demographic and clinical characteristics as well as clinical and RTW outcomes.

Methods

Data were collected on workers' compensation claimants undergoing interdisciplinary rehabilitation at WCB-Alberta’s Millard Health in 2012. Measures included demographic, occupation, and injury information, along with clinical questionnaires including the Short Form 36 Health Survey (SF36), Pain Disability Index (PDI) and pain Visual Analogue Scale (VAS). Analysis included chi-square and t tests to compare differences between those with and without extended programs.

Results

The sample included 1010 claimants with a variety of subacute and chronic musculoskeletal disorders. A relatively small proportion (7%) were granted program extension. Claimants granted extension were more likely to have specific diagnoses like fracture or dislocation (25.7% vs. 12.6%, p<0.05), injuries to the upper or lower extremities (57.2% vs. 47.7%, p<0.05), and were identified at time of initial assessment to likely require lengthier programs (4.0 vs. 4.6 weeks, p=0.02). Claimants granted extension were 22.5% less likely to be discharged fit for pre-injury levels (p<0.001) and a minority (22.9%) returned to pre-accident functional work levels. All SF-36 domain, PDI and VAS scores at program discharge were comparable between those with and without program extension (p>0.05).

Conclusions

Extended program durations are rare and typically granted to claimants with injuries requiring lengthier healing times such as fractures and dislocations of the extremities. Longer rehabilitation programs do not appear to result in large functional gains or higher RTW levels at discharge, but may provide moderate levels of enhanced quality of life.

Schedule Details

Monday September 29
12:45 - 13:45 Poster Viewing
Session: RTW interventions