Exploring activity limitations and sick leave among patients with spinal pain participating in multidisciplinary rehabilitation

Abstract

Purpose. To describe limitations in 12 activities at baseline, after multidisciplinary rehabilitation and at a 6-month follow-up for patients with spinal pain and, further, to investigate whether low limitation in any of the activities or in the mean score at baseline might predict increased working time at follow-up.

Method. A prospective cohort study of 302 patients, 22- to 63-years old, who participated in multidisciplinary rehabilitation because of chronic neck, thoracic and/or lumbar pain. Data from the Disability Rating Index questionnaire were obtained at baseline, after the 4-week rehabilitation programme, and at the 6-month follow-up. Two subgroups are described: patients who at baseline (1) worked full-time or (2) were on part- or full-time sick leave.

Results. The degree of limitation in the 12 activities (items) showed large variations in median scores (7–91). Both subgroups showed significant improvements in most activities after rehabilitation, which remained at the follow-up. Nevertheless, in the sick-leave group, patients who had increased their working time at follow-up (62%) were still very limited in running, heavy work, and lifting heavy objects. In logistic regressions, low limitation in standing bent over a sink at baseline was the only single activity that predicted increased working time at the follow-up: odds ratio (OR) 1.93 (95% CI 1.1–3.5). OR for the mean score was 1.8 (1.0–3.3).

Conclusion. A profile of the separate activities demonstrates the large variation in the degree of limitation, which is concealed in a mean score. The single items can be useful when evaluating interventions. However, to predict increased working time after rehabilitation, the mean score, as well as the activity standing bent over a sink, proved useful.

Keywords:

• Disability rating index
• low-back pain
• neck pain
• return to work
• sick leave

Acknowledgements

The study was financed by the Centre for Health Care Science, Karolinska Institutet, Stockholm, Sweden, and the Swedish Council for Working Life and Social Research.