Predictive factors of sustained return to work for persons with musculoskeletal disorders who participated in rehabilitation

Musculoskeletal disorders (MSD) account for the majority of total morbidity cases in the working-age Swedish population. These disorders are thought to be the reason given for one-third of total certified sick leave requests. In addition to the high cost to society, MSD involve both physical and emotional suffering, pain and financial and social problems for the injured persons. The aim of this study was to identify predictive multidimensional factors for sustainable return to work (RTW) in a long-term follow-up persons with MSD. During the period 1992-1999, 385 persons participated in a rehabilitation program. Ten years later, 354 of these took part in a prospective follow-up study. The average post-rehabilitation time was ten years (range = 7-13 years) and 243 persons (69%) completed a questionnaire. The "working full-time" group (n = 110) and the "sick-listed" group (n = 73) were included in the study. The two groups were compared in terms of predictors for RTW. Multiple stepwise logistic regression and bivariate analysis, as well as parametric and non-parametric tests, were used to identify predictive factors. The number of sick-listed days before rehabilitation, age, self-rated pain, life events, gender, physical capacity, self-rated functional capacity, educational level and light physical labor were predictors of long-term RTW. Return to work an be facilitated by planning at an early stage of the certified sick leave period using instrument that take these predictors into account.