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A 3-year follow-up of a multidisciplinary rehabilitation programme for back and neck pain
Abstract
The aim of the present study was to evaluate the long-term outcome of a behavioural medicine rehabilitation programme and the outcome of its two main components, compared to a 'treatment-as-usual' control group. The study employed a 4 x 5 repeated-measures design with four groups and five assessment periods during a 3-year follow-up. The group studied consisted of blue-collar and service/care workers on sick leave, identified in a nationwide health insurance scheme in Sweden. After inclusion, the subjects were randomised to one of the four conditions: behaviour-oriented physiotherapy (PT), cognitive behavioural therapy (CBT), behavioural medicine rehabilitation consisting of PT+CBT (BM) and a 'treatment-as-usual' control group (CG). Outcome variables were sick leave, early retirement and health-related quality of life. A cost-effectiveness analysis, comparing the programmes, was made. The results showed, consistently, the full-time behavioural medicine programme being superior to the three other conditions. The strongest effect was found on females. Regarding sick leave, the mean difference in the per-protocol analysis between the BM programme and the control group was 201 days, thus reducing sick leave by about two-thirds of a working year. Rehabilitating women has a substantial impact on costs for production losses, whereas rehabilitating men seem to be effortless with no significant effect on either health or costs. In conclusion, a full-time behavioural medicine programme is a cost-effective method for improving health and increasing return to work in women working in blue-collar or service/care occupations and suffering from back/neck pain.
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“Multidisciplinary treatment following a biopsychosocial model is widely accepted as the “golden standard” in the treatment and rehabilitation offered to patients with chronic pain [4,5]”
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Merrick, D., Sundelin, G., & Stålnacke, B. (2013) · Journal of Rehabilitation Medicine · doi:10.2340/16501977-1218 · Cited by 16
Metadata
- Authors
- Jensen, I. B., Bergström, G., Ljungquist, T., & Bodin, L.
- Affiliations
- Karolinska Institutet (SE)
- Örebro University Hospital (SE)
- Corresponding author
- Jensen, Irene B.
- Venue
- Pain
- Published
- 2005-06
- Volume
- 115
- Issue
- 3
- Pages
- 273-283
- ISSN
- 0304-3959 (ISSN-L)
- OpenAlex
- W1991092998
- Cited by
- 188
- References
- 51
- Citations by year
- 2025: 3 · 2024: 1 · 2023: 5 · 2022: 4 · 2021: 3 · 2020: 3 · 2019: 6 · 2018: 9 · 2017: 7 · 2016: 11 · 2015: 17 · 2014: 12 · 2013: 11 · 2012: 19
- FWCI
- 4.88
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Pain (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Musculoskeletal pain and rehabilitation
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Medical Practices and Rehabilitation
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Workplace Health and Well-being
- Keywords
- back pain, neck pain, multidisciplinary rehabilitation, behavioral medicine, cognitive behavioral therapy, sick leave, return to work, health-related quality of life, early retirement, cost-effectiveness, sex differences, blue-collar workers, care workers, occupational health
- MeSH terms
- Adult, Back Pain, Cost-Benefit Analysis, Delivery of Health Care, Employment, Female, Follow-Up Studies, Humans, Male, Middle Aged, Pensions, Quality of Life, Rehabilitation, Program Evaluation, Cognitive Behavioral Therapy, Health Care Costs, Sick Leave, Neck Pain, Physical Therapy Specialty
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