Effects of Musculoskeletal Rehabilitation Courses on Work Ability

Effects of Musculoskeletal Rehabilitation Courses on Work Ability (Tules-kurssit Ja Työkyky)

The goal of this observational study is to learn about the effects of two different musculoskeletal rehabilitation programs in working-age people with musculoskeletal disorders. The main question it aims to answer is:

Do musculoskeletal rehabilitation programs A or B improve work ability in people with musculoskeletal disorders?

Participants starting in rehabilitation programs A and B will answer survey questions about their work ability and related factors three times: when starting, immediately after the rehabilitation ends, and 4 months after ending the rehabilitation. Participants in study group C will answer the same questions during the same time period.

Researchers will compare participants in rehabilitation programs A and B to participants in group C, who have musculoskeletal disorders but will not participate in rehabilitation programs. The comparison is done to see if there are differences in the changes in work ability and related factors, such as pain or quality of life.

Study Overview

• Status: Enrolling by invitation
• Conditions: Musculoskeletal Diseases or Conditions; Musculoskeletal Disorders
• Intervention / Treatment: Other: Face-to-face musculoskeletal rehabilitation; Other: Musculoskeletal telerehabilitation; Other: Controls

• Study Type: Observational
• Enrollment (Estimated): 480

Contacts and Locations

Study Locations

• Finland
  • Helsinki, Finland, 00250
    • The Social Insurance Institution of Finland

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

Those starting in either of the following services between January 2025 and January 2026:

• Kela's face-to-face musculoskeletal rehabilitation (A)
• Kela's musculoskeletal telerehabilitation (B).

Persons with MSD who contacted their occupational health care between January 2025 and January 2026 because of musculoskeletal symptoms, but will not participate in Kela's musculoskeletal rehabilitation. Two private companies offering occupational health care services nationally are involved.

Description

Inclusion Criteria:

Groups 1 ja 2:

• diagnosed musculoskeletal disorder
• 18 years or older
• in employment, returning to work, studying, or receives rehabilitation subsidy

• participating in either of the following:

  • Kela's face-to-face musculoskeletal rehabilitation (A)
  • Kela's musculoskeletal telerehabilitation (B)
• willingness to participate in the study

Group 3 (Controls):

• diagnosed musculoskeletal disorder
• 18 years or older
• in employment, returning to work, studying, or receives rehabilitation subsidy
• musculoskeletal symptoms have lasted at least 3 months and the person has participated in physiotherapy or self-rehabilitation without satisfactory results
• willingness to participate in the study

Exclusion Criteria:

Group 3 (Controls):

• Current rehabilitation needs are related to post-treatment care or post-discharge rehabilitation.
• acute or untreated substance use disorder
• participating in or apply for Kela's musculoskeletal rehabilitation services (A or B) during the next few months

Study Plan

How is the study designed?

Number of groups / cohorts

3

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Face-to-face musculoskeletal rehabilitation (A); Participation in a face-to-face rehabilitation course organized by the Social Insurance Institution of Finland (Kela) for those with musculoskeletal disorders (MSD) (A)	Other: Face-to-face musculoskeletal rehabilitation; Kela's rehabilitation course for those with MSD includes two 5-day periods and one 3-day period of face-to-face rehabilitation, which are carried out in a Finnish rehabilitation center over a 9-month period and implemented by a multidisciplinary team of rehabilitation experts. The rehabilitation course is group-based and provided free of charge. The 9-month rehabilitation period also includes calls to the participants before and after rehabilitation. The course is intended for persons over the age of 18 with diagnosed MSD and difficulties coping with work or studies. The course provides support, tools, and coaching to help manage daily life and work with MSD. Self-rehabilitation is an important component of the program. Individual goals based on the GAS method are set, evaluated, and adjusted during the rehabilitation. A medical statement is required when applying for the rehabilitation course.
Musculoskeletal telerehabilitation (B); Participation in a telerehabilitation course organized by Kela for those with MSD (B)	Other: Musculoskeletal telerehabilitation; Kela´s MSD telerehabilitation course is arranged entirely as telerehabilitation, and it includes videoconferencing, online rehabilitation, and group-based rehabilitation days implemented by a multidisciplinary team of rehabilitation experts. Participation does not require particular IT skills, but appropriate equipment (e.g., mobile phone, laptop, tablet computer) is needed. The rehabilitation course is free of charge, and the total duration, including the calls before and after rehabilitation, is approximately 7 months. The course is intended for persons over the age of 18 with diagnosed MSD and difficulties coping with work or studies. The course provides support, tools, and coaching to help manage daily life and work with MSD. Self-rehabilitation is an important component of the program. Individual goals based on the GAS method are set, evaluated, and adjusted during the rehabilitation. A physiotherapist's recommendation is required when applying for the telerehabilitation course
Controls (C); Persons with MSD who had contacted their occupational health care because of musculoskeletal symptoms, and will not participate in Kela's musculoskeletal rehabilitation course during the study period	Other: Controls; The control participants have an MSD diagnosis and musculoskeletal symptoms. Based on an occupational physiotherapist's brief evaluation they are eligible to apply for Kela's musculoskeletal rehabilitation (the interventions below). By them own choice, however, they will not participate in these rehabilitation programs in the near future. The controls are recruited via two occupational health care producers in the private sector.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change from Baseline in Work Ability at 4-6 Months and 8-10 Months	Work Ability Index questionnaire (7-49 points; the higher score indicates better work ability)	Baseline (pre-intervention), 4-6 months (after the intervention), 8-10 months (4-month follow-up)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change from Baseline in Mood at 4-6 months	Beck's Depression Inventory (BDI-21) (0-63; the higher score indicates more depressive symptoms)	Baseline (pre-intervention), 4-6 months (after the intervention)
Change from Baseline in Quality of Life at 4-6 months	World Health Organization Quality of Life Instrument (WHOQOL-BREF) (0-100; the higher score indicates better quality of life)	Baseline (pre-intervention), 4-6 months (after the intervention)
Change from Baseline in Functional Ability at 4-6 months	PROMIS®-29 Profile v2.1 (without 4 questions concerning depression) (t-score; the higher score indicates more measured quality)	Baseline (pre-intervention), 4-6 months (after the intervention)
Change from Baseline in Pain at 4-6 months and 8-10 months	5 questions from PROMIS®-29 Profile v2.1 concerning pain and 5 questions concerning musculoskeletal pain characteristics	Baseline (pre-intervention), 4-6 months (after the intervention), 8-10 months (4-month follow-up)
Change from Baseline in Return-to-Work Self Efficacy at 4-6 months	Return-to-Work Self Efficacy (RTW-SE), modified version (0-66; the higher score indicates better self efficacy)	Baseline (pre-intervention), 4-6 months (after the intervention)
Invidual Goal Achievement	Goal Attainment Scaling method (GAS)	4-6 months (after intervention)
Days Lost Through Sickness	Register-based data concerning sickness allowance. The sickness allowance is paid as compensation for loss of income due to incapacity for work lasting less than a full year. Periods which have lasted ten days or more are available in Kela's register.	Between January 1, 2024 and June 30, 2026

Collaborators and Investigators

• Sponsor: Social Insurance Institution, Finland
• Collaborators: Finnish Institute of Occupational Health

Study record dates

Study Major Dates

• Study Start (Actual): January 13, 2025
• Primary Completion (Estimated): August 31, 2026
• Study Completion (Estimated): December 31, 2026

Study Registration Dates

• First Submitted: December 19, 2024
• First Submitted That Met QC Criteria: December 19, 2024
• First Posted (Actual): March 25, 2025

Study Record Updates

• Last Update Posted (Actual): March 25, 2025
• Last Update Submitted That Met QC Criteria: February 10, 2025
• Last Verified: February 1, 2025

More Information

Terms related to this study

• Keywords: Rehabilitation; Quality of Life; Pain; Chronic Pain; Telerehabilitation; Musculoskeletal Diseases; Musculoskeletal Disorders; Musculoskeletal Pain; Work Ability
• Additional Relevant MeSH Terms: Musculoskeletal Diseases
• Other Study ID Numbers: KELA_4822_2024

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No