Effects of Inpatient Multicomponent Occupational Rehabilitation versus Less Comprehensive Outpatient Rehabilitation on Somatic and Mental Health: Secondary Outcomes of a Randomized Clinical Trial

Lene Aasdahl, Kristine Pape, Ottar Vasseljen, Roar Johnsen, Sigmund Gismervik, Chris Jensen, Marius Steiro Fimland, Lene Aasdahl, Kristine Pape, Ottar Vasseljen, Roar Johnsen, Sigmund Gismervik, Chris Jensen, Marius Steiro Fimland

Abstract

Purpose To evaluate effects on somatic and mental health of a multicomponent inpatient occupational rehabilitation program compared to a less comprehensive outpatient program in individuals on sick leave for musculoskeletal complaints or mental health disorders. Methods A randomized clinical trial with parallel groups. Participants were individuals on sick-leave for 2-12 months with a sick-leave diagnosis within the musculoskeletal, psychological or general and unspecified chapters of ICPC-2. Potential participants were identified in the Social Security System Registry. The multicomponent inpatient program (4 + 4 days) consisted of Acceptance and Commitment Therapy, physical training and work-related problem-solving including creating a return to work plan and a workplace visit if considered relevant. The comparative outpatient program consisted primarily of ACT (6 sessions during 6 weeks). Self-reported health-related quality of life, subjective health complaints, pain and anxiety and depression symptoms were assessed up to 12 months after the program. Results 168 individuals were randomized to the multicomponent inpatient program (n = 92) or the outpatient program (n = 76). Linear mixed models showed no statistically significant differences between the programs, except for slightly more reduced pain after the outpatient program. Conclusions This study presents no support that a 4 + 4 days multicomponent inpatient rehabilitation program is superior to a less comprehensive outpatient program, in improving health outcomes.

Keywords: Absenteeism; Cognitive therapy; Musculoskeletal diseases; Return to work; Sick leave.

Conflict of interest statement

Conflict of interest

Marius Steiro Fimland has been employed at Hysnes Rehabilitation Center, St. Olavs Hospital. Sigmund Gismervik is employed at Department of Physical Medicine and Rehabilitation, St. Olavs Hospital. The other authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

Figures

Fig. 1
Fig. 1
Participant flow through the study
Fig. 2
Fig. 2
The Hospital Anxiety and Depression Scale (HADS), average pain and 15D. Data are estimated means with 95 % confidence intervals

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