Evaluating outcomes of a return-to-work rehabilitation program for patients with work-related low back pain
Mngoma, Nomusa F.
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Purpose: The overall aim of this thesis is to contribute new knowledge by examining psychosocial factors and return-to-work profiles of occupational low back pain patients in a rehabilitation clinic. Outcome measures for injured workers with subacute low back pain included: change in measures, program utilization, pain profiles and return-to-work. Methods: A total of 147 patients who met the eligibility criteria and consented, participated in a clinic-based, individualized, exercise-based treatment that included patient education and reassurance. A before-and-after design was used, with data collection on admission to and discharge from the program. Results: Pre-to-post analyses revealed that statistically significant improvements had occurred. However, subgroup analyses revealed differences in responses to treatment among the subgroups. Specifically, two sets of cluster analyses were conducted; each yielded two distinct subgroups of patients, one set with different lengths of time in the program, and another showing two pain intensity profiles. Furthermore, return-to-work rates varied between the groups although the overall return-to-work rate appeared high. Conclusion: Significant improvement was achieved following participation in the return-to-work rehabilitation program. However, participants with subacute nonspecific low back pain do not form a homogenous group in terms of their clinical presentation and responses to rehabilitation. Therefore, special attention might be warranted for subgroups within the sample, whom are at an increased risk for prolonged disability.