Abstract
Rehabilitation therapists made predictions of return to work for 57 patients evaluated prior to beginning a work-hardening program. These predictions, along with 14 specific demographic, injury, and physical function measures were entered into a stepwise discriminant analysis to develop a predictive model for return to work. Therapists correctly predicted the eventual return to work for 47 (73.7%) of the 57 subjects. Therapist prediction was the most powerful variable in the model, explaining 29% of the variance (p≤.0001). Only two other variables, self-report of pain severity and injury type, contributed significantly to the prediction model, accounting respectively for 12% and 9% of the variance (p's<.05). These data highlight the predictive acuity of rehabilitation therapists and suggest that the process involved in formulating clinical predictions merits further study. The findings also suggest that weighing information such as self-report of pain severity and injury type might further enhance the practitioner's ability to predict return to work.
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References
Spengler DM, Bigos SJ, Martin NA, Zeh J, Fisher L, Nachemson A. Back injuries in industry: A retrospective study I. overview and cost analysis.Spine 1986; 11: 241–245.
Snook SH, Jensen RC, Cost. In Pope MH, Frymoyer JW, Anderson G, eds.Occupational low back pain. New York: Praeger; 1984: 115–121.
Webster BS, Snook SH. The cost of compensable low back pain.J. Occup Med 1990; 32: 13–15.
Follick MJ, Smith TW, Ahern DK. The sickness impact profile: A global measure of disability in chronic low back pain.Pain 1985; 21: 67–76.
Fairbanks JCT, Davies JB, Cooper J, O'Brien JP. The Oswestry low back pain questionnaire.Physiotherapy 1980; 66: 271–272.
Cairns D, Mooney V, Crane P. Spinal pain rehabilitation: Inpatient and outpatient treatment results and development of predictors for outcome.Spine 1984; 9: 91–95.
Frymoyer JW, Rosen JC, Clements J, Pope MH. Psychologic factors in low back pain disability.Clin Orthop 1985; 195; 178–184.
Gallagher RM, Rauh V, Haugh LD, Milhous R, Callas PW, Langelier R, McClallen JM, Frymoyer J. Determinants of return-to-work among low back pain patients.Pain 1989; 39: 55–67.
Lacroix JM, Powell J, Lloyd GJ, Doxey NCS, Mitson GL, Aldam CF. Low-back pain: Factors of value in predicting outcome.Spine 1990; 15: 495–499.
MacKenzie EJ, Shapiro S, Smith RT, Siegel JH, Moody M, Pitt A. Factors influencing return to work following hospitalization for traumatic injury.Am. J Pub Health 1987; 77: 329–334.
Milhous RL, Haugh LD, Frymoyer JW, Ruess JM, Gallagher RM, Wilder DG, Callas PW. Determinants of vocational disability in patients with low back pain.Arch Phys Med Rehab 1989; 70: 589–593.
Polatin PB, Gatchel RJ, Barnes D, Mayer H, Arens C, Mayer TG. A psychosociomedical prediction model of response to treatment by chronically disabled workers with low-back pain.Spine 14; 1989: 956–961.
Sandstrom J. Clinical and social factors in rehabilitation of patients with chronic low back pain.Scand J Rehab Med 1986; 18: 35–43.
Volinn E, Koevering DV, Loeser, JD. Back sprain in industry: The role of socioeconomic factors in chronicity.Spine 1991; 16: 542–548.
Waring EM, Weisz GM, Bailey Sl. Predictive factors in the treatment of low back pain by surgical intervention. In Bonica JJ, Albe-Fessard D, eds.Advances in pain research and therapy (Vol. 1). New York: Raven, 1976; pp. 939–942.
Turner JA, McCreary CP. Chronic low back pain: Predicting response to nonsurgical treatment.Arch Phys Med Rehab 1983; 64: 560–563.
Beals RK, Hickman NW. Industrial injuries of the back and extremities.J Bone Joint Surg 1972; 54-A: 1593–1611.
Fredrickson BE, Trief PM, VanBeveren P, Yuan HA, Baum G. Rehabilitation of the patient with chronic back pain: A search for outcome predictors.Spine 1988; 13: 351–353.
Nay WR. Analogue measures. In Ciminero AR, Calhoun KS, Adams HE, eds.Handbook of behavioral assessment. New York: John Wiley & Sons, 1977, pp. 233–278.
Zealley AK, Aitken RBC. Measurement of mood.Proc R Soc Med 1969; 62: 993–996.
Matheson LN.WEST 2 work capacity evaluation device user's manual. Huntington Beach, CA: Work Evaluation Systems Technology, 1985.
Workstart Work Capacity Evaluation Protocol Manual of HEALTHSouth Rehabilitation Corporation. Birmingham AL (unpublished manual).
U.S. Department of Labor.Dictionary of occupational titles (Vol. II, 4th Ed.). Washington, D.C.: U.S. Government Printing Office, 1991.
Standards Manual for Organizations Serving People with Disabilities. Tucson, AZ: Commission on Accreditation of Rehabilitation Facilities, 1989.
SAS/STAT User's Guide, Release 6.03 Edition. Cary, NC: SAS Institute, 1988.
Rosenthal R.Experimenter effects in behavioral research. New York: Appleton-Century-Crofts, 1966.
Mayer TG, Gatchel RJ.Functional restoration for spinal disorders: The sports medicine approach. Philadelphia: Lea & Febiger, 1988.
Bigos SJ, Battie MC, Spengler DM, Fisher LD, Fordyce WE, Hansson TH, Nachemson AL, Wortley MD. A prospective study of work perceptions and psychosocial factors affecting the report of back injury.Spine 1991; 16: 1–6.
Lustman PJ, Velozo CA, Eubanks B, Montag JA, Cole DM. Psychiatric disorder: Effects on rehabilitation and return to work.Work 1991; 1: 29–35.
Feuerstein M, Sult S, Houle M. Environmental stressors and chronic low back pain: Life events, family and work environment.Pain 1985; 22: 295–307.
Svensson H, Anderson GBJ. Low-back pain in 40- to 47-year-old men: Work history and work environment factors.Spine 1983; 8: 272–276.
Wood DJ. Design and evaluation of a back injury prevention program within a geriatric hospital.Spine 1987; 12: 77–82.
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Velozo, C.A., Lustman, P.J., Cole, D.M. et al. Prediction of return to work by rehabilitation professionals. J Occup Rehab 1, 271–280 (1991). https://doi.org/10.1007/BF01073692
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DOI: https://doi.org/10.1007/BF01073692