Musculoskeletal disorders Musculoskeletal Diseases Musculoskeletal disorders
Conditions
Interventions
Intervention: Part-time sick leave (daily work load reduced by restricting work time by about 50%, and, if necessary, remaining work tasks modified so that working should be possible despite the sympt
Sponsors
Finnish Institute of Occupational Health
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: Employees who seek medical advice in the occupational health service primarily due to musculoskeletal pain in the neck or shoulder region, back or upper or lower extremities, are eligible to the study. The symptoms and related disability must warrant prescription of full-time sick leave according to the current practice, but the physician considers the employee to be able to work part-time without the risk of the health condition to deteriorate. Specific inclusion criteria: 1. 18 to 60 years of age 2. Permanent or long-term employment (30 hours or more per week) 3. No sick leave or other absence exceeding two weeks during the preceding month 4. Not more than 30 days on sick leave due to any health problem during three preceding months 5. Employee is not listed for any surgery that requires more than one week of sickness absence 6. No plan for longer absence from work during 12 months after enrollment 7. An employee can be enrolled only once
Exclusion criteria
Exclusion criteria: 1. General exclusion criteria: 1.1. Acute infections 1.2. Major accidental injury 1.3. Active inflammatory arthritis 1.4. Suspected occupational injury or disease 1.5. Malignant tumour diagnosed or treated during the preceding year 1.6. Severe mental disorder; 1.7. Pregnancy 1.8. Severe pain (>7 on a scale from 0 to 10) 1.9. Pain interferes with sleep severely (>7 on scale from 0 to 10) Pain area specific exclusion criteria: 2. Back region: 2.1. Muscle weakness in the lower extremities related to back pain 2.2. Positive straight-leg-raising test 2.3. Pain-related trunk list 2.4. Painful spasm of the back when bending forward 3. Neck and shoulder region: 3.1. Muscle weakness in the upper extremities related to the pain 3.2. Head compression or movements induce radiating pain below elbow level 3.3. Painful torticollis 4. Shoulder and upper extremity regions: 4.1. Muscle weakness related to the pain 4.2. Severe pain in movements interfering with most functions 5. Lower extremities: 5.1. Pain prevents walking
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| 1. Number of days from the initial visit to the return to regular work activities 2. Total number of part- and full-time sick leave days during one- and two-year follow-up | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. Pain, measured using numerical scale 0 to 10 (0 = no pain, 10 = unbearable pain) at 0, 1, 3, 8, 12 and 52 weeks 2. Self-assessed function (Oswestry back questionnaire; shortened Disabilities of the Arm, Shoulder and Hand questionnaire [Quick DASH]; Comprehensive OsteoArthritis Test [COAT]) at 0, 1, 3, 8, 12 and 52 weeks Costs and benefits to the employee, employer and society will be estimated in both study groups. | — |
Countries
Finland
Outcome results
None listed