Prognostic Indicators of Disability After a Work-Related Musculoskeletal Injury

Objective: The aim of the study was to determine specific clinical and behavioral factors that prognostically influence return to work following a musculoskeletal work related injury. Methods: A longitudinal cohort study was conducted on 148 randomly selected workers who had not returned to work in 3 months following musculoskeletal strain or sprain injury. The workers were interviewed at 3, 9, 15, and 21 months after injury. The WHO Classification of Impairment, Disabilities and Handicap was used as the conceptual framework. The analysis employed the Cox Proportional Hazards Regression model with allowance for time-dependent covariates. Results: The relative rate of return to work for males was one-and-a-half times that for females and 20% less for every 10-year-increase in age. After controlling for gender and age, psychologic distress and functional disability were negatively associated with the rate of return to work. Psychologic distressd associated with symptoms of fibromyalgia was prognostically important in the failure to return to work. Additionally, there was two times the rate of return to work for workers who were provided with light jobs. Conclusions: These prognostic indicators require consideration for rehabilitation programs for workers who suffer musculoskeletal soft tissue injuries.