On-line version ISSN 0038-2337
S. Afr. j. occup. ther. vol.41 n.3 Pretoria 2011
Herculene van StadenI; René KempII; Susan BeukesIII
IB OT, M OT (Vocational Rehabilitation). Occupational Therapist in Vocational Rehabilitation and Medico-Legal Private Practice
IIB OT, M OT. Lecturer - Division of Occupational Therapy, Department of Inter-disciplinary Sciences, Faculty of Health Sciences, University of Stellenbosch
IIIB OT, M OT. Head, Senior Lecturer - Division of Occupational Therapy, Department of Inter-disciplinary Sciences, Faculty of Health Sciences, University of Stellenbosch
BRACKGROUND: Return to work (RTW) after lumbar surgery due to a work-related injury poses a challenge internationally. Work hardening is used as an intervention for acute and chronic lower back pain (CLBP), but it is not necessarily used in post-operative treatments. Method: The RTW rate of an experimental group (Group A) of unskilled labourers was compared with that of a control group (Group B) of unskilled labourers. Group A received multidisciplinary intervention, including a work hardening programme with ergonomic adaptations, while Group B received only physiotherapy after surgery as a multidisciplinary team was not available. A RTW questionnaire was used as an outcome measure for both groups. During the multidisciplinary intervention, the improvement of pain and functionality of patients from Group A were also evaluated from the pre-operative state to 24 weeks post-operatively with the Visual Analogue Scale (VAS) and the Oswestry Disability Index (ODI) as additional outcome measures. Results: There was a positive tendency to successful RTW after work hardening for Group A, but no statistical significance between Groups A and B. The improvement of pain and functionality in Group A was highly significant from time of surgery to six months post-operatively. Conclusion: Work hardening was found to have a positive tendency towards ensuring RTW for work-injured patients after lumbar surgery, with a highly significant effect on pain and functionality.
Key words: Work hardening; work-injured patients; lumbar surgery; return to work (RTW); multidisciplinary approach
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Herculene van Staden