Work-related medical rehabilitation in neurology
Effective on the basis of individualized rehabilitant identification
Background:
Evidence for the effectiveness of work-related medical rehabilitation (WMR) for a successful return to work (RTW) is lacking for neurological diseases. The aim of this study was therefore to correlate the cross-indication screening instrument for the identification of the demand of work-related medical rehabilitation (SIMBO‑C) with the individualized clinical anamnestic determination of severe restrictions of work ability (SRWA) as a required access criterion for admittance to neurological WMR. A further aim was to compare the rate of successful RTW in rehabilitants with and without WMR measures 6 months after inpatient rehabilitation.
Methods:
On admission SRWA were routinely screened by an individualized clinical anamnestic determination with subsequent assignment to WMR or conventional rehabilitation. At the beginning of rehabilitation the SIMBO-C was applied and 6 months after the rehabilitation the RTW status was surveyed.
Results:
Of the 80 rehabilitants 44 (55 %) received WMR. On admission they showed a higher SIMBO-C score (41.3 ± 15.7 vs. 26.2 ± 18.6 points, p = 0.002), on discharge more often locomotor and psychomental disorders (55 % vs. 36 %, p = 0.10 and 46 % vs. 22%, p = 0.03, respectively) and longer incapacitation times after rehabilitation of > 4 weeks (66 % vs. 33 %, p = 0.02) compared to those without WMR. At 6 months follow-up after discharge the 2 groups did not significantly differ with respect to successful RTW (61 % vs. 66 %, p = 0.69). The SIMBO-C (cut-off ≥ 30 points) showed a medium correlation with the individualized clinical anamnestic determination of SRWA (r = 0.33, p = 0.01).
Conclusion:
The applied neurological WMR concept accomplished a comparable RTW rate between rehabilitants with SRWA by a WMR and those without SRWA and conventional rehabilitation. The SIMBO-C should only be used in combination with the individualized anamnesis to identify SRWA.
