4.0 Article

Work-related medical rehabilitation (WMR) in Neurology requires individualised rehabilitant identification

Journal

FORTSCHRITTE DER NEUROLOGIE PSYCHIATRIE
Volume 87, Issue 2, Pages 92-102

Publisher

GEORG THIEME VERLAG KG
DOI: 10.1055/a-0695-9074

Keywords

severe restrictions of work ability; work-related medical rehabilitation; rehabilitation services (follow-up/medical treatment)

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To increase the rate of successful return-to-work (RTW) after acute or chronic diseases, the German Pension Insurance established the concept of work-related medical rehabilitation (WMR) as a strategic advancement of conventional medical rehabilitation. Although in some indications, the WMR is demonstrably superior to conventional medical rehabilitation in terms of occupational reintegration, this has not yet been proven for neurology so far. Current studies on neurological WMR point to the complexity of clinical anamnestic characteristics of the target group, which makes it difficult to define severe restrictions of work ability (SRWA) as a prerequisite for access to the neurological WMR. In addition, the heterogeneous functional disabilities, multiple comorbidities and the different types of rehabilitation services (follow-up, medical treatment) significantly influence SRWA identification. Standardized SRWA screening instruments with a focus on socio-medical criteria identify SRWA less adequately than individual history taking. In neurology, an individualized SRWA screening is recommended at the beginning of WMR despite additional expense.

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