Does the Success of Work-related Interventions in the Rehabilitation of Neurological Diseases Depend on the Return-to-Work Prognosis? A Re-analysis of 2 Randomised Controlled Trials

Objective: The paper examines whether patients with neurological diseases and a poor return to work (RTW) prognosis gain more from work-related medical rehabilitation (WMR). Methods: Re-analysis of matched samples of 2 randomised controlled trials (N=442; questionnaire at admission of rehabilitation and 15-month follow-up). Linear regression models were used calculating the effect of the WMR dependent on the RTW prognosis. Primary outcome was time of sick leave in the follow-up and physical and mental health measured by the SF-36. As secondary outcomes, strategies of coping skills and work-related attitudes were defined. Results: Only for patients with a high non-RTW risk could positive effects of WMR be demonstrated on mental health, coping skills and the scale work as a resource. In the 15-month follow-up, there were no differences in effects on duration of sick leave and physical health. Conclusions: The results based on this analysis indicate that patients with neurological diseases derive benefit from WMR only if their empirical RTW prognosis is poor. However, this only applies for the mental health in the medium term. Our study confirms the previous findings that suggest different effectiveness of the WMR for patients with different RTW risk.