Randomized controlled trial of workplace-based rehabilitation for work-related rotator cuff disorder

Return to work following an occupational injury is a multifactoral process although many traditional clinic-based rehabilitation programs do not appreciate the importance of workplace factors. A randomized controlled trial was conducted to investigate the effect of workplace-based rehabilitation program on the return to work outcome of work-related rotator cuff disorder, which is based on the therapeutic use of actual work facilities and work environment. A total of 103 workers were recruited and randomly assigned into Clinic-based Work Hardening (CWH) or Workplace-based Work Hardening (WWH) groups. The CWH group were given traditional generic work hardening training while WWH group received workplace-based work hardening training with rehabilitative principles of athletic rotator cuff pathology, biomechanics and specific job activities. After four weeks, a higher return to work rate was obtained in WWH group compared to CWH group (71.4% vs. 37%, p < 0.01). A statistically significant difference (p < 0.05) was also noted in lowering of self-reported shoulder problems and functional work capabilities in the WWH group versus the CWH group. Workplace-based rehabilitation program appeared to be more effective in facilitating the return to work process of the injured worker as assessed immediately following intervention. In particular this approached was associated with many of the psychosocial workplace factors related to separation from the work routine. The influence of peer group and/or employer could be minimized. This initial attempt with rotator cuff injuries appears promising however long-term outcome needs to be determined.