Motivation as a predictor of changes in quality of life and working ability in multidisciplinary rehabilitation. A two-year follow-up of a prospective controlled study in patients with prolonged musculoskeletal disorders.

Abstract

To evaluate the two year outcome of multidisciplinary rehabilitation for patients with prolonged musculoskeletal disorders (MSDs), in terms of health-related quality of life (HRQL) and working ability. In addition, predictors of outcome were examined. The rehabilitation group and the matched control group comprised 122 and 114 patients respectively. Baseline data were compared with two year follow-up data within and between the groups. The variables that were measured were: HRQL (Nottingham Health Profile), motivation, body awareness, pain, pain-related medicine consumption, psychosomatic symptoms, working environment and working ability. Variables which improved significantly for the rehabilitation group compared with the control group were: HRQL (p = 0.049), emotional reactions (p = 0.043), pain related to movements (p = 0.028) and need for pain-related medicines (p = 0.009). Multivariate regression analysis including all patients revealed that motivation was a predictor of change in HRQL (p = 0.001) and working ability (p < 0.001). The rehabilitation programme appeared to improve HRQL to a greater extent than ordinary treatment available within primary care. The patient's level of motivation could be an important predictor of outcome.