NONPHYSICAL FACTORS THAT AFFECT WORK-HARDENING SUCCESS - A RETROSPECTIVE STUDY

The high cost of health care and limited information regarding the eff ects of work hardening have prompted a need to further study work hard ening programs. The purpose of this study was to determine the success oi a work hardening program that included physical, occupational, and psychological therapies, and to determine ii there are nonphysical fa ctors associated with successful work hardening. One hundred medical r ecords of injured workers with low back pain and other musculoskeletal disorders were retrospectively reviewed. Factors examined included mo nths of injury, education level, sex, race, presence oi an attorney, p rior surgery, pain behaviors, smoking, medication use, and diagnosis s everity. Seventy-six percent oi the subjects successfully completed th e program, and 50% of tile subjects were returned to work at discharge . Nonphysical factors that limited successful work hardening were pres ence of pain behaviors (p<.01), attorney representation (p<.01), McAnd rews score above 70 (p<.05), and education less than high school (p<.0 5). The author concludes that the return to work rate for injured work ers in this study is comparable to rates of previous studies and that there are nonphysical factors associated with the success of work hard ening.