EMPLOYMENT AFTER REHABILITATION FOR MUSCULOSKELETAL IMPAIRMENTS - THEIMPACT OF VOCATIONAL-REHABILITATION AND WORKING ON A TRIAL BASIS

Objective: To investigate to what extent vocational rehabilitation and working on a trial basis have an impact on employment after rehabilit ation. Design: Follow-up survey, conducted in 1991, among all patients , aged 14 to 64, who were treated between 1984 and 1987. Setting: An o ut-clinic department of a rehabilitation center in the west of The Net herlands. Subjects: 395 patients (59% of the original sample) particip ated in the study. They suffer from musculoskeletal impairments due to back pain (41%), brain injury (20%), neurological disorder (12%), tra uma to the upper and/or lower extremities (8%), rheumatoid arthritis ( 7%), or other disorders (12%). No differences were found between those who did and those who did not respond with regard to age, gender, mar ital status, disorder, work experience, and participation in vocationa l rehabilitation. Main Outcome Measure: Odds ratio of having a paid jo b after rehabilitation. Results: Participation in vocational rehabilit ation and working on a trial basis depends on age, gender, work experi ence, and disorder. When statistically controlled for these variables vocational rehabilitation (odds ratio 1.96; 95% confidence interval 1. 12 to 3.42) and working on a trial basis (odds ratio 3.26; 95% confide nce interval 1.74 to 6.11) proved to have a significant impact on empl oyment after rehabilitation. Conclusions: The findings suggest that re habilitation programs that aim specifically at promoting employment fo r people with disabilities are effective, in particular when they take place in both a laboratory and a natural setting. The validity of thi s suggestion must be further tested by means of an experimental design . (C) 1995 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation