Predictive factors for the outcome of a multidisciplinary pain rehabilitation programme on sick-leave and life satisfaction in patients with whiplashtrauma and other myofascial pain: a follow-up study

Objective: To evaluate the effects of a multidisciplinary rehabilitation pr ogramme on sick-leave, coping resources and life satisfaction in whiplash p atients and other pain patients. Subjects. Forty patients suffering from symptoms after whiplash trauma and 33 patients with musculoskeletal pain in the neck or back were recruited fo r this study. Ninety-seven consecutive patients admitted to the Department of Neurosurgery with cervical pain, cervical disc herniation;or symptomatic spondylosis served as a control group. Results: Decreased coping resources and poorer life satisfaction were obser ved for whiplash subjects at the beginning of the rehabilitation programme compared to the control group from the Department of Neurosurgery. After th e rehabilitation period 49% of the patients had improved their coping resou rces totalling to 63% after 2 years. At that follow-up 46% of patients had increased their life satisfaction. Furthermore, the group with whiplash inj ury showed a significant increase in sick absenteeism whereas the group wit hout whiplash trauma had decreased their sick-leave. Eighty-eight per cent of the subjects could be correctly classified according to their vocational outcome by means of discriminant function. The elapse of time since workin g, low life satisfaction, lack of increase in coping resources during the r ehabilitation programme, ethnic origin of the patient and living in the cou ntryside predicted poor vocational outcome. Conclusion: Our results suggest variables from the social environment and c oping resources as useful predictors for treatment outcome.