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

Purpose : 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. Methods : 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. Results : 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). Conclusion : 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.