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Comparison of Chronic Occupational Upper Extremity Versus Lumbar Disorders for Differential Disability-Related Outcomes and Predictor Variables

Howard, Krista J. PhD; Mayer, Tom G. MD; Gatchel, Robert J. PhD

Journal of Occupational & Environmental Medicine:
doi: 10.1097/JOM.0b013e3182546daf
Original Articles

Objective: To systematically evaluate if an interdisciplinary functional restoration program (FRP), shown to be a viable treatment option for patients with chronic disabling occupational lumbar disorders, is as effective in treating chronic disabling occupational upper extremity disorders.

Methods: Participants were 2484 consecutive patients with either arm or lumbar disorders admitted to an FRP. Analyses compared demographic, psychosocial, and work-related factors, and 1-year post-rehabilitation socioeconomic outcomes.

Results: Socioeconomic outcomes showed that work-return and work-retention rates after successful completion of the FRP did not differ between the two groups, or among the upper extremity subgroups.

Conclusions: FRP is equally effective for patients with chronic upper extremity or lumbar spine disorders, regardless of the injury type, site in the upper extremity, or the disparity in injury-specific and psychosocial factors identified before treatment.

Author Information

From the Department of Psychology (Dr Howard), Texas State University, San Marcos, Tex; Department of Orthopedic Surgery (Dr Mayer), University of Texas Southwestern Medical Center at Dallas; and Department of Psychology (Dr Gatchel), College of Science, The University of Texas at Arlington.

Address correspondence to: Tom G. Mayer, MD, 5701 Maple Ave, #100, Dallas, TX 75235 (

The authors declare no conflict of interest.

©2012The American College of Occupational and Environmental Medicine