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Recovery Expectations Predict Recovery in Workers With Back Pain but Not Other Musculoskeletal Conditions

Gross, Douglas Paul PhD*; Battié, Michele Crites PhD

Journal of Spinal Disorders & Techniques: October 2010 - Volume 23 - Issue 7 - p 451-456
doi: 10.1097/BSD.0b013e3181d1e633
Original Articles

Study Design Prospective cohort study.

Objective We examined whether recovery expectations predict future return-to-work in workers filing injury claims for a variety of musculoskeletal conditions.

Summary of Background Data Recovery expectations seem to influence recovery and return-to-work after back pain, but their role in other compensable conditions is uncertain.

Methods All workers' compensation claimants receiving time-loss benefits for a musculoskeletal condition and undergoing return-to-work assessment were enrolled. Claimants completed a work-related recovery expectations questionnaire. Outcomes during the 1-year follow-up included surrogate indicators of timely return-to-work (days until suspension of time-loss benefits) and recovery (claim closure). Analysis included multivariable Cox regression.

Results The sample consisted of 1040 claimants of whom 298 (29%) had back pain, 461 (44%) had sprains, strains, or pain of other body parts besides the back, 234 (23%) had specific injuries such as fracture, dislocation, or amputation, and 47 (5%) had other compensable conditions such as carpal tunnel syndrome or knee internal derangement. The majority of participants had chronic conditions (mean duration >6 mo). Negative work-related recovery expectations were consistently associated with slower suspension of time-loss benefits (Hazard Ratio 0.83) and slower claim closure (Hazard Ratio 0.84) in claimants with back pain, but associations in other diagnostic groups were inconsistent and not statistically significant. Associations were slightly larger within the group of claimants with back pain of less than 3-month duration.

Conclusions Recovery expectations provide some information for predicting future recovery in workers filing injury claims for back pain, but do not seem to predict recovery in claimants with other musculoskeletal conditions.

*Department of Physical Therapy, University of Alberta, Workers' Compensation Board Alberta/Millard Health

Department of Physical Therapy, University of Alberta, Canada Research Chair in Common Spinal Disorders, Canada

This research was financially supported by a grant from the Workers' Compensation Board of Alberta. Millard Health facilitated data acquisition.

Reprints: Douglas Paul Gross, PhD, Department of Physical Therapy, University of Alberta, Workers' Compensation Board Alberta/Millard Health, 2-50 Corbett Hall, University of Alberta, Edmonton, Alberta, Canada T6G 2G4 (e-mail:

Received for publication September 22, 2009; accepted November 23, 2009

© 2010 Lippincott Williams & Wilkins, Inc.