Affiliations: Cleveland Clinic Foundation, Cleveland, OH,
USA | Cleveland State University, Cleveland, OH, USA
Note: [] Address for correspondence: Patrick Baker, MS, OTR/L, CLVT,
CDRS, The Cleveland Clinic Foundation, Occupational Therapy Department, C21,
9500 Euclid Avenue, Cleveland, OH 44195, USA. Tel.: +1 216 444 5615; Fax: +1
216 445 5749; E-mail: bakerp1@ccf.org
Abstract: Objective: The purpose of this pilot study was to examine the
effectiveness of a four-week work rehabilitation program. Method: Investigators conducted a retrospective chart review of 312
clients participating in the Work Evaluation and Rehabilitation Clinic (WERC)
Program from 1994–2000. Only 196 charts were sufficiently complete to be
included in the study. Of these 196 prospective clients, 166 began the WERC
program and 141 completed the program and were included in the database. Data
were gathered from the initial history and evaluations conducted upon admission
to the program and from the final evaluation conducted at the time of
discharge. Demographic information was recorded. Data from the following
assessments were collected: pre- and post-scores for subjective measures of
pain using the Oswestry Back Pain Scale and a self-report of pain, the Beck
Depression Inventory, the Waddell Sign, and pre- and post-scores of several
physical performance tasks. Results: Statistically significant post-test improvements were shown
in all six outcome measures used in this study. A decrease in pain correlated
with the Floor to Waist Lift test and with the Carrying An Object 20 Feet test.
The percentage increase in Waddell's Sign correlated with a decrease in the
Carrying An Object 20 Feet test. The Floor to Waist Lift test correlated with
the Carrying an Object 20 Feet test. The Oswestry Test correlated with the Beck
Depression Scale. There was no significant relationship found between diagnosis
of back injury and Waddell's Sign, between either the Waddell's Sign and the
Oswestry, or the Waddell's Sign and depression. A regression analysis revealed
diagnosis, level of education, gender, and pre-injury work load as significant
predictors of improvements made during the work program. Conclusion: The program was shown to be effective as measured by the
post-test improvements in all 6 performance tests. Although more research is
warranted into the effectiveness of treatment for clients with chronic pain, it
appears that there is a relationship between pain and physical performance and
pain and depression in clients completing a work hardening program.
