The aim of this study was to determine if job availability at initial assessment altered the return to work (RTW) recommendations and six month outcomes for ACC claimants undergoing an activity based rehabilitation program (ABP).

Sixty five cases who underwent an ABP at The Back Institute, Wellington were enrolled (28 female, 37 male). Patients were categorized as: Working (IN WORK; n= 21), Not Working/Job Available (OFF WORK; n=20), and Not Working/Job Not Available (NO JOB; n = 24). All patients underwent a similar treatment program. Recommendations on completion of the program and work status at six months follow-up were recorded.

All patients in the IN WORK group, 90% in the OFF WORK group, and 83% in NO JOB group were recommended to RTW at completion of the ABP. At six months a follow-up work status was obtained – all patients in the IN WORK group, 70% in the OFF WORK group, and 29% in the NO JOB group were working (p< 0.05).

Patients that present for rehab without a job (NO JOB) yield similar RTW recommendations at discharge but poorer RTW outcomes at six months when compared to those in work (IN WORK) or off work with a job (OFF WORK). This highlights the importance of job availability in achieving robust return to work outcomes. It is recommended that patients without immediate work available undergo a concurrent Pre-Employment Programme which identifies immediate return to work options.

To determine if patients referred to a back clinic in NZ would respond to a structured program based on the Canadian Back Institute (CBI) system and match results obtained by the system in Canada.

All patients referred to the Wakefield Back Institute over one year were assessed using the CBI system. The program employs a structured history and physical exam to identify a pattern of pain. The identified syndrome then forms the basis for initial treatment and achieving the anticipated outcome confirms the original pattern. Patients undergo a 3-stage exercise program. A Spinal Status assessment and a satisfaction survey were completed on discharge. These were compared with the CBI National Outcomes (CBINO) data for 2001.

The clinic was referred 532 patients of whom 508 could be classified in to one of the recognised patterns of mechanical pain for the lumbar or cervical region. The distribution of pain patterns and patient’s demographics were similar to the CBINO data. Thus far, 162 patients have completed their program. Positive pain management (pain gone or markedly decreased) was reported in 85% of the lumbar group (93% in Canada) and 92% of the cervical group (same as Canada). Better pain control (lumbar 86%, cervical 93%) and longer pain-free episodes (lumbar 64%, cervical 75%) were reported. Patient Satisfaction was high (4.57 on a 1–5 scale).

The CBI program has been adapted and applied in a New Zealand environment and early results suggest outcomes similar to those reported in Canada can be obtained here.