Cost-effectiveness of physical training for self-employed persons with musculoskeletal disorders: the FysiOke study.

Objective:

To evaluate the cost-effectiveness of physical training in the reduction of musculoskeletal disorders and disability.

Both the insurance company and the Dutch government wants to know if this physical training is more cost-effective than usual care. Therefore, we started a randomised controlled trial (RCT) of 300 self-employed persons with MSDs. Participants are randomly assigned to either physical training, or usual care. Outcome measures are level of pain, functional restrictions, disability and return-to-work. Data are collected by questionnaire at baseline and at 6 and 12 months follow-up. These questionnaires contain questions on kind of job, physical and mental workload (VBA), type of complaints (Kuorinka), level of pain (VAS), functional restrictions (NDI, QBPDS), fear of movement (Tampa), treatment, return-to-work, general health and demographic variables. Additionally, data are derived from the insurance company (disability, costs) and physical training institutes (compliance). Besides, we started a cohort of persons who do not want to take part in the RCT but are willing to fill in the questionnaires. This gives us the opportunity to add these persons to the RCT population when possible or to change the study design when necessary.


Anticipated trial start date:

The study has started in July 2004, but inclusion of participants started at November 1th 2004.


Recruitment status:

At August 10th 2005 91 participants were included in the study.

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1. Psysical training;

2. Usual care.

Participants in the intervention group will receive physical training by a physiotherapist. This tailored training takes place 2 or 3 times a week during three months and consists of cardiovascular training, strengthening, relaxation and posture exercises. During an intake meeting each participant is screened for medical or physical contra indications and aspects of motivation. Participants in the control group will receive usual care mostly by general practitioner or physiotherapist (or no treatment at all).