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Efficacy of temporary work modifications on disability related to musculoskeletal pain or depressive symptoms—study protocol for a controlled trial
  1. Eija Haukka1,2,
  2. Kari-Pekka Martimo2,3,
  3. Teija Kivekäs2,4,
  4. Ritva Horppu1,2,
  5. Tea Lallukka1,2,
  6. Svetlana Solovieva1,2,
  7. Rahman Shiri1,2,
  8. Irmeli Pehkonen1,2,
  9. Esa-Pekka Takala1,2,
  10. Ellen MacEachen5,6,
  11. Eira Viikari-Juntura2
  1. 1Health and Work Ability, OHS and Work Health, Finnish Institute of Occupational Health, Helsinki, Finland
  2. 2Disability Prevention Research Centre, Finnish Institute of Occupational Health, Helsinki, Finland
  3. 3Client Services, Occupational Health Collaboration, Finnish Institute of Occupational Health, Helsinki, Finland
  4. 4Development of Work and Organizations, Mental Health and Cognition, Finnish Institute of Occupational Health, Helsinki, Finland
  5. 5University of Waterloo, School of Public Health and Health Systems, Waterloo, Ontario, Canada
  6. 6University of Toronto, Dalla Lana School of Public Health, Toronto, Ontario, Canada
  1. Correspondence to Dr Eija Haukka; Eija.Haukka{at}


Introduction Previous research suggests that work with a suitable workload may promote health and work retention in people with disability. This study will examine whether temporary work modifications at the early stage of work disability are effective in enhancing return to work (RTW) or staying at work among workers with musculoskeletal or depressive symptoms.

Methods and analysis A single-centre controlled trial with modified stepped wedge design will be carried out in eight enterprises and their occupational health services (OHSs) in nine cities in Finland. Patients seeking medical advice due to musculoskeletal pain (≥4 on a scale from 0–10) or depressive symptoms (≥1 positive response to 2 screening questions) and fulfilling other inclusion criteria are eligible. The study involves an educational intervention among occupational physicians to enhance the initiation of work modifications. Primary outcomes are sustained RTW (≥4 weeks at work without a new sickness absence (SA)) and the total number of SA days during a 12-month follow-up. Secondary outcomes are intensity of musculoskeletal pain (scale 0–10), pain interference with work or sleep (scale 0–10) and severity of depressive symptoms (Patient Health Questionnaire, PHQ-9), inquired via online questionnaires at baseline and 3, 6, 9 and 12 months after recruitment. Information on SA days will be collected from the medical records of the OHSs over 12 months, before and after recruitment.

The findings will give new information about the possibilities of training physicians to initiate work modifications and their effects on RTW in employees with work disability due to musculoskeletal pain or depressive symptoms.

Ethics and dissemination The Coordinating Ethics Committee of Hospital District of Helsinki and Uusimaa has granted approval for this study. The results will be published in peer-reviewed journals.

Trial registration number ISRCTN74743666.

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  • Return to work

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