Schmidt Detlef, Hedin Jakob, Pelegrina Anna, Weyland Susanne, Rittmann Lena-Marie, Jekauc Darko
DRV Knappschaft-Bahn-See, Bochum, Germany.
Karlsruhe Institute of Technology, Karlsruhe, Germany.
J Occup Rehabil. 2025 Mar 27. doi: 10.1007/s10926-025-10284-5.
The primary aim of this study was to compare the effectiveness of digital rehabilitation aftercare (digIRENA) with conventional rehabilitation aftercare (IRENA) and a control group without organized aftercare in improving work ability among orthopedic patients.
A total of 1056 orthopedic rehabilitation patients were recruited from multiple rehabilitation clinics in Germany and randomly assigned to three groups: digIRENA (n = 405), IRENA (n = 352), or a control group (n = 299). Work ability was assessed using the short version of the Work Ability Index at four time points: baseline, 13, 26, and 43 weeks post-baseline. Repeated-measures ANOVA was conducted to examine longitudinal trends in work ability, with additional analyses to assess the impact of age, gender, and employment status on outcomes.
Work ability improved significantly over time in all three groups (F = 37.6, p < 0.01, η = 0.045). In the unadjusted analysis, the interaction between time and group was significant (F = 2.2, p < 0.01, η = 0.006), indicating a steeper initial improvement in the digIRENA group compared to IRENA and control. However, when adjusting for age, gender, and employment status, this difference was no longer significant, suggesting that selection bias and baseline differences explain the unadjusted group effect. Across all groups, younger and unemployed participants showed greater improvements in work ability.
In unadjusted comparisons, digital aftercare showed a steeper initial improvement in work ability. However, once key sociodemographic factors were controlled for, these group differences disappeared.
本研究的主要目的是比较数字康复后续护理（digIRENA）与传统康复后续护理（IRENA）以及无组织后续护理的对照组在改善骨科患者工作能力方面的有效性。
从德国多家康复诊所招募了总共1056名骨科康复患者，并随机分为三组：digIRENA组（n = 405）、IRENA组（n = 352）或对照组（n = 299）。在四个时间点使用工作能力指数简版评估工作能力：基线、基线后13周、26周和43周。进行重复测量方差分析以检查工作能力的纵向趋势，并进行额外分析以评估年龄、性别和就业状况对结果的影响。
所有三组的工作能力均随时间显著改善（F = 37.6，p < 0.01，η = 0.045）。在未调整分析中，时间与组之间的交互作用显著（F = 2.2，p < 0.01，η = 0.006），表明与IRENA组和对照组相比，digIRENA组的初始改善更为显著。然而，在调整年龄、性别和就业状况后，这种差异不再显著，这表明选择偏倚和基线差异解释了未调整的组效应。在所有组中，年轻和失业参与者的工作能力改善更大。
在未调整的比较中，数字后续护理在工作能力方面显示出更显著的初始改善。然而，一旦控制了关键的社会人口统计学因素，这些组间差异就消失了。
