Mapping Vocational Rehabilitation Interventions for People with Chronic Low Back Pain: A Scoping Review

Low back pain (LBP) is the leading cause of years lived with disability worldwide. Clinical guidelines recommend multidisciplinary rehabilitation for managing chronic LBP. This scoping review maps vocational rehabilitation (VR) interventions delivered within the healthcare sector for individuals with chronic LBP. It explores (1) which professional groups are involved and how they collaborate, (2) the setting, (3) the duration, intensity, and components of interventions, and (4) how work status is assessed.

A systematic search across six databases (MEDLINE, Embase, CINAHL, AMED, OT Seeker, and Scopus) was conducted in September 2023 and updated in October 2024, following PRISMA-ScR guidelines. Studies were included if they involved working age individuals with chronic LBP receiving VR initiated within the healthcare sector. Articles published before 2013, from outside Europe, or with > 50% of participants on sick leave > 12 months were excluded.

Of 7032 records, 26 articles representing 21 studies from seven European countries were included. Interventions varied in duration (1-12 weeks or until return-to-work (RTW) or a new plan was established), intensity (a few hours to 30 h/week), complexity, and follow-up periods (5 weeks to 5 years). Interdisciplinary collaboration was most common (six studies), although descriptions were limited. Interventions ranged from simple to complex, with up to seven components. Nineteen different methods were used to assess work status.

Substantial heterogeneity in intervention design and RTW outcome measures limits comparability and evidence synthesis. Clearer definitions of collaboration and standardized RTW reporting are needed to inform future development of VR in healthcare contexts.