"Fit for work and life": an innovative concept to improve health and work ability of employees, integrating prevention, therapy and rehabilitation.

The evaluation is ongoing and only six-month follow-up was analysed; the authors say longer-term data are planned. The analysis compares baseline with six-month follow-up within each track, rather than reporting a control group or random allocation. The rehabilitation group was small (200) compared with the prevention group (859), and allocation was asymmetrical. Medical diagnoses and archived findings could not be collected because of data-protection restrictions, so some results are not assessable. The minimal detectable change and minimal clinically important difference for the Work Ability Index are unknown, so statistical significance does not show clinical meaning. The text says 1,547 persons started at least six months before analysis, while Table I reports 1,059 analysed; the paper does not explain this difference. Improvements cannot be attributed to physiotherapy or any single component because the tracks bundled multiple services.

The project received major financial support from the authors’ university hospital, which the authors say gives financial leeway but makes transfer to other companies difficult.

Do not conclude that physiotherapy alone improved work ability or sick leave. The paper describes a bundled programme that could include physician assessment and decision-making, preventive or rehabilitative measures, manual medicine and other physical and rehabilitation medicine interventions, physiotherapy, physical modalities, supportive and diagnostic sessions, psychotherapy when needed, and ergonomic consulting or coaching. The contribution of any single component cannot be separated.