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Digital rehabilitation aftercare shows steeper initial work ability improvement that disappears after adjustmentDigital rehab aftercare shows early work ability gains

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Key Takeaway
Note that unadjusted digital aftercare benefits disappear after adjusting for sociodemographic factors.

This randomized controlled trial evaluated the impact of digital rehabilitation aftercare on work ability among 1056 orthopedic rehabilitation patients. The study took place in multiple rehabilitation clinics in Germany. Participants were assigned to receive digital rehabilitation aftercare (digIRENA), conventional rehabilitation aftercare (IRENA), or a control group without organized aftercare. Assessments occurred at baseline, 13, 26, and 43 weeks post-baseline.

Work ability improved significantly over time in all three groups with a p-value less than 0.01. In unadjusted analysis, the digIRENA group demonstrated steeper initial improvement compared to the IRENA and control groups. The effect size for this unadjusted comparison was F = 2.2 with eta squared of 0.006.

After adjusting for age, gender, and employment status, the difference between groups was no longer significant. Selection bias and baseline differences explain the unadjusted group effect. No adverse events, serious adverse events, discontinuations, or tolerability data were reported. Funding or conflicts of interest were not reported.

Researchers conducted a randomized trial in Germany with 1,056 orthopedic rehabilitation patients. They compared digital rehabilitation aftercare (digIRENA) to conventional aftercare and a control group with no organized aftercare. The study measured work ability at baseline and at 13, 26, and 43 weeks.

Work ability improved significantly over time in all three groups. In unadjusted analysis, the digital aftercare group showed a steeper initial improvement compared to the other groups. However, after adjusting for age, gender, and employment status, the difference between groups was no longer significant.

No safety concerns were reported, as adverse events were not tracked. The main reason to be careful is that the initial advantage may be explained by baseline differences between the groups, not the digital intervention itself.

The realistic takeaway is that digital aftercare may offer a temporary edge in work ability recovery, but this effect is not sustained once patient characteristics are considered. More research is needed to confirm any lasting benefit.

What this means for you:
Digital rehab aftercare may speed early work ability gains, but the effect fades after adjusting for patient factors.

Study Details

Study typeRct
EvidenceLevel 2
PublishedJun 2026
View Original Abstract ↓
PURPOSE: 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. METHODS: 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. RESULTS: 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. CONCLUSION: 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.
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