Increasing Days at Work Using Function-Centered Rehabilitation in Nonacute Nonspecific Low Back Pain: A Randomized Controlled Trial

• DOI: 10.1016/j.apmr.2004.10.044
• Publication Date: 2005-05-06T22:48:44Z
• Authors: Jan P. Kool; Peter R. Oesch; Stefan Bachmann; Otto Knuesel; Judith G. Dierkes; Mirella Russo; Rob A. de Bie; Piet A. van den B...
• Keywords: Adult; Male; Chi-Square Distribution; Rehabilitation; Pain; Middle Aged; Statistics, Nonparametric; 3. Good health; 03 medical and health sciences; Treatment Outcome; 0302 clinical medicine; Randomized controlled trial; Sick leave; Linear Models; Humans; Low back pain; Female; Single-Blind Method; Sick Leave; Low Back Pain; Physical Therapy Modalities; Pain Measurement

To evaluate the effect of function-centered compared with pain-centered inpatient rehabilitation in patients whose absence from work is due to chronic nonspecific low back pain (LBP).Single-blinded randomized controlled trial with follow-up assessments immediately after treatment and at 3 months.Center for work rehabilitation in Switzerland.Patients with more than 6 weeks of work absence due to chronic nonspecific LBP (N=174; 137 men, 37 women; mean age +/- standard deviation, 42+/-8 y; mean sick leave before study, 6.5 mo).Function-centered treatment (FCT) (4h/d, 6d/wk, for 3 wk) consisted of work simulation, strength, endurance, and cardiovascular training. Pain-centered treatment (PCT) (2.5h/d, 6d/wk, for 3 wk) used a mini back school, individually selected passive and active mobilization, stretching, and low-intensity strength training.The number of days at work in 3 months after treatment, self-efficacy, lifting capacity, pain, mobility, strength, and global perceived effect. Effect sizes (ESs) (Cohen d ) were defined as small (ES range, 0.2-0.5), moderate (ES range, 0.5-0.8), and large (ES, >0.8).Groups were comparable at baseline. Moderate ESs for the FCT group versus PCT group were found for days at work (25.9 d vs 15.8d, ES=.36, P =.029), self-efficacy (5.9 points vs -7.4 points, ES=.55, P =.003), and lifting capacity (2.3 kg vs 0.2 kg, ES=.54, P =.004).Function-centered rehabilitation increases the number of work days, self-efficacy, and lifting capacity in patients with nonacute nonspecific LBP.