• Ghislaine Roche-Leboucher, Audrey Petit-Lemanac'h, Luc Bontoux, Valérie Dubus-Bausière, Elsa Parot-Shinkel, Serge Fanello, Dominique Penneau-Fontbonne, Natacha Fouquet, Erick Legrand, Yves Roquelaure, and Isabelle Richard.
• Laboratoire d'épidémiologie, ergonomie, et santé au travail, University of Angers, Angers, France.
• Spine. 2011 Dec 15;36(26):2235-42.

Study DesignRandomized parallel group comparative trial with a 1-year follow-up period.ObjectiveTo compare in a population of patients with chronic low back pain, the effectiveness of a functional restoration program (FRP), including intensive physical training and a multidisciplinary approach, with an outpatient active physiotherapy program at 1-year follow-up.Summary Of Background DataControlled studies conducted in the United States and in Northern Europe showed a benefit of FRPs, especially on return to work. Randomized studies have compared these programs with standard care. A previously reported study presented the effectiveness at 6 months of both functional restoration and active physiotherapy, with a significantly greater reduction of sick-leave days for functional restoration.MethodsA total of 132 patients with low back pain were randomized to either FRP (68 patients) or active individual therapy (64 patients). One patient did not complete the FRP; 19 patients were lost to follow-up (4 in the FRP group and 15 in the active individual treatment group). The number of sick-leave days in 2 years before the program was similar in both groups (180 ± 135.1 days in active individual treatment vs. 185 ± 149.8 days in FRP, P = 0.847).ResultsIn both groups, at 1-year follow-up, intensity of pain, flexibility, trunk muscle endurance, Dallas daily activities and work and leisure scores, and number of sick-leave days were significantly improved compared with baseline. The number of sick-leave days was significantly lower in the FRP group.ConclusionBoth programs are efficient in reducing disability and sick-leave days. The FRP is significantly more effective in reducing sick-leave days. Further analysis is required to determine if this overweighs the difference in costs of both programs.

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