• Johannes R Anema, Ivan A Steenstra, Paulien M Bongers, Henrica C W de Vet, Dirk L Knol, Patrick Loisel, and Willem van Mechelen.
• Body@Work, Research Centre Physical Activity, Work and Health, Amsterdam, The Netherlands. h.anema@vumc.nl
• Spine. 2007 Feb 1; 32 (3): 291-8; discussion 299-300.

Study DesignPopulation-based randomized controlled trial.ObjectiveTo assess the effectiveness of workplace intervention and graded activity, separately and combined, for multidisciplinary rehabilitation of low back pain (LBP).Summary Of Background DataEffective components for multidisciplinary rehabilitation of LBP are not yet established.MethodsParticipants sick-listed 2 to 6 weeks due to nonspecific LBP were randomized to workplace intervention (n = 96) or usual care (n = 100). Workplace intervention consisted of workplace assessment, work modifications, and case management involving all stakeholders. Participants still sick-listed at 8 weeks were randomized for graded activity (n = 55) or usual care (n = 57). Graded activity comprised biweekly 1-hour exercise sessions based on operant-conditioning principles. Outcomes were lasting return to work, pain intensity and functional status, assessed at baseline, and at 12, 26, and 52 weeks after the start of sick leave.ResultsTime until return to work for workers with workplace intervention was 77 versus 104 days (median) for workers without this intervention (P = 0.02). Workplace intervention was effective on return to work (hazard ratio = 1.7; 95% CI, 1.2-2.3; P = 0.002). Graded activity had a negative effect on return to work (hazard ratio = 0.4; 95% CI, 0.3-0.6; P < 0.001) and functional status. Combined intervention had no effect.ConclusionWorkplace intervention is advised for multidisciplinary rehabilitation of subacute LBP. Graded activity or combined intervention is not advised.

18 keywords...

hide…