Archives of Physical Medicine and Rehabilitation
Volume 86, Issue 5 , Pages 857-864, May 2005

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

Presented orally to the Swiss National Congress for Physiotherapy, May 2004, Lugano, Switzerland.

  • Jan P. Kool, MSc, PT

      Affiliations

    • Department of Rheumatology, Rehabilitation Center Valens, Valens, Switzerland
    • Corresponding Author InformationReprint requests to Jan P. Kool, MSc, PT, Rehabilitation Center, 7317 Valens, Switzerland.
    • ,
  • Peter R. Oesch, PT

      Affiliations

    • Department of Rheumatology, Rehabilitation Center Valens, Valens, Switzerland
    • ,
  • Stefan Bachmann, MD

      Affiliations

    • Department of Rheumatology, Rehabilitation Center Valens, Valens, Switzerland
    • ,
  • Otto Knuesel, MD

      Affiliations

    • Department of Rheumatology, Rehabilitation Center Valens, Valens, Switzerland
    • ,
  • Judith G. Dierkes, MSc

      Affiliations

    • Department of Epidemiology, Maastricht University, Maastricht, the Netherlands.
    • ,
  • Mirella Russo, PT

      Affiliations

    • Department of Rheumatology, Rehabilitation Center Valens, Valens, Switzerland
    • ,
  • Rob A. de Bie, PhD

      Affiliations

    • Department of Epidemiology, Maastricht University, Maastricht, the Netherlands.
    • ,
  • Piet A. van den Brandt, PhD

      Affiliations

    • Department of Epidemiology, Maastricht University, Maastricht, the Netherlands.

Abstract 

Kool JP, Oesch PR, Bachmann S, Kneusel O, Dierkes JG, Russo M, de Bie RA, van den Brandt PA. Increasing days at work using function-centered rehabilitation in nonacute nonspecific low back pain: a randomized controlled trial.

Objective

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).

Design

Single-blinded randomized controlled trial with follow-up assessments immediately after treatment and at 3 months.

Setting

Center for work rehabilitation in Switzerland.

Participants

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±8y; mean sick leave before study, 6.5mo).

Interventions

Function-centered treatment (FCT) (4h/d, 6d/wk, for 3wk) consisted of work simulation, strength, endurance, and cardiovascular training. Pain-centered treatment (PCT) (2.5h/d, 6d/wk, for 3wk) used a mini back school, individually selected passive and active mobilization, stretching, and low-intensity strength training.

Main outcome measures

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).

Results

Groups were comparable at baseline. Moderate ESs for the FCT group versus PCT group were found for days at work (25.9d vs 15.8d, ES=.36, P=.029), self-efficacy (5.9 points vs –7.4 points, ES=.55, P=.003), and lifting capacity (2.3kg vs 0.2kg, ES=.54, P=.004).

Conclusions

Function-centered rehabilitation increases the number of work days, self-efficacy, and lifting capacity in patients with nonacute nonspecific LBP.

Key words:  Low back pain , Randomized controlled trial , Rehabilitation , Sick leave

 

 Supported by the Swiss Federal Office of Health (grant no. 00.00437).No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the author(s) or on any organization with which the author(s) is/are associated.

PII: S0003-9993(05)00007-9

doi:10.1016/j.apmr.2004.10.044

Archives of Physical Medicine and Rehabilitation
Volume 86, Issue 5 , Pages 857-864, May 2005

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