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

      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

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