Effects of functional restoration versus 3 hours per week physical therapy: a randomized controlled study.
METHODS
Randomized parallel-group comparative trial with a 6-month follow-up period.


OBJECTIVE
To compare, in chronic low back pain patients, the effectiveness of a functional restoration program, including intensive physical training, occupational therapy, and psychological support to an active individual therapy consisting of 3 hours physical therapy per week during 5 weeks.


BACKGROUND
Controlled studies conducted in the United States showed a benefit of functional restoration in patients with low back pain, especially on return to work. Randomized Canadian and European trials had less favorable results. In France, there has been up to now no randomized study. Controlled studies suggested a positive effect of functional restoration programs.


METHODS
Eighty-six patients with low back pain were randomized to either the functional restoration (44 patients) or the active individual therapy (42 patients) program. One person in each group never started the program. Two patients did not complete the functional restoration program, and one was lost to follow-up at 6 months. The mean number of sick-leave days in the 2 previous years was 6 months.


RESULTS
After adjustment on the variable "workplace enrolled in an ergonomic program", the mean number of sick-leave days was significantly lower in the functional restoration group. Physical criteria and treatment appreciation were also better. There was no significant difference in the intensity of pain, the quality of life and functional indexes, the psychological characteristics, the number of contacts with the medical system, and the drug intake.


CONCLUSIONS
This study demonstrates the effectiveness of a functional restoration program on important outcome measures, such as sick leave, in a country that has a social system that protects people facing difficulties at work.
Jousset
Nathalie
N
Département de Santé Publique, UFR Médecine, 1 rue Haute de Reculée, 49045 Angers cedex 01, France.
Fanello
Serge
S
Bontoux
Luc
L
Dubus
Valérie
V
Billabert
Colette
C
Vielle
Bruno
B
Roquelaure
Yves
Y
Penneau-Fontbonne
Dominique
D
Richard
Isabelle
I
D000041:Absenteeism; D000328:Adult; D002908:Chronic Disease; D003131:Combined Modality Therapy; D005080:Exercise Test; D005260:Female; D005500:Follow-Up Studies; D005602:France; D006801:Humans; D017116:Low Back Pain / Q000523:psychology / Q000534:rehabilitation / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009788:Occupational Therapy; D010147:Pain Measurement; D026741:Physical Therapy Modalities; D018583:Pliability; D011613:Psychotherapy; D011788:Quality of Life; D020127:Recovery of Function; D016896:Treatment Outcome