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).


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


METHODS
Center for work rehabilitation in Switzerland.


METHODS
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+/-8 y; mean sick leave before study, 6.5 mo).


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


METHODS
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 (25.9 d vs 15.8d, ES=.36, P =.029), self-efficacy (5.9 points vs -7.4 points, ES=.55, P =.003), and lifting capacity (2.3 kg vs 0.2 kg, 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.
Kool
Jan P
JP
Department of Rheumatology, Rehabilitation Center Valens, Valens, Switzerland.
Oesch
Peter R
PR
Bachmann
Stefan
S
Knuesel
Otto
O
Dierkes
Judith G
JG
Russo
Mirella
M
de Bie
Rob A
RA
van den Brandt
Piet A
PA
D000328:Adult; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D016014:Linear Models; D017116:Low Back Pain / Q000534:rehabilitation*; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology / Q000534:rehabilitation*; D010147:Pain Measurement; D026741:Physical Therapy Modalities; D018582:Sick Leave / Q000706:statistics & numerical data*; D016037:Single-Blind Method; D018709:Statistics, Nonparametric; D016896:Treatment Outcome