RTW in back conditions.
OBJECTIVE
Back conditions are a group of impairments that induce limitation of activities and restriction of participation, in particular delaying the Return to work (RTW). The purpose of this review is to analyse the components involved in RTW.


METHODS
We have included the studies and reviews about the intervention, assessment tools, variables used to forecast the RTW and the cost-benefit ratio.


RESULTS
We found a relevant number of studies concerning back conditions and Return to work. The evidence is moderate and the meta-analysis failed to show strong indications of efficacy. The better interventions to facilitate RTW are multidisciplinary, not necessarily intensive but taking into account a bio-psycho-social approach. The predictor of RTW does not only concern impairment (pain, rigidity etc.), but the self-estimation of ability is also important to forecast RTW. Intervention seems to be cost-effective if we calculate the saving cost in pension.


CONCLUSIONS
Comprehensive bio-psycho-social approaches seem to be the better modality of intervention to facilitate the RTW. More research is needed to obtain more knowledge about these issues. Particular attention should be placed on the choice of outcome measures and the cost-effectiveness of interventions.
Zampolini
Mauro
M
Department of Rehabilitation, Local Health Service (ASL3), Umbria, 06039 Trevi, Perugia, Italy. m.zampolini@asl3.umbria.it
Bernardinello
Mara
M
Tesio
Luigi
L
D003362:Cost-Benefit Analysis; D004651:Employment / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000145:classification / Q000191:economics / Q000534:rehabilitation; D008297:Male; D015201:Meta-Analysis as Topic; D009788:Occupational Therapy; D017063:Outcome Assessment, Health Care; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D012720:Severity of Illness Index