Early intervention options for acute low back pain patients: a randomized clinical trial with one-year follow-up outcomes.
BACKGROUND
In an earlier study, Gatchel et al. (J Occup Rehabil 13:1-9, 2003) demonstrated that participants at high risk for developing chronic low back pain disability (CLBPD), who received a biopsychosocial early intervention treatment program, displayed significantly more symptom improvement, as well as cost savings, relative to participants receiving standard care. The purpose of the present study was to expand on these results by examining whether the addition of a work-transition component would further strengthen the effectiveness of this early intervention treatment.


METHODS
Using an existing algorithm, participants were identified as being high-risk (HR) or low-risk (LR) for developing CLBPD. HR participants were then randomly assigned to one of three groups: early intervention (EI); early intervention with work transition (EI/WT); or standard care (SC). Participants provided information regarding pain, disability, work status, and psychosocial functioning at baseline, periodically during treatment, and again 1 year following completion of treatment.


RESULTS
At 1-year follow-up, no significant differences were found between the EI and EI/WT groups in terms of occupational status, self-reports of pain and disability, coping ability or psychosocial functioning. However, significant differences in all these outcomes were found comparing these groups to standard care.


CONCLUSIONS
The addition of a work transition component to an early intervention program for the treatment of ALBP did not significantly contribute to improved work outcomes. However, results further support the effectiveness of early intervention for high-risk ALBP patients.
Whitfill
Travis
T
Division of Clinical Psychology, The University of Texas Southwestern Medical Center at Dallas, Dallas, TX, USA. trawitfill@msn.com
Haggard
Robbie
R
Bierner
Samuel M
SM
Pransky
Glenn
G
Hassett
Robert G
RG
Gatchel
Robert J
RJ
D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D000368:Aged; D000465:Algorithms; D001521:Behavior Therapy; D004185:Disability Evaluation; D006233:Persons with Disabilities / Q000534:rehabilitation*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017116:Low Back Pain / Q000523:psychology / Q000534:rehabilitation*; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D026741:Physical Therapy Modalities; D012306:Risk; D012959:Socioeconomic Factors; D013997:Time Factors; D016896:Treatment Outcome; D014938:Work Capacity Evaluation; D055815:Young Adult