Efficacy of a functional restoration program for chronic low back pain: prospective 1-year study.
OBJECTIVE
To evaluate the efficacy of a functional restoration program for patients with chronic low back pain, using overall disability and work ability as the primary evaluation criteria.


METHODS
We prospectively studied patients aged 18 years or older who had been on sick leave because of nonspecific low back pain for at least 3 months and whose job position was still open. The program was delivered on a day-hospital basis 5 days a week for 5 weeks. Patients were followed up for 1 year.


RESULTS
We included 39 patients, 11 females and 28 males with a mean (± SD) age of 43 ± 8 years and a mean sick-leave duration of 10 ± 7 months. After 1 year, 26 (67%) patients reported improvements and 25 (64%) had returned to work. Compared to the year before the program, the number of sick leave days was decreased by 51% (120 ± 140 vs. 244 ± 114, P < 0.05). The work-and-leisure-activities subscore of the validated French version of the Dallas Pain Questionnaire (DRAD) was significantly improved (57 ± 24 vs. 70 ± 17 at baseline, P < 0.05). The patients still on sick leave after 1 year were older and had greater alterations in baseline DRAD subscores for anxiety/depression and daily activities, compared to the patients who had returned to work.


CONCLUSIONS
Our functional restoration program was effective and allowed two-thirds of patients to resume work. Factors associated with failure to resume work were well-known correlates of chronicity. Our results support the use of functional restoration programs in patients with incapacitating low back pain. They suggest that functional restoration may deserve to be started earlier, after only 3 months with chronic pain, in patients who are unable to work.
Beaudreuil
Johann
J
Service de rhumatologie, groupe hospitalier Lariboisière-Fernand-Widal, Paris cedex 10, France. johann.beaudreuil@lrb.ap-hop-paris.fr
Kone
Hinna
H
Lasbleiz
Sandra
S
Vicaut
Eric
E
Richette
Pascal
P
Cohen-Solal
Martine
M
Lioté
Frédéric
F
de Vernejoul
Marie-Christine
MC
Nizard
Rémy
R
Yelnik
Alain
A
Bardin
Thomas
T
Orcel
Philippe
P
D000328:Adult; D002908:Chronic Disease; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D017116:Low Back Pain / Q000534:rehabilitation*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D026741:Physical Therapy Modalities; D011446:Prospective Studies; D018582:Sick Leave; D011795:Surveys and Questionnaires; D016896:Treatment Outcome