A multidisciplinary rehabilitation programme for patients with chronic low back pain: a prospective study.
OBJECTIVE
To examine the effectiveness of a multidisciplinary rehabilitation programme for patients with chronic low back pain in Hong Kong, and to identify factors associated with work resumption.


METHODS
57 men and 8 women aged 20 to 56 (mean, 39) years who had a more than 3-month history of low back pain and were unresponsive to more than 6 months of conventional treatment participated in a 14-week multidisciplinary rehabilitation programme involving physical conditioning, work conditioning, and work readiness. Training protocols entailed flexibility and endurance training, hydrotherapy, weight lifting, and work stimulation. Patients were assessed at baseline (week 1), week 7, week 14, and month 6 with regard to the intensity of low back pain, self-perceived disability, range of lumbar motion, isoinertial performance of the trunk muscles, and depression level. Patient demographics that influenced work resumption were identified using a prediction model. Patients who did and did not return to work were compared.


RESULTS
Of the 54 patients who completed all follow-up assessments, 28 returned to work and 26 did not. The latter was significantly older (37 vs. 42 years, p=0.038) and absent from work longer (11 vs. 22 months, p=0.029) than the former. The rehabilitation programme helped patients regain physical function and the ability to work. Patients who returned to work showed greater improvement in self-perceived disability and physical function.


CONCLUSIONS
This rehabilitation programme facilitated regain of physical functioning and the ability to return to work. The pre-programme employment status, duration of absence from work, and patient age were the most important predictors for work resumption.
Luk
Keith Dip Kei
KD
Department of Orthopaedics and Traumatology, The University of Hong Kong, Hong Kong.
Wan
Thomas Wai Man
TW
Wong
Yat Wa
YW
Cheung
Kenneth Man Chee
KM
Chan
Keith Ying Kei
KY
Cheng
Aldous Chun Shing
AC
Kwan
Mike Wing Wang
MW
Law
Karlen Kar Pui
KK
Lee
Peter Wing Ho
PW
Cheing
Gladys Lai Ying
GL
D000328:Adult; D002908:Chronic Disease; D004185:Disability Evaluation; D006233:Persons with Disabilities / Q000534:rehabilitation; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017116:Low Back Pain / Q000534:rehabilitation*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011446:Prospective Studies; D012050:Rehabilitation, Vocational / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult