title: Multidisciplinary intensive functional restoration versus outpatient active physiotherapy in chronic low back pain: a randomized controlled trial.
abstract: METHODS
  Randomized parallel group comparative trial with a 1-year follow-up period.
  
  
  OBJECTIVE
  To compare in a population of patients with chronic low back pain, the effectiveness of a functional restoration program (FRP), including intensive physical training and a multidisciplinary approach, with an outpatient active physiotherapy program at 1-year follow-up.
  
  
  BACKGROUND
  Controlled studies conducted in the United States and in Northern Europe showed a benefit of FRPs, especially on return to work. Randomized studies have compared these programs with standard care. A previously reported study presented the effectiveness at 6 months of both functional restoration and active physiotherapy, with a significantly greater reduction of sick-leave days for functional restoration.
  
  
  METHODS
  A total of 132 patients with low back pain were randomized to either FRP (68 patients) or active individual therapy (64 patients). One patient did not complete the FRP; 19 patients were lost to follow-up (4 in the FRP group and 15 in the active individual treatment group). The number of sick-leave days in 2 years before the program was similar in both groups (180 ± 135.1 days in active individual treatment vs. 185 ± 149.8 days in FRP, P = 0.847).
  
  
  RESULTS
  In both groups, at 1-year follow-up, intensity of pain, flexibility, trunk muscle endurance, Dallas daily activities and work and leisure scores, and number of sick-leave days were significantly improved compared with baseline. The number of sick-leave days was significantly lower in the FRP group.
  
  
  CONCLUSIONS
  Both programs are efficient in reducing disability and sick-leave days. The FRP is significantly more effective in reducing sick-leave days. Further analysis is required to determine if this overweighs the difference in costs of both programs.
authors.affiliation: Laboratoire d'épidémiologie, ergonomie, et santé au travail, University of Angers, Angers, France.
authors.forename: Ghislaine
authors.initials: G
authors.lastname: Roche-Leboucher
authors.forename: Audrey
authors.initials: A
authors.lastname: Petit-Lemanac'h
authors.forename: Luc
authors.initials: L
authors.lastname: Bontoux
authors.forename: Valérie
authors.initials: V
authors.lastname: Dubus-Bausière
authors.forename: Elsa
authors.initials: E
authors.lastname: Parot-Shinkel
authors.forename: Serge
authors.initials: S
authors.lastname: Fanello
authors.forename: Dominique
authors.initials: D
authors.lastname: Penneau-Fontbonne
authors.forename: Natacha
authors.initials: N
authors.lastname: Fouquet
authors.forename: Erick
authors.initials: E
authors.lastname: Legrand
authors.forename: Yves
authors.initials: Y
authors.lastname: Roquelaure
authors.forename: Isabelle
authors.initials: I
authors.lastname: Richard
mesh_terms: D000328:Adult; D059350:Chronic Pain / Q000503:physiopathology / Q000628:therapy*; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D058025:Interdisciplinary Studies; D059012:Lost to Follow-Up; D017116:Low Back Pain / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D026741:Physical Therapy Modalities; D011613:Psychotherapy / Q000379:methods*; D020127:Recovery of Function / Q000502:physiology; D018582:Sick Leave / Q000706:statistics & numerical data; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult