Print Email Facebook Twitter Multidisciplinary rehabilitation for subacute low back pain : graded activity or workplace intervention or both? : a randomized controlled trial Title Multidisciplinary rehabilitation for subacute low back pain : graded activity or workplace intervention or both? : a randomized controlled trial Author Anema, J.R. Steenstra, I.A. Bongers, P.M. de Vet, H.C.W. Knol, D.L. Loisel, P. TNO Kwaliteit van Leven Publication year 2007 Abstract To assess the effectiveness of workplace intervention and graded activity, separately and combined, for multidisciplinary rehabilitation of low back pain (LBP). Summary of Background Data. Effective components for multidisciplinary rehabilitation of LBP are not yet established. Methods: Participants sick-listed 2 to 6 weeks due to nonspecific LBP were randomized to workplace intervention (n = 96) or usual care (n = 100). Workplace intervention consisted of workplace assessment, work modifications, and case management involving all stakeholders. Participants still sick-listed at 8 weeks were randomized for graded activity (n = 55) or usual care (n = 57). Graded activity comprised biweekly 1-hour exercise sessions based on operant-conditioning principles. Outcomes were lasting return to work, pain intensity and functional status, assessed at baseline, and at 12, 26, and 52 weeks after the start of sick leave. Results: Time until return to work for workers with workplace intervention was 77 versus 104 days (median) for workers without this intervention (P = 0.02). Workplace intervention was effective on return to work (hazard ratio = 1.7; 95% CI, 1.2-2.3; P = 0.002). Graded activity had a negative effect on return to work (hazard ratio = 0.4; 95% CI, 0.3-0.6; P < 0.001) and functional status. Combined intervention had no effect. Conclusion: Workplace intervention is advised for multidisciplinary rehabilitation of subacute LBP. Graded activity or combined intervention is not advised. Subject WorkplaceEffectivenessGraded activityLow back painReturn to workWorkplace interventionAdultCase managementClinical trialControlled clinical trialControlled studyExerciseFemaleFunctional statusHumanInstrumental conditioningMajor clinical studyMaleMedical leaveRandomizationRandomized controlled trialSingle blind procedureWorkplace To reference this document use: http://resolver.tudelft.nl/uuid:4b743901-c612-4bc1-8c67-e7e235440b3c TNO identifier 278193 Source Spine, 32 (3), 291-298 Document type article Files To receive the publication files, please send an e-mail request to TNO Library.