Randomised controlled trial of integrated care to reduce disability from chronic low back pain in working and private life

The objectve of this study was to evaluate the effectiveness of an integrated care programme, combining a patient directed and a workplace directed intervention, for patients with chronic low back pain. 134 adults aged 18-65 sick listed for at least 12 weeks owing to low back pain underwent usual care (n=68) or integrated care (n=66). Integrated care consisted of a workplace intervention based on participatory ergonomics, involving a supervisor, and a graded activity programme based on cognitive behavioural principles. The primary outcome was the duration of time off work (work disability) due to low back pain until full sustainable return to work. Secondary outcome measures were intensity of pain and functional status. The median duration until sustainable return to work was 88 days in the integrated care group compared with 208 days in the usual care group (P=0.003). Integrated care was effective on return to work (hazard ratio 1.9, 95% confidence interval 1.2 to 2.8, P=0.004). After 12 months, patients in the integrated care group improved significantly more on functional status compared with patients in the usual care group (P=0.01). Improvement of pain between the groups did not differ significantly.

The integrated care programme substantially reduced disability due to chronic low back pain in private and working life.

Lambeek LC, van Mechelen W, Knol DL, Loisel P, Anema JR. Randomised controlled trial of integrated care to reduce disability from chronic low back pain in working and private life. BMJ. 2010;340:c1035

Neck Pain

Out of all 291 conditions studied in the Global Burden of Disease 2010 Study, neck pain ranked 4th highest in terms of disability and 21st in terms of overall burden.
Research article posted by: Rachael Lowe

Rachael Lowe is Co-Founder and Executive Director of Physiopedia. A physiotherapist and technology specialist Rachael has been working with Physiopedia since 2008 to create a resource that provides universal access to physiotherapy knowledge as well as a platform for connecting and educating the global physiotherapy profession.

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