Efficacy of a functional restoration program for chronic low back pain: Prospective 1-year study |
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| Authors: | Johann Beaudreuil Hinna Kone Sandra Lasbleiz Éric Vicaut Pascal Richette Martine Cohen-Solal Frédéric Lioté Marie-Christine de Vernejoul Rémy Nizard Alain Yelnik Thomas Bardin Philippe Orcel |
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| Institution: | 1. Service de rhumatologie, groupe hospitalier Lariboisière–Fernand-Widal, université Paris 7, 2, rue Ambroise-Paré, 75475 Paris cedex 10, France;2. Unité de recherche clinique, groupe hospitalier Lariboisière–Fernand-Widal, université Paris 7, 75475 Paris cedex 10, France;3. Service de chirurgie orthopédique, groupe hospitalier Lariboisière–Fernand-Widal, université Paris 7, 75475 Paris cedex 10, France;4. Service de médecine physique et de réadaptation, groupe hospitalier Lariboisière–Fernand-Widal, université Paris 7, 75475 Paris cedex 10, France;1. Service de médecine physique et réadaptation fonctionnelle, hôpital militaire principal d’instruction de Tunis, Mont Fleury, CP 1008 Tunis, Tunisie;2. Service de médecine physique et réadaptation fonctionnelle, hôpital de Mahdia, Mahdia, Tunisie;1. Janssen-Cilag GmbH, Abteilung Health Economics, Neuss, Deutschland;2. Institut für Volkswirtschaftslehre, Universität Wien, Österreich;3. Klinik für Immunologie und Rheumatologie, Zentrum Innere Medizin, Medizinische Hochschule Hannover, Hannover, Deutschland;1. Center for Child Health, Behavior, and Development, Seattle Children''s Research Institute, Seattle, Washington;2. Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, Washington;3. Department of Psychology, Faculty of Health, York University, Toronto, Ontario, Canada;2. Institute for Vascular Signalling, Centre for Molecular Medicine, Goethe University, 60590 Frankfurt, Germany;4. Institute of Food Research, Norwich NR4 7UA, United Kingdom;1. Department of Physical Therapy, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel;4. Department of Psychiatry, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel;2. Sagol School of Neuroscience, Tel-Aviv University, Tel-Aviv, Israel;3. Department of Psychiatry, Sourasky Medical Center, Tel-Aviv University, Tel-Aviv, Israel;5. Bob Shapell School of Social Work, Tel-Aviv University, Tel-Aviv, Israel;1. Sorbonne Université, Inserm, Institut Pierre Louis d’Épidémiologie et de santé Publique, (IPLESP), (équipe PEPITES), 7-83, boulevard de l’Hôpital, 75013 Paris, France;2. Pitié Salpêtrière hospital, AP–HP, Rheumatology department, Paris, France |
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| Abstract: | ObjectiveTo 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.Patients and methodsWe 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.ResultsWe 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.ConclusionsOur 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. |
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