Multidisciplinary programme for rehabilitation of chronic low back pain – factors predicting successful return to work

Abstract

Background There are no clear indicators for predicting return to work for patients with chronic low back pain (LBP). We aim to report the outcomes of a 14-week multidisciplinary programme targeting patients with chronic LBP who failed conventional physiotherapy to provide functional rehabilitation. Also, this study will identify factors predicting successful return to work (RTW). Methods A collected cohort of patients with chronic LBP was consecutively enrolled into the programme from 1996 to 2014. All recruited patients failed to RTW despite at least 3 months of conservative treatment. Patient underwent weekly multidisciplinary sessions with physiotherapists, occupational therapists and clinical psychologists. Patient perceived function was considered the primary outcome of the programme. Patients were assessed for their sitting, standing and walking tolerance. Oswestry Disability Index (ODI) and Spinal Function Sort Score (SFSS) were used to assess patient perceived disability. Results One hundred and fifty-eight patients were recruited. After the programme, statistically significant improvement was found in ODI (47.5 to 45.0, p = 0.01) and SFSS (98.0 to 109.5, p < 0.001). There was statistically significant improvement (p < 0.01) in sitting, standing, walking tolerance and straight leg raise tests. 47.4% of the patients were able to meet their work demand. Multivariate logistic regression model (R2 = 59.5%, χ2 (9) = 85.640, p < 0.001) demonstrated that lower initial job demand level and higher patient-perceived back function correlated with greater likelihood of returning to work. Conclusion The results of this study may support the use of this multidisciplinary programme to improve patient function and return to work.

Propensity-matched Comparison Between Chronic Nonspecific Low Back Pain and Axial Spondyloarthritis: Impact on patient-perceived Quality of Life

“…Patients’ mental health and burden has potential implications on the results of treatment. Persistent pervasive negative cognitions and ideas have been shown despite rehabilitation 49. As the natural history of acute LBP dictates up to one third of patients debilitating into chronic LBP with persistent pain and resistant to physiotherapy and analgesics,50,51 our results reiterates the dire need of substantial resource allocation focusing on early treatment and functional rehabilitation to prevent progression into chronic LBP.…”

Impact of Active Physiotherapy Rehabilitation on Pain and Global and Functional Improvement 1–2 Months after Lumbar Disk Surgery: A Systematic Review and Meta-Analysis

“…The “active” component of physiotherapeutic rehabilitation is less understood by patients owing to a paucity of concrete societal guidelines on this intervention. In simple terms, active rehabilitation focuses on playing a non-static role in resuming function and strength; this tends to improve stability, strength, endurance, and exercise progression [ 41 ]. Our meta-analysis summarizes quantitative evidence available for physiotherapists, surgeons, researchers, and patients.…”

Integrative medicine for musculoskeletal pains - A proposed model based on clinical experience

“…Since pain is multifactorial, multidisciplinary treatment is the ultimate key to treating the pain [ [4] , [5] , [6] ]. And since many of these causative factors are not even in the epistemology of modern medicine, the role of traditional medicine becomes crucial.…”