A Review of 1985 Volvo Award Winner in Clinical Science: Objective Assessment of Spine Function Following Industrial Injury

Abstract

It is now 2 decades since Mayer et al published their Volvo Award-winning paper entitled "Objective assessment of spine function following industrial injury: a prospective study with comparison group and one-year follow-up." Their landmark paper reported that return to work rates of patients that underwent a "functional restoration" treatment program were double that of a comparative group of patients that were denied treatment by their insurers. These results were considered extraordinary and inspired both debate and enthusiasm. Our goal is to review this landmark study, report on its strengths and weaknesses, and review the studies that have attempted to replicate this work in other settings. We also highlight its contribution to our current knowledge about the treatment of back pain and disability. The major weaknesses of the paper of Mayer et al are the possibility of selection bias in the development of their cohort of patients and the lack of a true randomized controlled study design. These factors may have inflated the rates of return to work. Regardless, their reported results were robust, and cannot be easily dismissed. During the last 20 years, this treatment model has received considerable study worldwide, and it is generally agreed that it is superior to standard care for reducing work absence in patients with chronic low back pain. Additionally, the concepts underlying functional restoration have been found to be highly relevant to patients with chronic low back pain, medical providers, and disability systems and continue to gain acceptance and integration into the care of patients throughout the industrialized world.

The importance of lumbar dynamometric examination in patients with low-back pain

“…Although there was a decrease in both flexor and extensor strength in the people with LBP, the main loss was suggested to be in the extensor strength. Although this rate varied across the studies, it was stated that 1.3 was the most commonly seen value and that this rate decreased to 0.8-1 in the patient population (19). Our study conflicted with literature findings.…”

Cost-Effectiveness of Early Versus Delayed Functional Restoration for Chronic Disabling Occupational Musculoskeletal Disorders

“…Developed in 1983, this rehabilitation program is a variant of chronic pain management based on the biopsychosocial model of pain and disability, and is specifically intended for rehabilitation of compensation injuries (Mayer et al, 1985). The efficacy of functional restoration for CDOMD, as well as the objective outcomes for treatment monitoring, have been extensively reviewed in the literature (Bendix et al, 1996;Hildebrandt, Pfingsten, Saur, & Jansen, 1997;Jousset et al, 2004;Mayer et al, 1998;Mayer et al, 1985;Mayer et al, 1987;Rainville, Kim, & Katz, 2007;Wright, Mayer, & Gatchel, 1999).…”

Topics and trends in research on non-clinical interventions aimed at preventing prolonged work disability in workers compensated for work-related musculoskeletal disorders (WRMSDs): a systematic, comprehensive literature review

“…Twenty-seven theoretical articles were retrieved from 17 different scientific journals and one handbook. The authors discussed results from broad-based national or international studies, scrutinizing them from a comparative or replication perspective [13,[68][69][70][71][72] and focussing on conceptual models [9,17,[73][74][75][76][77] or methodological topics [33,78,79] in terms of general approaches to RTW [80][81][82], particular areas of application [83][84][85][86][87][88] or intervention context [89,90].…”