Effects of Functional Restoration Versus 3 Hours per Week Physical Therapy: A Randomized Controlled Study

Abstract

This study demonstrates the effectiveness of a functional restoration program on important outcome measures, such as sick leave, in a country that has a social system that protects people facing difficulties at work.

Chapter 4 European guidelines for the management of chronic nonspecific low back pain

“…A more recent low quality RCT from the same research group (N=127), however, found that intensive multidisciplinary treatment and exercise therapy showed no significant differences in the resulting improvements in pain and function -only the global rating of "overall improvement" was better in the group of patients receiving the intensive treatment (Bendix et al 2000). An additional high quality trial (N=86) on patients with an average sick-leave of 6 months in the last 2 years found that the mean number of sick-leave days was significantly lower in the functional restoration group, but there was no significant difference in the intensity of pain, the quality of life, functional indexes, psychological characteristics, the number of contacts with the medical system, or the drug intake (Jousset et al 2004).…”

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).…”

“…Objective oneyear post-rehabilitation outcomes have been obtained from cohort studies, as well as RCTs, and include: increased resumption of active occupational status and activities of daily living; decreased health care utilization; reduced levels of pain intensity; improved readiness to change; improved psychological well being; and, resolution of outstanding medico-legal issues (Becker, Sjogren, Beck, Olsen, & Eriksen, 2000;Guzman et al, 2001;Hazard et al, 1989;Mayer et al, 1985;Patrick, Altmaier, & Found, 2004). The highly satisfactory results of functional restoration have been shown to be temporally stable (Mayer et al, 1987), and can be generalized across different socioeconomic and medico-legal systems (Bendix et al, 1996;Corey, Koepfler, Etlin, & Day, 1996;Hildebrandt, Pfingsten, Saur, & Jansen, 1997;Jousset et al, 2004). Finally, it has been demonstrated that functional restoration, along with other interdisciplinary approaches to pain management, are more cost-effective than standard conservative treatment (Gatchel & Okifuji, 2006;Skouen, Grasdal, Haldorsen, & Ursin, 2002;Turk, 2002;Turk & Okifuji, 1997).…”

“…Furthermore, even at the outset of injury, it will be impossible to a priori randomly assign patients into disability duration groups. Nevertheless, randomized trials have been utilized in evaluating functional restoration within nations adopting socialized medicine, and the results have documented the superiority of the functional restoration approach in rehabilitating CDOMD patients relative to less intensive singlediscipline treatment modalities (Bendix et al, 1996;Corey, Koepfler, Etlin, & Day, 1996;Hildebrandt, Pfingsten, Saur, & Jansen, 1997;Jousset et al, 2004). Given the logistical limitations, a prospective matched cohort design was best suited to explore the research question of interest in this study, i.e., the effect of disability duration on both the treatment-and cost-effectiveness of a functional restoration program.…”

Effectiveness of Integrated Soft Tissue Mobilization on the Functional Outcome in Chronic Low Back Pain Patients

“…Although many treatment modalities do promise relief of pain, not much evidence is present as to its true potential in relieving and curing the disability. With the question of immobilization during rehabilitation; many concluded the beneficial use of exercises (Hagen, 2000, Kuukkanen, 2000, Mannion, 2001, Moseley, 2002, Peterson, 2002, Aure, 2003, Liddle, 2004, Jousset, 2004, Niemisto, 2003. Interest then emerged in the role of manual therapy, mobilization and massage (Furlan, 2002, Hemmila, 2002, Aure, 2003, Cherkin, 2003, Chiradejnant, 2003, Harvey, 2003, Licciardone, 2003, Walach, 2003, Assendelft, 2004, Jette, 2006.…”