Multidisciplinary Intensive Functional Restoration Versus Outpatient Active Physiotherapy in Chronic Low Back Pain

Roche-Leboucher, Ghislaine; Petit-LeManac’h, A.; Bontoux, L.; Dubus-Bausière,; Parot-Shinkel, Elsa; Fanello, S.; Penneau-Fontbonne, D.; Fouquet, Natacha; Legrand, Érick; Roquelaure, Yves; Rodet-Belarbi, Isabelle

doi:10.1097/brs.0b013e3182191e13

Cited by 60 publications

(49 citation statements)

References 46 publications

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“…Despite minor improvements in case 1's Biering Sorensen results, Previous studies have demonstrated improvements in the Biering Sorensen of 56.9 secs at one year follow up with 'functional restoration' training incorporating aerobic and resistance exercise for 5 weeks in back pain patients [13]. Few studies have followed trunk muscle endurance over an entire year, however studies of shorter durations have found increases in the Biering Sorensen ranging from 30.34% to 46.95% [14,15].…”

Section: Casementioning

confidence: 97%

The Long-Term Effects of Stand-up Paddle Boarding: A Case Study

Schram

Hing

Climstein

2017

Int J Sports Exerc Med

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Introduction: The association between inactivity and poor quality of life has been well documented. A major barrier to exercise is a perceived lack of time and lack of enjoyment of exercise modalities. Stand up Paddle Boarding (SUP) is an aquatic physical activity deemed easy to learn, enjoyable with a reported multitude of both physiological and psychological benefits. The long-term effects of participation in SUP however are unclear.

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Section: Casementioning

confidence: 97%

The Long-Term Effects of Stand-up Paddle Boarding: A Case Study

Schram

Hing

Climstein

2017

Int J Sports Exerc Med

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“…Exercise-based interventions were used in all five studies, with one study47 also making ergonomic modifications, which comprised postural retraining. While two studies44 45 reported significant reductions in sick leave following functional rehabilitation interventions compared to other therapies, three studies43 46 47 reported no significant effect compared with individual physiotherapy, exercise therapy or ergonomic training. The quality of evidence for the outcome of sick leave was assessed as low.…”

Section: Resultsmentioning

confidence: 99%

Persistent musculoskeletal pain and productive employment; a systematic review of interventions

et al. 2016

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A systematic analysis of the literature was undertaken to determine which characteristics of workplace interventions are most effective in assisting people with persistent musculoskeletal pain (PMP) to remain productively employed. Databases of Medline, PsychINFO, CINAHL and Embase were searched using MeSH and other relevant terms. Studies that reported on interventions at, or involving, the workplace were included. Interventions were considered as either focused on the individual or multilevel. Outcome measures assessed included: job loss, productivity, sick leave, pain and cost benefit. A quality assessment was undertaken using GRADE criteria with development of impact statements to synthesise the results. Eighteen relevant articles (14 studies) were identified for inclusion in the review. No high-level evidence for workplace interventions to assist people with PMP were identified. Low numbers of participants and limited studies resulted in downgrading of evidence. However, individually focused interventions will probably reduce job loss and sick leave, but are unlikely to reduce pain. Multilevel focused interventions will probably result in decreased sick leave and provide some cost benefit. The evidence on productivity was limited and of poor quality. Further research is required because sustainable employment for individuals with PMP is important and understanding what works is necessary to ensure effective workplace interventions are developed.

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“…The specific program descriptions of its procedures has been published in multiple outcome studies documenting its effectiveness in providing functional improvement, often cited in national treatment guideline references. 8, 9, 25–32 The effectiveness of functional restoration methods have also been well documented in the literature. 33–41 …”

Section: Methodsmentioning

confidence: 99%

Lumbar surgery in work-related chronic low back pain: can a continuum of care enhance outcomes?

et al. 2014

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Background Context Systematic reviews of lumbar fusion outcomes in purely workers’ compensation (WC) patient populations have indicated mixed results for efficacy. Recent studies on lumbar fusions in the WC setting have reported return-to-work rates of 26–36%, re-operation rates of 22–27%, and high rates of persistent opioid use two years post-surgery. Other types of lumbar surgery in WC populations are also acknowledged to have poorer outcomes than in non-WC. The possibility of improving outcomes by employing a biopsychosocial model with a continuum of care, including post-operative functional restoration in this “at risk” population, has been suggested as a possible solution. Purpose To compare objective socioeconomic and patient-reported outcomes for WC patients with different lumbar surgeries followed by functional restoration, relative to matched comparison patients without surgery. Study Design/Setting A prospective cohort study of chronic disabling occupational lumbar spinal disorder (CDOLD) patients with WC claims treated in an interdisciplinary functional restoration program. Patient Sample A consecutive cohort of 564 patients with pre-rehab surgery completed an functional restoration and was divided into groups based on surgery type: lumbar fusion (F group, n = 331) and non-fusion lumbar spine surgery (NF group, n = 233). An unoperated comparison group was matched for length of disability (U group, n = 349). Outcome Measures Validated patient-reported measures of pain, disability and depression were administered PRE- and POST-rehab. Socioeconomic outcomes were collected via a structured one-year POST interview. Methods All patients completed an intensive, medically-supervised FRP, combining quantitatively-directed exercise progression with a multimodal disability management approach. The writing of this manuscript was supported in part by NIH Grant 1K05-MH-71892 and no conflicts of interest are noted among the authors. Results The F group had a longer length of disability compared to the NF and U groups (M = 31.6, 21.7, and 25.9 months, respectively, p < .001). There were relatively few statistically significant differences for any socioeconomically-relevant outcome among groups, with virtually identical POST-rehab return-to-work (F=81%, NF=84%, U=85%, p =.409). The groups differed significantly after surgery on diagnosis of major depressive disorder and opioid dependence disorder, as well as patient-reported depressive symptoms and pain intensity PRE-rehab. However, no significant differences in patient-reported outcomes were found POST-rehab. PRE-rehab opioid dependence disorder significantly predicted lower rates of work return and work retention, as well as higher rates of treatment-seeking behavior. Higher levels of PRE-rehab perceived disability and depressive symptoms were significant risk factors for poorer work return and retention outcomes. Conclusions Lumbar surgery in the WC system (particularly lumbar fusion) have the potential achieve positive outcomes that are comparable t...

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Multidisciplinary Intensive Functional Restoration Versus Outpatient Active Physiotherapy in Chronic Low Back Pain

Abstract: Both programs are efficient in reducing disability and sick-leave days. The FRP is significantly more effective in reducing sick-leave days. Further analysis is required to determine if this overweighs the difference in costs of both programs.

Cited by 60 publications

References 46 publications

The Long-Term Effects of Stand-up Paddle Boarding: A Case Study

The Long-Term Effects of Stand-up Paddle Boarding: A Case Study

Persistent musculoskeletal pain and productive employment; a systematic review of interventions

Lumbar surgery in work-related chronic low back pain: can a continuum of care enhance outcomes?

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