Return to work of 87 severely impaired low back pain patients two years after a program of intensive functional restoration

Bontoux, L.; Dubus, V.; Colin, D.; Brami, Laurent; Roché, G; Fanello, S.; Penneau-Fontbonne, D.; Rodet-Belarbi, Isabelle

doi:10.1016/j.rehab.2008.12.005

Cited by 12 publications

(5 citation statements)

References 47 publications

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“…- The first [16,23] prospectively evaluated an intensive multidisciplinary Functional Restoration Program (FRP). A cohort of 87 patients had been treated and followed up two years after treatment and the results revealed a significant reduction (60%) in the number of days’ sick leave during the two years following inclusion.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of three treatment strategies on occupational limitations and quality of life for patients with non-specific chronic low back pain: Is a multidisciplinary approach the key feature to success: study protocol for a randomized controlled trial

Petit

Roche-Leboucher

Bontoux

et al. 2014

BMC Musculoskelet Disord

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BackgroundChronic low back pain (cLBP) is a significant public health problem, being the primary cause of work absenteeism, as well as affecting sufferers’ quality of life, in industrialized society. International guidelines recommend intensive multidisciplinary approaches for patients with cLBP. However, these costly and time-consuming programs can only be offered to a minority of the most heavily affected patients and therefore do not seem likely to respond to public health requirements. Lighter programs may be an alternative to full time hospital-based programs with valuable results in terms of disability and occupational activity for cLBP patients. It is therefore important to define both what the determining components of management to improve activity restriction are and how to treat a larger number of patients more effectively at a lower cost. The aim of this study is to compare three programs with various levels of intensity and multidisciplinary.Methods/DesignThis paper describes the protocol for a prospective, randomized, controlled, clinical trial in working aged patients with cLBP. Three treatment strategies are compared: (1) intensive and multidisciplinary program conducted in a rehabilitation center; (2) less intensive outpatient program conducted by a private physiotherapist; (3) mixed strategy combining the same out program with a multidisciplinary intervention. The primary outcome of the trial is the impact of the mixed strategy on being able to work compared to hospital centered-program and out program. The secondary outcome is the impact of the mixed strategy on quality of life and social ability compared to the two others programs. The intervention part of the trial programs will take 5 weeks and observational follow-up will take 12 months. The sample size will be 180 participants (60 for each arm). The project has been approved by the Ethical Committee of Angers Hospital, France.DiscussionOn the hypothesis that a multidisciplinary approach is the key feature to programs success in reducing social and occupational impairment in cLBP patients, we suggest that it is possible to achieve the same results with less intensive strategies if a multidisciplinary approach is maintained.Trial registrationCurrent Controlled Trials NCT02030171.

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Section: Introductionmentioning

confidence: 99%

Effectiveness of three treatment strategies on occupational limitations and quality of life for patients with non-specific chronic low back pain: Is a multidisciplinary approach the key feature to success: study protocol for a randomized controlled trial

Petit

Roche-Leboucher

Bontoux

et al. 2014

BMC Musculoskelet Disord

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“…La diminution du flux sanguin local ( 37 ), l’évacuation difficile des catabolites ( 38 ), l’augmentation de la fréquence cardiaque, de la pression artérielle ( 39 ) et de la pression intrathoracique pourraient accentuer les influx nociceptifs. Ces influx nociceptifs renvoient ensuite à des stratégies de coping différentes ( 40 ) s’exprimant par une relation négative entre les performances et la douleur anticipée puis ressentie ( 41 ).…”

Section: Discussionunclassified

“…Les résultats de notre étude affichent également un facteur anxiété significativement plus affecté lorsque la douleur est sévère, mais l’analyse des corrélations est négative. Pour certains auteurs, l’intensité douloureuse et la dépression sont considérées comme des facteurs indépendants ( 40 ), alors que, pour d’autres, ils seraient dépendants ( 3 ), laissant le débat ouvert. À l’issue du programme (T5sem), les résultats physiques, fonctionnels et psychologiques des sujets très douloureux sont identiques à ceux des sujets moins douloureux, et témoignent des effets positifs, bénéfiques et antalgiques du traitement dynamique sur la douleur.…”

Section: Discussionunclassified

Restauration Fonctionnelle du Rachis : Effet du Niveau Initial de Douleur sur Les Performances des Sujets Lombalgiques Chroniques

Caby

Olivier

Mendelek³

et al. 2014

Pain Research and Management

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Intensive care programs are very useful for the treatment of chronic low back pain; however, the initial pain intensity reported by patients may affect the degree of improvement following participation in such programs. The authors of this article aimed to determine whether an intensive spine functional restoration program would be as effective for individuals presenting with severe pain as those presenting with mild to moderate pain.

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“…Programmes incorporating the biopsychosocial approach into rehabilitation programmes for low back pain, thereby addressing physical deconditioning, pain coping mechanisms and workplace and health system barriers, revealed a positive effect on either RTW or reduction of the number of sick-leave days [ 15 , 16 ]. In general, strength and endurance training [ 12 , 17 ], behavioural interventions [ 18 , 19 ] and specific vocational training (which includes workplace interventions and participatory ergonomics, if necessary [ 20 ]) are key components of these programmes.…”

Section: Interventionsmentioning

confidence: 99%

Personalised rehabilitation to improve return to work in patients with persistent spinal pain syndrome type II after spinal cord stimulation implantation: a study protocol for a 12-month randomised controlled trial—the OPERA study

Moens

Goudman²,

Velde³

et al. 2022

Trials

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Background For patients with therapy-refractory persistent spinal pain syndrome type II (PSPS-T2), spinal cord stimulation (SCS) may serve as an effective minimally invasive treatment. Despite the evidence that SCS can improve return to work (RTW), only 9.5 to 14% of patients implanted with SCS are effectively capable of returning to work. Thus, it seems that current post-operative interventions are not effective for achieving RTW after SCS implantation in clinical practice. The current objective is to examine whether a personalised biopsychosocial rehabilitation programme specifically targeting RTW alters the work ability in PSPS-T2 patients after SCS implantation compared to usual care. Methods A two-arm, parallel-group multicentre randomised controlled trial will be conducted including 112 patients who will be randomised (1:1) to either (a) a personalised biopsychosocial RTW rehabilitation programme of 14 weeks or (b) a usual care arm, both with a follow-up period until 12 months after the intervention. The primary outcome is work ability. The secondary outcomes are work status and participation, pain intensity, health-related quality of life, physical activity and functional disability, functional capacities, sleep quality, kinesiophobia, self-management, anxiety, depression and healthcare expenditure. Discussion Within the OPERA project, we propose a multidisciplinary personalised biopsychosocial rehabilitation programme specifically targeting RTW for patients implanted with SCS, to tackle the high socio-economic burden of patients that are not re-entering the labour market. The awareness is growing that the burden of PSPS-T2 on our society is expected to increase over time due to the annual increase of spinal surgeries. However, innovative and methodologically rigorous trials exploring the potential to decrease the socio-economic burden when patients initiate a trajectory with SCS are essentially lacking. Trial registration ClinicalTrials.gov NCT05269212. Registered on 7 March 2022.

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Return to work of 87 severely impaired low back pain patients two years after a program of intensive functional restoration

Abstract: Sick leaves remained significantly reduced and the number of workers who were at work significantly increased at 2 years after an intensive program.

Cited by 12 publications

References 47 publications

Effectiveness of three treatment strategies on occupational limitations and quality of life for patients with non-specific chronic low back pain: Is a multidisciplinary approach the key feature to success: study protocol for a randomized controlled trial

Effectiveness of three treatment strategies on occupational limitations and quality of life for patients with non-specific chronic low back pain: Is a multidisciplinary approach the key feature to success: study protocol for a randomized controlled trial

Restauration Fonctionnelle du Rachis : Effet du Niveau Initial de Douleur sur Les Performances des Sujets Lombalgiques Chroniques

Personalised rehabilitation to improve return to work in patients with persistent spinal pain syndrome type II after spinal cord stimulation implantation: a study protocol for a 12-month randomised controlled trial—the OPERA study

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