Effect of Interventions in Return to Work for Patients With Neck and Low Back Pain

Summary

Low back pain is a usual condition in the western countries and several treatments available for patients with "non-specific low back pain". According to the European guidelines both Brief intervention and exercise/cognitive intervention are effective treatments with regard to pain and function (www.backpaineurope.org), but none have documented effect on return to work.

The challenges for health personnel is not cure of the patients back pain, but to build up rehabilitation programs which focus on disability and work incapacity, in patients which are at risk of loosing their work. Dr. P. Loisel, Montreal, Canada", has since 1995 treated patients with back pain according to the "The PREVICAP model - (PREVention of work handICAP)", where the main purpose with work-related program is to prevent prolonged disability and to help patients back to work. Loisel demonstrated that the PREVICAP models accelerated the "return to work" factor by a factor 2.4 (p=0.01). The PREVICAP model had also been evaluated in Amsterdam, by Dr. Anema with the same results.

At the Back Clinic, Ullevål University Hospital we are presently involved in a randomized controlled trial after the PREVICAP model, where patients are randomized to Brief intervention including a work-related intervention or usual care. All included patients in both groups, will have a clinical examination by specialist in Physical Medicine and Rehabilitation and advice from a physiotherapist. The current study replaces Brief intervention with an exercise - and a work-related program, so patients with non-specific LBP will be randomized to an exercise and work-related program or usual care.

The main purpose of this study

* to investigate if rehabilitation programs specifically focusing on the return to work process will reduce sickness absence and disability pension in patients with neck and low back pain.
* to assess the work-, individual- and health factors and their interrelationship predicting sickness absence and work disability.
* to compare results from the rehabilitation program with results from rehabilitation program in Toronto
* to which extent are the patients met by actions from employers and employment services, and does is influence sickness absence and disability.
* do these actions represent favourable cost benefit for the work places and the society

Conditions

• Low Back Pain
• Neck Pain

Interventions

BEHAVIORAL

Exercises and work related rehabilitation

Treatment in groups, twice a week for 3 weeks. The treatment includes exercises, cognitive intervention and work related rehabilitation. The exercises include fitness, strength and stretching

BEHAVIORAL

Brief intervention

1 consultation at the physiotherapist, which give advice Summary talk with the physician about activity and work when having neck- and low back pain

BEHAVIORAL

multidisciplinary exercise group

10 days during 3 weeks. Treatment in groups, exercise and cognitive treatment

Sponsors & Collaborators

• The Research Council of Norway

  collaborator OTHER

• Ullevaal University Hospital

  lead OTHER

Principal Investigators

• Erik Bautz-Holter, Professor · Ullevaal University Hospital

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Model

PARALLEL

Eligibility

Min Age

18 Years

Max Age

60 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2009-08-31

Primary Completion

2011-08-31

Completion

2013-08-31

Countries

• Norway

Study Locations