Journal of Occupational Rehabilitation

, Volume 15, Issue 4, pp 569–580 | Cite as

The Effects of a Graded Activity Intervention for Low Back Pain in Occupational Health on Sick Leave, Functional Status and Pain: 12-Month Results of a Randomized Controlled Trial

  • Hynek Hlobil
  • J. Bart Staal
  • Jos Twisk
  • Albere Köke
  • Geertje Ariëns
  • Tjabe Smid
  • Willem van MechelenEmail author


Introduction: Behaviorally oriented graded activity interventions have been suggested for sick-listed workers with low back pain on return to work, but have not been extensively evaluated. Methods: One hundred and thirty-four workers were randomly assigned to either a graded activity intervention (n = 67) or usual care (n = 67) and followed-up for 12 months. Results: The graded activity group returned back to work faster with a median of 54 days compared to 67 days in the usual care group. The graded activity intervention was more effective after approximately 50 days post-randomization (HRR = 1.9, CI = 1.2–3.1, p = 0.01). Differences between the groups in number of recurrent episodes, total number of days of sick leave due to low back pain, and total number of days of sick leave due to all diagnoses, were in favor of the graded activity group, although not statistically significant. No effects of the graded activity intervention were found for functional status or pain. Conclusion: Graded activity intervention is a valuable strategy to enhance short-term return to work outcomes.

Key Words

graded activity low back pain occupational health return to work sick leave 


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Copyright information

© Springer Science + Business Media, Inc. 2005

Authors and Affiliations

  • Hynek Hlobil
    • 1
    • 3
  • J. Bart Staal
    • 1
    • 5
  • Jos Twisk
    • 2
  • Albere Köke
    • 4
  • Geertje Ariëns
    • 1
  • Tjabe Smid
    • 1
    • 3
  • Willem van Mechelen
    • 1
    • 6
    Email author
  1. 1.Department of Public and Occupational HealthVU University Medical CentreAmsterdamThe Netherlands
  2. 2.Department of Clinical Epidemiology and Biostatistics, Institute for Research in Extramural MedicineVU University Medical CentreAmsterdamThe Netherlands
  3. 3.KLM Health ServicesSchipholThe Netherlands
  4. 4.Rehabilitation Center HoensbroeckHoensbroeckThe Netherlands
  5. 5.Department of EpidemiologyMaastricht UniversityMaastrichtThe Netherlands
  6. 6.Department of Public and Occupational Health, Institute for Research in Extramural MedicineVU University Medical CentreAmsterdamThe Netherlands

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