Skip to main content

Advertisement

SpringerLink
Log in

Long-term return to work after a functional restoration program for chronic low-back pain patients: a prospective study

  • Original Article
  • Published:
European Spine Journal Aims and scope Submit manuscript

Abstract

Low-back pain is a major health and socio economic problem. Functional restoration programs (FRP) have been developed to promote the socio-professional reintegration of patients with important work absenteeism. The aim of this study was to determine the long-term effectiveness of FRP in a group of 105 chronic low-back pain patients and to determine the predictive factors of return to work. One hundred-and-five chronic LBP patients with over 1 month of work absenteeism were included in a FRP. Pain, professional status, quality of life, functional disability, psychological impact, and fear and avoidance beliefs were evaluated at baseline, after 1 year and at the end of follow-up. Main effectiveness criterion was return to work. Fifty-five percent of the patients returned to work after mean follow-up time of 3.5 years, compared with 9% of the patients at work at baseline. Quality of life, functional disability, psychological factors, and fear and avoidance beliefs were all significantly improved. Three predictive factors were found: younger age at the onset of low-back pain, practice of sports, and shorter duration of sick leave at baseline. FRP show positive results in terms of return to work for chronic LBP patients with prolonged work absenteeism. Efforts should be made to propose such programs at an earlier stage of the disease.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Andersson GB (1999) Epidemiological features of chronic low-back pain. Lancet 354(9178):581–585

    Article  CAS  PubMed  Google Scholar 

  2. Waddell G (1993) Simple low back pain: rest or active exercise? Ann Rheum Dis 52(5):317–319

    Article  CAS  PubMed  Google Scholar 

  3. Frymoyer JW (1988) Back pain and sciatica. N Engl J Med 318(5):291–300

    Article  CAS  PubMed  Google Scholar 

  4. Spitzer (1987) Scientific approach to the assessment and management of activity-related spinal disorders: a monograph for clinicians. Report of the Quebec task force on spinal disorders. Spine 12:S1–S59

  5. Bigos SJ et al (2009) High-quality controlled trials on preventing episodes of back problems: systematic literature review in working-age adults. Spine J 9(2):147–168

    Article  PubMed  Google Scholar 

  6. Henchoz Y, Kai-Lik So A (2008) Exercise and nonspecific low back pain: a literature review. Joint Bone Spine 75(5):533–539

    Article  PubMed  Google Scholar 

  7. Poiraudeau S, Rannou F, Revel M (2007) Functional restoration programs for low back pain: a systematic review. Ann Readapt Med Phys 50(6):419–424, 425–429

    Google Scholar 

  8. Burke SA, Harms-Constas CK, Aden PS (1994) Return to work/work retention outcomes of a functional restoration program. A multi-center, prospective study with a comparison group. Spine 19(17):1880–1885 (discussion 1886)

    Article  CAS  PubMed  Google Scholar 

  9. Chou R, Huffman LH (2007) Nonpharmacologic therapies for acute and chronic low back pain: a review of the evidence for an American Pain Society/American College of Physicians clinical practice guideline. Ann Intern Med 147(7):492–504

    PubMed  Google Scholar 

  10. Genet F, Poiraudeau S, Revel M (2002) Effectiveness and compliance to a center-based short rehabilitation program with a home-based program for chronic low back pain. Ann Readapt Med Phys 45(6):265–272

    CAS  PubMed  Google Scholar 

  11. Bontoux L et al (2004) Prospective study of the outcome at one year of patients with chronic low back pain in a program of intensive functional restoration and ergonomic intervention factors predicting their return to work. Ann Readapt Med Phys 47(8):563–572

    CAS  PubMed  Google Scholar 

  12. Jousset N et al (2004) Effects of functional restoration versus 3 hours per week physical therapy: a randomized controlled study. Spine 29(5):487–493 (discussion 494)

    Article  PubMed  Google Scholar 

  13. Wands K et al (1990) A questionnaire investigation of anxiety and depression in early dementia. J Am Geriatr Soc 38(5):535–538

    CAS  PubMed  Google Scholar 

  14. Bjelland I et al (2002) The validity of the Hospital Anxiety and Depression Scale. An updated literature review. J Psychosom Res 52(2):69–77

    Article  PubMed  Google Scholar 

  15. Chaory K et al (2004) Validation of the French version of the fear avoidance belief questionnaire. Spine 29(8):908–913

    Article  PubMed  Google Scholar 

  16. Marty M et al (1998) Validation of the French version of the Dallas Pain Questionnaire in chronic low back pain patients. Rev Rhum Engl Ed 65(2):126–134

    CAS  PubMed  Google Scholar 

  17. Yvanes-Thomas M et al (2002) Validity of the French-language version of the Quebec back pain disability scale in low back pain patients in France. Joint Bone Spine 69(4):397–405

    Article  PubMed  Google Scholar 

  18. Merritt JL et al (1986) Measurement of trunk flexibility in normal subjects: reproducibility of three clinical methods. Mayo Clin Proc 61(3):192–197

    CAS  PubMed  Google Scholar 

  19. Biering-Sorensen F (1984) Physical measurements as risk indicators for low-back trouble over a one-year period. Spine (Phila Pa 1976) 9(2):106–119

    CAS  Google Scholar 

  20. Shirado O et al (1995) Concentric and eccentric strength of trunk muscles: influence of test postures on strength and characteristics of patients with chronic low-back pain. Arch Phys Med Rehabil 76(7):604–611

    Article  CAS  PubMed  Google Scholar 

  21. Elfering A (2006) Work-related outcome assessment instruments. Eur Spine J 15(Suppl 1):S32–S43

    Article  PubMed  Google Scholar 

  22. Verfaille S et al (2005) Evaluation after four years of exercise therapy for chronic low back pain. Ann Readapt Med Phys 48(2):53–60

    CAS  PubMed  Google Scholar 

  23. Bendix AE et al (1998) A prospective, randomized 5-year follow-up study of functional restoration in chronic low back pain patients. Eur Spine J 7(2):111–119

    Article  CAS  PubMed  Google Scholar 

  24. Hazard RG et al (1989) Functional restoration with behavioral support. A one-year prospective study of patients with chronic low-back pain. Spine 14(2):157–161

    Article  CAS  PubMed  Google Scholar 

  25. Alaranta H et al (1994) Intensive physical and psychosocial training program for patients with chronic low back pain. A controlled clinical trial. Spine 19(12):1339–1349

    Article  CAS  PubMed  Google Scholar 

  26. Hlobil H et al (2005) 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. J Occup Rehabil 15(4):569–580

    Article  PubMed  Google Scholar 

  27. Indahl A, Velund L, Reikeraas O (1995) Good prognosis for low back pain when left untampered. A randomized clinical trial. Spine (Phila Pa 1976) 20(4):473–477

    CAS  Google Scholar 

  28. Indahl A et al (1998) Five-year follow-up study of a controlled clinical trial using light mobilization and an informative approach to low back pain. Spine (Phila Pa 1976) 23(23):2625–2630

    CAS  Google Scholar 

  29. Lindstrom I et al (1992) The effect of graded activity on patients with subacute low back pain: a randomized prospective clinical study with an operant-conditioning behavioral approach. Phys Ther 72(4):279–290 (discussion 291–293)

    CAS  PubMed  Google Scholar 

  30. Loisel P (1997) A population-based, randomized clinical trial on back pain management. Spine (Phila Pa 1976) 22(24):2911–2918

    CAS  Google Scholar 

  31. Andersson GB, Svensson HO, Oden A (1983) The intensity of work recovery in low back pain. Spine 8(8):880–884

    Article  CAS  PubMed  Google Scholar 

  32. Taimela S et al (2000) The role of physical exercise and inactivity in pain recurrence and absenteeism from work after active outpatient rehabilitation for recurrent or chronic low back pain: a follow-up study. Spine 25(14):1809–1816

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Rheumatology, University Pierre et Marie Curie-Paris VI, Groupe Hospitalier Pitié Salpêtrière, 83 Boulevard de l’Hôpital, 75651, Paris Cedex 13, France

    Cécile Poulain, Sylvie Rozenberg, Bruno Fautrel, Pierre Bourgeois & Violaine Foltz

  2. Pôle de médecine, AP-HP, Groupe Hospitalier Cochin Saint Vincent de Paul, CIC de vaccinologie Cochin Pasteur, Paris, France

    Solen Kernéis

  3. INSERM, CIC de Vaccinologie Cochin-Pasteur (CIC BT505), Paris, France

    Solen Kernéis

Authors
  1. Cécile Poulain
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Solen Kernéis
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Sylvie Rozenberg
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Bruno Fautrel
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Pierre Bourgeois
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Violaine Foltz
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Cécile Poulain.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Poulain, C., Kernéis, S., Rozenberg, S. et al. Long-term return to work after a functional restoration program for chronic low-back pain patients: a prospective study. Eur Spine J 19, 1153–1161 (2010). https://doi.org/10.1007/s00586-010-1361-6

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00586-010-1361-6

Keywords

Search

Navigation