The Effect of a Work-hardening Program for Return-to-work for Workers With Low Back Pain
Condition: Low Back Pain
MeSH terms: Back Pain; Low Back Pain
Study type: Interventional

Summary: 
      Occupational injury results in family economic crisis and national productivity loss; it is
      really becoming an important issue in Taiwanese society. Low back pain is the most frequent
      injury affecting workers. In addition to the prevention of injury, having a work-hardening
      program and getting the injured workers returned to work are also challenges for medical
      personnel. The purposes of this study are:

        1. to develop a guideline to assess the low back pain workers' impairment and working
           capacity;

        2. to formulate a feasible work-hardening program for the low back pain workers; and

        3. to execute the program, evaluate the training effect and then follow up the rate of
           return to work of the low back pain workers.

      In the first year, a guideline for assessment of low back impairment and working capacity
      will be developed. It may consist of the demographic data, the working status, the physical
      need in work, trunk muscle isokinetic strength, Oswestry low back disability questionnaire,
      functional capacity evaluation and quality of life questionnaire. The whole assessment
      package will be empirically applied in low back pain workers and the validity and reliability
      will be tested. A work-hardening program for low back pain workers will be established in the
      first year through meetings with experts and literature review. The work-hardening program
      will consist of training of trunk muscle strength, flexibility, and general fitness. A
      sling-exercise training model will be applied in the program. In the second year, low back
      pain workers in outpatient departments will be recruited with their own agreement and grouped
      randomly into either the work-hardening group or the control group. The expected number of
      subjects is 30 in each group. According to the result of impairment assessment and work
      capacity, the workers in the work-hardening group will start the individualized
      work-hardening program for 3 months. After the program, the workers will be assessed again to
      evaluate the training's effect, and the investigators will follow the rate of return to work
      among them 3 and 6 months after the program. The workers in the control group will be
      followed for 6 and 9 months after enrollment to collect the rate of return to work in this
      group.
    

Detailed description: 
      Occupational injury results in family economic crisis and national productivity loss; it is
      really becoming an important issue in our society. Low back pain is the most frequent injury
      affecting workers. In addition to the prevention of injury, having a work-hardening program
      and getting the injured workers returned to work are also challenges for medical personnel.
      The purposes of this study are:

        1. to develop a guideline to assess the low back pain workers' impairment and working
           capacity;

        2. to formulate a feasible work-hardening program for the low back pain workers; and

        3. to execute the program, evaluate the training effect and then follow up the rate of
           return to work of the low back pain workers.

      In the first year, a guideline for assessment of low back impairment and working capacity
      will be developed. It may consist of the demographic data, the working status, the physical
      need in work, trunk muscle isokinetic strength, Oswestry low back disability questionnaire,
      functional capacity evaluation and quality of life questionnaire. The whole assessment
      package will be empirically applied in low back pain workers and the validity and reliability
      will be tested. A work-hardening program for low back pain workers will be established in the
      first year through meetings and literature review. The work-hardening program will consist of
      training of trunk muscle strength, flexibility, and general fitness. A
      sling-exercise-training model will be applied in the program. In the second year, low back
      pain workers in outpatient departments will be recruited with their own agreement and grouped
      randomly into either the work-hardening group or the control group. The expected number of
      subjects is 30 in each group. According to the result of impairment assessment and work
      capacity, the workers in the work-hardening group will start the individualized
      work-hardening program for 3 months. After the program, the workers will be assessed again to
      evaluate the training's effect, and the investigators will follow the rate of return to work
      among them 3 and 6 months after the program. The workers in the control group will be
      followed for 6 and 9 months after enrollment to collect the rate of return to work in this
      group.
    

Intervention name(s): work-hardening program
Intervention type(s): Behavioral
Allocation: Non-Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Keywords: work hardening; chronic low back pain over 3 months