Evaluation of Return to Work One Year After a Rehabilitation Program for Chronic Back Pain
Condition: Non Specific Chronic Low Back Pain
MeSH terms: Back Pain; Low Back Pain
Study type: Observational

Summary: 
      Return to work is one of the essential objectives of functional spinal restoration programs.
      When the duration of the work stoppage increases, the chances of returning to work become
      worse. No studies have yet evaluated the value of a short 2-week restoration program.

      The purpose of this study is to determine whether a 2-week functional restoration program
      regains a return-to-work rate similar to longer-term restoration programs at one year
      post-program.

      This retrospective study with prospective referral included 200 patients with non specific
      chronic low-back pain who participated in a self-care rehabilitation program between May 2018
      and May 2019. The program included both physical and educational approaches to dealing with
      the condition. The duration was two weeks with follow-up at three months.

      The main evaluation criterion was to evaluate the return to work rate by telephone at one
      year post-program. Secondary objectives were to observe return-to-work conditions,
      absenteeism, recovery time, pain and physical activity at one year post-program and also to
      observe if there was a possible association between intrinsic/extrinsic factors and return to
      work
    

Detailed description: 
      Patients were included in the study from May 2019 to May 2020 if they had chronic nonspecific
      low back pain of more than 12 weeks according to the French health authority (High Authority
      of Health).

      The data for this study were collected after validation by the ethics committee
      (Institutional Review Board). Initial data were collected from generation of a list of
      computerized medical records of low back pain patients who participated in the program
      between May 2018 and May 2019 and were hospitalized in the day or week area of follow-up and
      rehabilitative care : age, sex, BMI, marital status, clinical elements related to the
      low-back pain (total duration of low back pain, history of spine surgery, last spinal
      imaging, pain measured on a visual analog scale, analgesic consumption, tobacco consumption,
      physical activity, self-exercise, physiotherapy, Schober index, finger-ground distance,
      poplitates angles, heel-buttock distance) and professional situation (professional status,
      carrying heavy loads, sick leave accumulated prior hospitalization for back pain,
      professional status, occupational disease, occupational accident, disability, half-time
      therapy).

      One-year post-program data were collected by telephone after consent was received. The
      investigators collected the date of return to work, elements concerning the conditions of
      return to work (modification of the previous position, working time, type of contract, work
      stoppages related to back pain, evolution of global job satisfaction before/after program )
      and clinical elements (change in pain after the program, physical activity, self-stretching
      exercises, spine operation after the program,satisfaction of the rehabilitation program,
      benefit provided by the program).

      Reference Methodology MR-004 was applied to the study after approval by the Data Protection
      Officer (CNIL). An information letter was sent to the selected patients to comply with the
      applicable regulations (RGPD). The patient was not included if he returned the non-consent
      form.

      Program : The duration of hospitalization was 2 weeks and the care program was delivered, for
      each patient, by the same medical and paramedical team including doctors, physiotherapists,
      occupational therapists, a nurse. There was no change in the program during the 2018-2019
      year, so the hospitalized patients received the same program. The functional restoration
      program included stretching and muscle strengthening of the spine and sub-pelvic planes,
      abdominal sheathing, gymnastics, exercise re-training sessions, self-exercise training,
      balneotherapy, relaxation sessions, sessions of body awareness and ergonomics.
    

Intervention name(s): 1 year phone call : data collection
Intervention type(s): Other
Intervention description(s): Included patients are contacted by telephone at 12 months after discharge. The investigators explain to the patient that this call is in the same context as a regular follow-up rehabilitation consultation and that the data collected will also be part of a study to evaluate and improve the program in which they participated. The interview will be transcribed in writing in their computerized and secure medical file. During this 20-minute telephone conversation, the patient answers a number of questions via a standardized questionnaire, in order to gather the various criteria for judgment.
If patients do not answer the first call, a phone message will be left and they will be contacted again up to 2 times. Patients who do not respond to 3 calls will be considered lost to follow-up.
Observational model: Other
Time perspective: Retrospective
Sampling method: Probability Sample
Study population: 
        Patients who participated in the functional spine rehabilitation program proposed by the
        department of Physical Medicine and Rehabilitation of the University Hospital of Lapeyronie
        in Montpellier
      
Keywords: Rehabilitation program; Non specific chronic low back pain; Return to work