Return to Work Interventions for Patients With Low Back Pain
Condition: Low Back Pain
MeSH terms: Back Pain; Low Back Pain
Study type: Interventional

Summary: 
      Low back pain has become a major concern to employees and employers because of its negative
      impact on employee health and productivity.

      The objective of this study is to investigate whether a return-to-work intervention conducted
      during inpatient rehabilitation improves functional limitations that are related with low
      back pain and interfere with job performance.
    

Detailed description: 
      In recent years most industrialized nations have been confronted with a dramatic increase in
      cases dealing with back pain; in Germany, back pain belongs to the major individual and
      societal health problems with associated costs that have put a strain not only on health care
      systems. Besides frequent demand for medical services, loss of production (due to temporal
      sick leave) and disability allowances are important economic factors. In total, the estimated
      annual costs caused by back pain range between 16 and 22 billion Euros. Population based
      studies revealed high life-time prevalence with 80% report having ever experienced back pain.
      The point prevalence lies between 30 and 40%. Approximately one-fourth to one-third of those
      affected suffer from clinically significant back pain. Epidemiological evidence for the
      prevalence of back pain, its severity, course and associated risk factors is extensive;
      however, little systematic knowledge is available about treatment of back pain especially
      about return-to-work interventions.

      This study is designed as a quasi-experimental study to evaluate benefits of return-to-work
      interventions during medical rehabilitation. Positive effects are expected for low back pain
      related functional limitations and subsequently job performance. The intervention tested is
      based on the biomechanical model of chronic pain that assumes a relationship between external
      strain, body posture, muscle activity, and intravertebral pressure. According to this model,
      chronic low back pain is partially caused by overexertion and poor postural habits. The
      intervention aims at lowering the impact of biomechanical stress by training an adequate body
      posture while performing activities of daily living or job-related activities. Additionally,
      performing job-related activities target fear-avoidance beliefs especially assumptions about
      the connection between pain and work activities. The experimental group training good
      postural habits while performing activities of daily living or job-related activities
      (additionally to standard rehabilitation activities such as physiotherapy or education and
      counselling) will be compared with participants receiving a standard rehabilitation only.

      Outcome measures are assessed at baseline, post-intervention, and 6 month post-intervention.
    

Intervention name(s): Occupational ergonomic training
Intervention type(s): Behavioral
Intervention description(s): Adequate postural habits in activities of daily living
Allocation: Non-Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Keywords: Low back pain;; Return to work;; Posture