Low Back Pain Clinical Trial
Official title:
Return to Work Interventions for Patients With Low Back Pain During Inpatient Rehabilitation: a Quasi-Experimental Study
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.
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.
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Allocation: Non-Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label
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