Non Specific Chronic Low Back Pain Clinical Trial
Official title:
Evaluation of Return to Work One Year After a Short Rehabilitation Program for Chronic Non Specific Low Back Pain Patients
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
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.
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