Return to work of 87 severely impaired low back pain patients two years after a program of intensive functional rehabilitation.

UNLABELLED: Return to work is the main long-term objective of rehabilitation programs for patients with chronic low back pain (LBP). OBJECTIVES: Evaluation of work status and number of sick leaves in 87 severely impaired LBP patients 2 years after a functional restoration program. PATIENTS AND METHODS: Open prospective study. POPULATION: 87 chronic LBP patients. INTERVENTION: multidisciplinary functional restoration program. Ergonomic advice on the workplace was performed for 53 patients. OUTCOME: work status and number of sick leaves due to LBP. RESULTS: The characteristics of the 26 patients lost to follow-up did not differ significantly from the rest of the population before the program. In the 61 remaining patients, 48 (78%) were at work at 2 years, 43 full-time and 22 at the same job. Nineteen worked in a different environment. Sick leaves were reduced by 60% compared to the 2 years prior to the program: 128 days (+/-200 days) versus 329 days (+/-179 days); p<0.005. CONCLUSION: Sick leaves remained significantly reduced and the number of workers who were at work significantly increased at 2 years after an intensive program.

[Prospective study of the outcome at one year of patients with chronic low back pain in a program of intensive functional restoration and ergonomic intervention. Factors predicting their return to work]. / Etude du devenir à un an de lombalgiques chroniques inclus dans un programme associant reconditionnement à l'effort et action ergonomique. Recherche de facteurs prédictifs de retour et de maintien au travail.

OBJECTIVES: Evaluation of 1-year outcome after patients with chronic low back pain participated in an intensive functional restoration program associated with an ergonomic intervention on the workplace. Study of the factors predicts a return to work. METHODS: Prospective study of a cohort of 87 patients face major difficulties due to low back pain at work. Patients who visited a multidisciplinary clinic were included. Parameters, evaluating physical and psychological status, quality of life, presence at work, length of sick leaves, were determined before and after the program and at 6 and 12 months' followup. The correlation between these parameters and presence at work at 1 year was studied. RESULTS: A total of 86 patients completed the program; three were lost to followup at 1 year. Ergonomic interventions were tried in 53 patients. All parameters were improved at the end of the program and remained significantly improved at 12 months. A total of 90% of the patients returned to work at the end of the program, whereas only 17% were at work before; 72% were at work in 1 year. The number of sick leave days decreased by 60%. The Dallas index at the beginning and the end of the program, the number of sick leave days before the program and score on the item "feels able to work" correlated with the presence at work in 1 year. There was no correlation between presence at work and physical parameters. CONCLUSION: This study shows the effect of the program and determines factors predictive of successful return to work for patients with chronic low back pain. Further data are necessary to discuss the specific effect of ergonomic interventions.