Abstract
BackgroundThere are no clear indicators for predicting return to work for patients with chronic low back pain (LBP). We aim to report the outcomes of a 14-week multidisciplinary programme targeting patients with chronic LBP who failed conventional physiotherapy to provide functional rehabilitation. Also, this study will identify factors predicting successful return to work (RTW).MethodsA collected cohort of patients with chronic LBP was consecutively enrolled into the programme from 1996 to 2014. All recruited patients failed to RTW despite at least 3 months of conservative treatment. Patient underwent weekly multidisciplinary sessions with physiotherapists, occupational therapists and clinical psychologists. Patient perceived function was considered the primary outcome of the programme. Patients were assessed for their sitting, standing and walking tolerance. Oswestry Disability Index (ODI) and Spinal Function Sort Score (SFSS) were used to assess patient perceived disability.ResultsOne hundred and fifty-eight patients were recruited. After the programme, statistically significant improvement was found in ODI (47.5 to 45.0, p = 0.01) and SFSS (98.0 to 109.5, p < 0.001). There was statistically significant improvement (p < 0.01) in sitting, standing, walking tolerance and straight leg raise tests. 47.4% of the patients were able to meet their work demand. Multivariate logistic regression model (R2 = 59.5%, χ2 (9) = 85.640, p < 0.001) demonstrated that lower initial job demand level and higher patient-perceived back function correlated with greater likelihood of returning to work.ConclusionThe results of this study may support the use of this multidisciplinary programme to improve patient function and return to work.
Highlights
Low back pain (LBP) is the leading cause of disability worldwide, accounting for 50 million years of disability with significant healthcare costs [1, 2]
The current study aims to report the southern Chinese experience with a 14-week intensive multidisciplinary programme aiming at functional recovery in patients with chronic low back pain (LBP), and to determine the predictive factors for successful return to work (RTW)
Current evidence suggests that a multidisciplinary model is helpful in achieving reduction in pain and symptoms, there is a lack of understanding of predictive factors of outcomes related to RTW [26]
Summary
Low back pain (LBP) is the leading cause of disability worldwide, accounting for 50 million years of disability with significant healthcare costs [1, 2]. Rehabilitation and reintegration of these patients into the working population, is paramount to alleviating the enormous medical and social costs of LBP. Amongst this population, up to onethird of patients with acute LBP progress into chronic LBP (pain for duration of at least 3 months), rendering them more prone to developing a persistent course of pain, typically resistant to conventional treatments such as physiotherapy and analgesics [5, 6]. This study will identify factors predicting successful return to work (RTW)
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