The effectiveness of two active interventions compared to self-care advice in employees with non-acute low back symptoms: a randomised, controlled trial with a 4-year follow-up in the occupational health setting

Rantonen, J.; Luoto, S.; Vehtari, A.; Hupli, M.; Karppinen, J.; Malmivaara, A.; Taimela, S.
January 2012
Occupational & Environmental Medicine;Jan2012, Vol. 69 Issue 1, p12
Academic Journal
Objective Evaluate the effectiveness of two active interventions, aimed at secondary prevention of low back pain (LBP), in occupational health. Methods We performed a survey of LBP (n=2480; response rate 71%) and randomized 143 employees (66% males, 45 years) with LBP over 34 mm on VAS into Rehabilitation (n=3), Exercise (n=43) or self-care (n=40) groups. Primary outcomes were LBP, physical impairment (PI) and health-related quality of life (HRQoL) for two years and sickness absence (SA) days during four years (LBP specific, total). Results Compared to self-care, exercise reduced LBP at 12 months (mean difference (MD) -12 mm; 95% CI -21 to -2) and improved HRQoL at 12 and 24 months (0.03; 0.00 to 0.05), but did not reduce PI. The MDs of SA days in four years were -17 (-70 to 35, total) and -15 (-47 to 13, LBP specific). Exercise reduced the probability of LBP specific SA during the third and fourth year. Compared to self-care, Rehabilitation reduced LBP at 3 months (-10 mm; -19 to -1) and 6 months (-10 mm; -20 to - 1), but was not effective in HRQoL or PI. The MDs of SA days in four years were -41 (-93 to 8; total) and 5 (-30 to 47; LBP specific). Rehabilitation reduced the probability of total SA during first and second year and amount of total SA days in the fourth year. Conclusions Among employees with relatively mild LBP, both interventions reduced pain, but the effects on SA and PI were minor. Exercise improved HRQoL. The effect sizes were rather small.


Related Articles

  • Diagnosis and Management of Acute Low Back Pain. Patel, Atul T.; Ogle, Abna A. // American Family Physician;3/15/2000, Vol. 61 Issue 6, p1779 

    Discusses information on acute low back pain. Evaluation of low back pain; Physical examination of a patient with an acute low back pain; Treatment plan for the patient.

  • Developing common metrics of mechanical exposures across aetiological studies of low back pain in working populations for use in meta-analysis. Griffith, L. E.; Wells, R. P.; Shannon, H. S.; Walter, S. D.; Cole, D. C.; Hogg-Johnson, S. // Occupational & Environmental Medicine;Jul2008, Vol. 65 Issue 7, p467 

    Objectives: One of the challenges of conducting meta- analyses on the relationship between workplace mechanical exposures and low back pain is that mechanical exposures are reported in a wide variety of ways. We aimed to develop common metrics to apply in the translation of literature-based...

  • RESEARCH BRIEFS: Firm mattress may not be best for low-back pain.  // GP: General Practitioner;11/17/2003, p13 

    People using medium-firm mattresses were twice as likely as those with firm mattresses to report improvements in back pain while lying in or getting out of bed. According to the Spanish study involving 313 people with non-specific low-back pain, the medium-firm mattress group also suffered less...

  • The effectiveness of graded activity for low back pain in occupational healthcare. Steenstra, I. A.; Anema, J. R.; Bongers, P. M.; De Vet, H. C. W.; Knol, D. L.; van Mechelen, W. // Occupational & Environmental Medicine;Nov2006, Vol. 63 Issue 11, p718 

    Background: Low back pain is a common medical and social problem associated with disability and absence from work. Knowledge on effective return to work (RTW) interventions is scarce. Objective: To determine the effectiveness of graded activity as part of a multistage RTW programme. Design:...

  • The International Universities Walking Project: Development of a Framework for Workplace Intervention Using the Delphi Technique. Gilson, Nicholas; Brown, Wendy J.; Faulkner, Guy; McKenna, Jim; Murphy, Marie; Pringle, Andy; Proper, Karin; Puig-Ribera, Anna; Stathi, Aphroditi // Journal of Physical Activity & Health;Jul2009, Vol. 6 Issue 4, p520 

    Background: This paper aimed to use the Delphi technique to develop a consensus framework for a multinational, workplace walking intervention. Methods: Ideas were gathered and ranked from eight recognized and emerging experts in the fields of physical activity and health, from universities in...

  • Relation between indicators for quality of occupational rehabilitation of employees with low back pain. Van der Weide, W.E.; Verbeek, J.H.A.M.; van Dijk, F.J.H. // Occupational & Environmental Medicine;Jul1999, Vol. 56 Issue 7, p488 

    Focuses on studies regarding relation between indicators for quality of occupational rehabilitation of employees with low back pain. Sample size of the study; Application of various analysis methods for assessment of relation between quality of care and outcome.

  • Magnetic resonance imaging for low back pain: indications and limitations.  // Postgraduate Medical Journal;Jun2010, Vol. 86 Issue 1016, p374 

    Magnetic resonance imaging (MRI) is the preferred investigation for most spinal diseases and is increasingly requested for people with low back pain (LBP). However, determining the cause of back pain is complicated as it is often multifactorial and anatomical abnormalities are common in the...

  • SELF ASSESSMENT ANSWERS: Low back pain in a child -- a diagnostic dilemma.  // Postgraduate Medical Journal;May2001, Vol. 77 Issue 907, p349 

    This article presents results of a diagnostic study conducted on a child with low back pain. Differential diagnosis showed acute lymphoblastic leukaemia, tuberculosis of the spine, metastasis from neuroblastoma, Hodgkin's lymphoma and langerhan's cell histiocytosis. In this patient a skeletal...

  • Health Care Self-Care. Johnson, Tom // Risk Management (00355593);Dec87, Vol. 34 Issue 12, p14 

    This article reports on the launch of a benefit program called Informed Care by the Center for Corporate Health Promotion that reduces medical costs by teaching employees self-care techniques. The program also addresses the need to educate employees on health care decisions to ensure...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics