Effects of an early multidisciplinary intervention on sickness absence in patients with persistent low back pain-a randomized controlled trial

Annette Fisker; Henning Langberg; Tom Petersen; Ole Steen Mortensen

doi:10.1186/s12891-022-05807-7

Effects of an early multidisciplinary intervention on sickness absence in patients with persistent low back pain-a randomized controlled trial

BMC Musculoskelet Disord. 2022 Sep 10;23(1):854. doi: 10.1186/s12891-022-05807-7.

Authors

Annette Fisker^{1

2}, Henning Langberg³, Tom Petersen⁴, Ole Steen Mortensen^{5

3}

Affiliations

¹ Department of Occupational and Social Medicine, Holbæk Hospital, part of Copenhagen University Hospital, Smedelundsgade 60, 4300, Holbæk, Denmark. [email protected].
² Section of Social Medicine, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, Copenhagen K, Denmark. [email protected].
³ Section of Social Medicine, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, Copenhagen K, Denmark.
⁴ Back- and Rehabilitation Centre Copenhagen, Mimersgade 41, Copenhagen N, Denmark.
⁵ Department of Occupational and Social Medicine, Holbæk Hospital, part of Copenhagen University Hospital, Smedelundsgade 60, 4300, Holbæk, Denmark.

Abstract

Background: Multidisciplinary rehabilitation is recommended to reduce sickness absence and disability in patients with subacute or chronic low back pain (LBP). This study aimed to investigate whether a 12-week coordinated work oriented multidisciplinary rehabilitation intervention was effective on return to work and number of days off work during one-year follow-up when compared to usual care.

Methods: This study is a randomized controlled trial comparing the effectiveness of a 12-week multidisciplinary vocational rehabilitation program in addition to usual treatment. 770 patients with LBP, who were sick-listed, or at risk of being sick-listed were included in the study. The primary outcome was number of days off work due to LBP. The secondary outcomes were disability, health-related quality of life, pain, psychological distress and fear avoidance behavior. Data were collected at baseline, at the end of treatment, and at 6- and 12-months follow-up. Analyses were carried out according to the "intention-to-treat" principles.

Results: A significant decrease in the number of patients who were on sick-leave was found in both groups at the end of treatment and at 6- and 12-months follow-up. Additionally, disability, pain, health related quality of life, psychological distress, and fear avoidance beliefs improved in both groups. No statistically significant differences were found between the groups on any of the outcomes.

Conclusions: The coordinated multidisciplinary intervention had no additional effect on sickness absence, disability, pain, or health related quality of life as compared with that of usual care.

Trial registration: This study was retrospectively registered in ClinicalTrials.gov (registration ID: NCT01690234). The study was approved by The Danish Regional Ethics Committee (file no: H-C-2008-112) as well as registered at and approved by the Danish Data Protection Agency.

Keywords: Back pain; Low back pain; Multidisciplinary intervention; Occupational health; Randomized controlled trial; Rehabilitation; Return to work; Sick leave.

Publication types

Randomized Controlled Trial

MeSH terms

Humans
Low Back Pain* / diagnosis
Low Back Pain* / psychology
Low Back Pain* / therapy
Persons with Disabilities*
Quality of Life
Rehabilitation, Vocational
Sick Leave

Associated data

ClinicalTrials.gov/NCT01690234