The effectiveness of high-intensity versus low-intensity back schools in an occupational setting: a pragmatic randomized controlled trial

Spine
Martijn W HeymansWillem van Mechelen

Abstract

Randomized controlled trial. To compare high- and low-intensity back schools with usual care in occupational health care. The content and intensity of back schools vary widely and the methodologic quality of randomized controlled trials is generally weak. Until now, no back school has proven to be superior for workers sick-listed because of subacute nonspecific low back pain. Workers (n = 299) sick-listed for a period of 3 to 6 weeks because of nonspecific low back pain were recruited by the occupational physician and randomly assigned to a high-intensity back school, a low-intensity back school, or care as usual. Outcome measures were days until return to work, total days of sick-leave, pain, functional status, kinesiophobia, and perceived recovery and were assessed at baseline and at 3 and 6 months of follow-up. Principal analyses were performed according to the intention-to-treat principle. We randomly allocated 299 workers. Workers in the low-intensity back school returned to work faster compared with usual care and the high-intensity back school, with hazard ratios of 1.4 (P = 0.06) and 1.3 (P = 0.09), respectively. The comparison between high-intensity back school and usual care resulted in a hazard ratio of 1.0 (P = 0.83...Continue Reading

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Citations

Mar 17, 2010·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Steven J KamperRobert J Smeets
Jun 17, 2010·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Steven J KamperJulia M Hush
Oct 26, 2006·Journal of Occupational Rehabilitation·Martijn W HeymansWillem van Mechelen
Jul 29, 2011·Journal of Occupational Rehabilitation·Manon TruchonMarie-José Durand
Mar 27, 2012·Journal of Occupational Rehabilitation·Angela HigginsSam Porter
Oct 23, 2009·International Journal of Technology Assessment in Health Care·Eija RoineTiina Saarto
Jul 17, 2007·BMC Medical Research Methodology·Martijn W HeymansHenrica C W de Vet
Nov 15, 2007·Journal of Occupational and Environmental Medicine·Radoslaw WasiakGlenn S Pransky
Aug 31, 2007·Disability and Rehabilitation·Mauro ZampoliniLuigi Tesio
Jul 14, 2010·The Spine Journal : Official Journal of the North American Spine Society·Martijn W HeymansHenrica C W de Vet
Jan 1, 2008·The Spine Journal : Official Journal of the North American Spine Society·Jens Ivar BroxHege R Eriksen
Nov 21, 2007·The Spine Journal : Official Journal of the North American Spine Society·J I BroxH R Eriksen
Aug 12, 2006·Journal of Science and Medicine in Sport·Karin I ProperWillem van Mechelen
Dec 3, 2013·Journal of Clinical Epidemiology·Iris EekhoutMartijn W Heymans
Feb 1, 2017·Archives of Physical Medicine and Rehabilitation·Marco StreibeltChristoph Reichel
Jun 24, 2016·Statistical Methods in Medical Research·Iris EekhoutMartijn W Heymans
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