Economic Evaluation of a Multi-Stage Return to Work Program for Workers on Sick-Leave Due to Low Back Pain

2006 ◽  
Vol 16 (4) ◽  
pp. 557-578 ◽  
Author(s):  
Ivan A. Steenstra ◽  
Johannes R. Anema ◽  
Maurits W. van Tulder ◽  
Paulien M. Bongers ◽  
Henrica C. W. de Vet ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Economic Evaluation ◽  
Sick Leave ◽  
Return To Work ◽  
Low Back ◽  
Work Program ◽  
Multi Stage

scholarly journals Designing a workplace return-to-work program for occupational low back pain: an intervention mapping approach

2009 ◽  
Vol 10 (1) ◽  
Author(s):  
Carlo Ammendolia ◽  
David Cassidy ◽  
Ivan Steenstra ◽  
Sophie Soklaridis ◽  
Eleanor Boyle ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Return To Work ◽  
Intervention Mapping ◽  
Low Back ◽  
Work Program ◽  
Mapping Approach ◽  
Occupational Low Back Pain

scholarly journals Does light mobilization treatment reduce long-term sick leave for low back pain? / Kan råd om fysisk aktivitet redusere sykefraværet for pasienter med ryggplager?

2009 ◽  
Vol 16 (2) ◽  
Author(s):  
Eli Molde Hagen
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Sick Leave ◽  
Return To Work ◽  
Intervention Group ◽  
Normal Activity ◽  
Subjective Health ◽  
Control Group ◽  
Low Back ◽  
Main Effect

<p>Background: Low back pain is one of the most frequent reasons for sick leave and disability pension. Early intervention with information, advice, reassurance, and encouragement to stay active may be a cost-effective method for returning patients quickly to normal activity.<br />Material and methods: 457 patients sick listed 8-12 weeks for low back pain with or without radiating pain and age between 18-60 years were included. The patients were randomised into an intervention group (n=237) and a control group (n=220). The intervention group was examined at a spine clinic by a treatment team consisting of a physician (specialist in physical medicine and rehabilitation) and a physiotherapist. The patients were given time to express their concerns and explain how the back problem affected their life and daily activities. They were given practical advice in how to resume normal activity, and they were encouraged to stay active despite the pain. The control group was treated within the primary health care. All subjects filled out questionnaires. Data on sick leave, disability, and other social benefits were collected register data from the National Insurance Offices. Finally, the subjective health complaints scored by all the subjects in the study group at inclusion time were compared to reference values from a Norwegian normal population, consisting of 1240 adults.<br />Results: The intervention program had significant effect in reducing sick leave. At 12 months 68.4% in the intervention group vs 56.4% in the control group had returned to work. Over the 3 years of observation, the intervention group had significantly fewer days of sickness compensation (average 125.7 d/person) than the control group (169.6 d/person). The difference was mainly caused by a more rapid return to work during the first year. The intervention had economic gains for the society. Net benefits accumulated over 3 years of treating the 237 patients in the intervention group amount to approximately NOK 6 049 649 ($ 828 719). At three months follow up the strongest modifying effect of the intervention on return to work was the perception of constant back strain when working, and beliefs about reduced ability to work. At 12 months,gastrointestinal complaints were the strongest modifier for the effect of the intervention. Compared to the normal reference population, the low back pain patients had significantly more subjective health complaints.<br />Conclusion: Early intervention with examination, information, reassurance, and encouragement to engage in physical activity as normal as possible reduced sick leave for subacute low back pain and had economic gains for the society. There was no increased risk for reoccurrence of sick leave due to low back pain over the next 2 years in patients returning early. The intervention was short and simple and seemed to have a main effect on work absenteeism via interacting with concerns of being unable to work. Patients suffering from low back pain also have other complaints, and these comorbid conditions may influence the prognosis,<br />in particular the trust and ability to return to work. The intervention may have its main effect via the perception and interpretation of the condition, and the concerns underlying the decision to return to work.</p><table border="0" width="90%"><tbody><tr><td width="73%" valign="top"><p>Bakgrunn: Ryggsmerter er en av de hyppigste årsaker til sykmelding og uføretrygd. Behandlingstiltak rettet mot å redusere utvikling av kroniske plager og langvarig sykmelding vil derfor kunne være kostnadseffektive.<br />Materiale og metode: 457 pasienter sykmeldt 8-12 uker for ryggsmerter med eller uten utstrålende smerter og alder 18-60 år ble inkludert og randomisert til en intervensjonsgruppe (n=237) og en kontrollgruppe (n=220). Pasientene i intervensjonsgruppen ble undersøkt på en ryggpoliklinikk. De fikk informasjon om årsak til plagene, råd og veiledning om mestring av plagene og hvordan de kunne gjenoppta normal aktivitet, og de ble oppmuntret til å være i mest mulig normal fysisk aktivitet selv om ryggen var vond. Kontrollgruppen fikk vanlig behandling i primærhelsetjenesten.<br />Resultater: Pasientene som ble behandlet på ryggpoliklinikken kom fortere tilbake i jobb enn de pasientene som fikk vanlig behandling i primærhelsetjenesten. Etter et år var 68% friskmeldt i ryggpoliklinikkgruppen og 56% friskmeldt i primærhelsetjenestegruppen. Den raskere tilbakekomst til jobb det første året medførte ikke økt risiko for resykmelding de påfølgende to år og ga samfunnsøkonomiske besparelser. De som hadde best nytte av behandlingen på ryggpoliklinikken, var de som trodde at deres arbeidsevne var betydelig redusert, hadde konstant belastning på ryggen mer enn halve arbeidstiden, og trodde at årsak til ryggplagene ikke hadde sammenheng med tilfeldigheter. Studien viser også at ryggpasienter har flere subjektive helseplager enn normalbefolkningen.<br />Fortolkning: Den tidlige intervensjonen på ryggpoliklinikken medførte mindre sykefravær, og resultater fra analysene kan tyde på at denne behandlingen reduserte pasientenes frykt og engstelse for smertene og endret tro og forventninger om hvilken betydning jobben hadde som årsak til plagene.<script type="text/javascript"></script></p><p align="left"> </p><p><!-- Script Size: 2.75 KB --></p></td><td width="2%"> </td></tr><tr><td> </td><td> </td></tr></tbody></table>

scholarly journals The Effects of Workplace Interventions on Low Back Pain in Workers: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 18 (23) ◽  
pp. 12614
Author(s):  
Fabrizio Russo ◽  
Giuseppe Francesco Papalia ◽  
Gianluca Vadalà ◽  
Luca Fontana ◽  
Sergio Iavicoli ◽  
...  
Keyword(s):  
Systematic Review ◽  
Low Back Pain ◽  
Back Pain ◽  
Sick Leave ◽  
Return To Work ◽  
Clinical Outcomes ◽  
Meta Analysis ◽  
Low Back ◽  
Workplace Interventions ◽  
Physical Scale

This systematic review and meta-analysis aimed to analyze the effects of workplace interventions (WI) on clinical outcomes related to low back pain (LBP) in a worker population, and to assess socio-economic parameters as participants on sick leave, days of sick leave, and return to work following WI. A systematic literature search was performed to select randomized clinical trials that investigated the effectiveness of WI on return to work, sick leave, and working capacity of workers affected by nonspecific LBP. Fourteen articles were included in the review and meta-analysis. The meta-analysis showed improvements in pain (p = 0.004), disability (p = 0.0008), fear-avoidance for psychical activity (p = 0.004), and quality of life (p = 0.001 for physical scale and p = 0.03 for mental scale) for patients who underwent WI compared to controls. Moreover, the pain reduction following WI was statistically significant in the healthcare workers’ group (p = 0.005), but not in the other workers’ group. The participants on sick leave and the number of days of sick leave decreased in the WI group without statistical significance (p = 0.85 and p = 0.10, respectively). Finally, LBP recurrence was significantly reduced in the WI group (p = 0.006). WI led to a significant improvement of clinical outcomes in a workers’ population affected by LBP.

Avaliação de Medos, Crenças e Comportamentos de Evitação em Policiais Militares de Minas Gerais Portadores de Dor Lombar Crônica/Fear-Avoidance Assessment in Minas Gerais Military Police Agents With Low Back Pain

1970 ◽  
Vol 5 (3) ◽  
pp. 18-26
Author(s):  
Marcelo von Sperling de Souza ◽  
Maximiliano Ferreira Torres de Carvalho ◽  
Anna Florence Alves Paulino Souza ◽  
Flávia Corrêa Assumpção
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Sick Leave ◽  
Minas Gerais ◽  
Low Back ◽  
Fear Avoidance ◽  
Invasive Procedures ◽  
Military Police ◽  
Fear Avoidance Beliefs ◽  
Fear Avoidance Beliefs Questionnaire

RESUMO Objetivo: descrever os índices de medos, crenças e evitação em policiais militares portadores de dor lombar crônica, acompanhados pelo Grupo de Coluna Vertebral do Hospital da Polícia Militar de Minas Gerais (PMMG). Materiais e métodos: durante um período de três anos, estas variáveis foram medidas pelo Fear-avoidance beliefs questionnaire (FABQ) versão português-brasileira, preenchido por autorrelato. As demais variáveis utilizadas para classificação da amostra em subgrupos e comparação destes quanto aos seus escores no FABQ foram idade, sexo, histórico de procedimento invasivo de coluna, presença de radiculopatia e encaminhamento pela Junta Central de Saúde (JCS), órgão oficial de perícias médicas na PMMG. Resultados: 248 militares preencheram o questionário satisfatoriamente e foram incluídos no estudo. A média de pontuação do FABQ-Work foi de 23,18 ± 10,79, enquanto a média de pontuação do FABQ-Phys foi de 18,10 ± 6,09. Não foram encontradas diferenças significativas nos escores dos subgrupos divididos por sexo, histórico de procedimento invasivo ou presença de radiculopatia. Indivíduos com idade superior a 40 anos apresentaram maiores índices de medo e evitação para atividades físicas (FABQ-Phys). Indivíduos que se encontravam em afastamento prolongado do trabalho (encaminhados pela JCS) apresentaram maior medo e evitação tanto para atividades físicas quanto atividades de trabalho. Conclusão: estes resultados permitiram identificar características dos policias militares em risco de incapacidade prolongada, ressaltando a necessidade de medidas educativas focadas na correção de crenças errôneas sobre dor lombar crônica para um melhor prognóstico na sua reabilitação.Palavras-chave: Dor lombar, Polícia, Medo, Questionários ABSTRACTObjectives: the purpose of this study was to describe fear-avoidance levels in military police agents with chronic low back pain followed by the Spine Group of the Military Police Hospital. Materials and Methods: The Brazilian Portuguese version of the Fear-avoidance Beliefs Questionnaire (FABQ) was applied during a three-year period. Secondary variables (age, sex, history of spinal invasive procedures, presence of radiculopathy, referral from medical experts due to prolonged sick-leave) were used for subgroup analysis and FABQ mean scores comparison. Results: 248 patients filled out FABQ correctly and were included in the study. FABQ-work and FABQ-Phys means were 23.18±10.79 and 18.10±6.09, respectively. There were no differences in FABQ scores between subgroups divided by sex, invasive procedures or radiculopathy. Age subgroup comparisons revealed that older individuals (> 40-years old) showed higher FABQ-Phys scores. Individuals with prolonged sick-leave showed higher scores at both FABQ-Phys and FABQ-Work subscales. Conclusion: Our results allowed identification of variables possibly related to long-time disability in military police agents and put emphasis on the need of educational interventions in which fear-avoidance beliefs are addressed in order to improve their rehabilitation prognosis.Keywords: Low back pain, Police, Fear, Questionnaires.

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