One-Year Follow-Up in Employees Sick-Listed Because of Low Back Pain: Randomized Clinical Trial Comparing Multidisciplinary and Brief Intervention

Jensen, Chris; Jensen, Ole Kudsk; Christiansen, David Høyrup; Nielsen, Claus Vinther

doi:10.1097/brs.0b013e3181eba711

Cited by 71Musculoskeletal pain and rehabilitationMedical Practices and RehabilitationWorkplace Health and Well-being

One-Year Follow-Up in Employees Sick-Listed Because of Low Back Pain: Randomized Clinical Trial Comparing Multidisciplinary and Brief Intervention

Jensen, Chris, Jensen, Ole Kudsk, Christiansen, David Høyrup, Nielsen, Claus Vinther·2011·Spine

DOI 10.1097/brs.0b013e3181eba711

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Abstract

STUDY DESIGN: Randomized clinical trial comparing two interventions in employees sick-listed 3 to 16 weeks because of low back pain (LBP). OBJECTIVE: To compare 1-year return to work (RTW), pain, disability and physical and mental health dimensions in subjects offered a hospital-based multidisciplinary intervention or a brief intervention. SUMMARY OF BACKGROUND DATA: Previous studies in sick-listed employees with LBP have indicated efficacy of both brief and more comprehensive multidisciplinary interventions. However, it remains unknown, which is the more effective, and which elements are instrumental in furthering RTW, and improving health. METHODS: The brief intervention comprised clinical examination and advice offered by a rehabilitation physician and a physiotherapist. In the multidisciplinary intervention, this intervention was supplemented with the expertise of a team and the assignment of a case manager who drew up a rehabilitation plan in collaboration with the patient and the multidisciplinary team. One-year RTW was estimated by data from a comprehensive national database of social transfer payments. Questionnaires were used to obtain baseline and 1-year data on Roland Morris disability score, LBP Rating Scale, SF36, and fear-avoidance. RESULTS: A total of 351 patients were included and randomized and 344 (98%) patients participated in all the consultations according to the study protocol. RTW was achieved by 125 (71.0%) participants in the multidisciplinary and 133 (76.0%) participants in the brief intervention group. The hazard ratio was 0.84 after adjustment for sex, age, smoking, compensation claims, disability score, and diagnosis (95% confidence interval [CI]: 0.65-1.08,P = 0.18). Multiple linear regression analysis displayed no differences in secondary outcomes, except for the mental health score (SF36), which was a little higher in the multidisciplinary intervention group than in the brief intervention group. CONCLUSION: Hospital-based multidisciplinary intervention may be no better than brief intervention to increase RTW and improve health in sick-listed employees with low back pain.

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The finding of no substantial difference on somatic and mental health outcomes between the two rehabilitation programs is in line with some earlier studies on individuals with musculoskeletal complaints and mental health disorders.
“No substantial difference on somatic and mental health outcomes between the two rehabilitation programs is in line with some earlier studies on individuals with musculoskeletal complaints [5, 32] and mental health disorders [9].”
From Effects of Inpatient Multicomponent Occupational Rehabilitation versus Less Comprehensive Outpatient Rehabilitation on Somatic and Mental Health: Secondary Outcomes of a Randomized Clinical Trial. (2017) · cites this paper as [5]
Jensen et al. did not find added effects on return to work or pain reduction of multidisciplinary occupational rehabilitation compared to a brief intervention program for subjects with low back pain.
“For example, Jensen et al. [5] did not find added effects on return to work or pain reduction of multidisciplinary occupational rehabilitation compared to a brief intervention program for subjects with low back pain.”
From Effects of Inpatient Multicomponent Occupational Rehabilitation versus Less Comprehensive Outpatient Rehabilitation on Somatic and Mental Health: Secondary Outcomes of a Randomized Clinical Trial. (2017) · cites this paper as [5]

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The comparative effects of brief or multidisciplinary intervention on return to work at 1 year in employees on sick leave due to low back pain: A randomized controlled trial
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Subgroup analyses on return to work in sick-listed employees with low back pain in a randomised trial comparing brief and multidisciplinary intervention
Stapelfeldt, C. M., Christiansen, D. H., Jensen, O. K., Nielsen, C. V., Petersen, K. D., & Jensen, C. (2011) · BMC Musculoskeletal Disorders · doi:10.1186/1471-2474-12-112 · Cited by 55 · see citing works
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Comparing multidisciplinary and brief intervention in employees with different job relations on sick leave due to low back pain: protocol of a randomised controlled trial
Pedersen, P., Nielsen, C. V., Andersen, M., Langagergaard, V., Boes, A., Jensen, O. K., Jensen, C., & Labriola, M. (2017) · BMC Public Health · doi:10.1186/s12889-017-4975-3 · Cited by 6 · see citing works
Self-citation
Two-Year Follow-Up on Return to Work in a Randomised Controlled Trial Comparing Brief and Multidisciplinary Intervention in Employees on Sick Leave Due to Low Back Pain
Pedersen, K. K. W., Langagergaard, V., Jensen, O. K., Nielsen, C. V., Sørensen, V., & Pedersen, P. (2022) · Journal of Occupational Rehabilitation · doi:10.1007/s10926-022-10030-1 · Cited by 7 · see citing works
Self-citation

Authors: Jensen, C., Jensen, O. K., Christiansen, D. H., & Nielsen, C. V.
Affiliations: Aarhus University (DK)
Regionshospitalet Silkeborg (DK)
Corresponding author: Jensen, Chris
Christiansen, David Høyrup
Nielsen, Claus Vinther
ORCID: Jensen, Ole Kudsk
Christiansen, David Høyrup
Nielsen, Claus Vinther
Venue: Spine
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2011-07
Volume: 36
Issue: 15
Pages: 1180-1189
ISSN: 0362-2436 (ISSN-L)
DOI: 10.1097/brs.0b013e3181eba711
OpenAlex: W2181316415
Cited by: 71
References: 25
Citations by year: 2025: 3 · 2024: 3 · 2023: 1 · 2022: 9 · 2021: 7 · 2020: 2 · 2019: 3 · 2018: 4 · 2017: 8 · 2016: 1 · 2015: 9 · 2014: 7 · 2013: 7 · 2012: 5
FWCI: 4.45
Type: journal article
Language: en
Open access: closed
Locations: Spine (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Medical Practices and Rehabilitation
Health Sciences › Health Professions › General Health Professions › Workplace Health and Well-being
Keywords: low back pain, sick leave, return to work, multidisciplinary intervention, brief intervention, case management, rehabilitation, disability, pain, mental health, occupational health
MeSH terms: Adult, Disability Evaluation, Female, Follow-Up Studies, Humans, Male, Middle Aged, Pain Measurement, Surveys and Questionnaires, Time Factors, Multivariate Analysis, Linear Models, Treatment Outcome, Low Back Pain, Sick Leave, Pain Clinics, Physical Therapy Modalities

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One-Year Follow-Up in Employees Sick-Listed Because of Low Back Pain: Randomized Clinical Trial Comparing Multidisciplinary and Brief Intervention

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