Cited by 293Musculoskeletal pain and rehabilitationMedical Practices and RehabilitationWorkplace Health and Well-being

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Randomised controlled trial of integrated care to reduce disability from chronic low back pain in working and private life

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Lambeek, L. C, van Mechelen, W., Knol, D. L, Loisel, P., Anema, J. R·2010·BMJ

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Abstract

OBJECTIVE: To evaluate the effectiveness of an integrated care programme, combining a patient directed and a workplace directed intervention, for patients with chronic low back pain. DESIGN: Population based randomised controlled trial. SETTING: Primary care (10 physiotherapy practices, one occupational health service, one occupational therapy practice) and secondary care (five hospitals). PARTICIPANTS: 134 adults aged 18-65 sick listed for at least 12 weeks owing to low back pain. INTERVENTION: Patients were randomly assigned to usual care (n=68) or integrated care (n=66). Integrated care consisted of a workplace intervention based on participatory ergonomics, involving a supervisor, and a graded activity programme based on cognitive behavioural principles. MAIN OUTCOME MEASURES: The primary outcome was the duration of time off work (work disability) due to low back pain until full sustainable return to work. Secondary outcome measures were intensity of pain and functional status. RESULTS: The median duration until sustainable return to work was 88 days in the integrated care group compared with 208 days in the usual care group (P=0.003). Integrated care was effective on return to work (hazard ratio 1.9, 95% confidence interval 1.2 to 2.8, P=0.004). After 12 months, patients in the integrated care group improved significantly more on functional status compared with patients in the usual care group (P=0.01). Improvement of pain between the groups did not differ significantly. CONCLUSION: The integrated care programme substantially reduced disability due to chronic low back pain in private and working life. Trial registration Current Controlled Trials ISRCTN28478651.

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Authors: Lambeek, L. C., van Mechelen, W., Knol, D. L., Loisel, P., & Anema, J. R.
Affiliations: Amsterdam Public Health (NL)
University of Toronto (CA)
Corresponding author: Anema, J. R
ORCID: Anema, J. R
Venue: BMJ
Publisher: BMJ
Published: 2010-03-16
Volume: 340
Issue: mar16 1
Pages: c1035-c1035
ISSN: 0007-1447 (ISSN-L)
0959-8138
1468-5833
DOI: 10.1136/bmj.c1035
PMC: PMC2840223
OpenAlex: W2028702370
Cited by: 293
References: 38
Citations by year: 2026: 11 · 2025: 9 · 2024: 10 · 2023: 14 · 2022: 13 · 2021: 15 · 2020: 13 · 2019: 17 · 2018: 17 · 2017: 19 · 2016: 22 · 2015: 28 · 2014: 16 · 2013: 22 · 2012: 27
FWCI: 21.00
Type: journal article
Language: en
Open access: hybrid
doi.org
Licence: cc-by-nc
Locations: BMJ (publishedVersion, cc-by-nc)
PubMed Central (publishedVersion, cc-by-nc)
PubMed (publishedVersion)
Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
VU Research Portal (publishedVersion, other-oa)
HighWire Press Open Archive (submittedVersion)
Pure Amsterdam UMC (submittedVersion)
Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
Data Archiving and Networked Services (DANS) (submittedVersion)
Funders: ZonMw
Vrije Universiteit Amsterdam
Instituut Gak
Canadian Institutes of Health Research (FRN53909)
Topics: Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Musculoskeletal pain and rehabilitation
Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Medical Practices and Rehabilitation
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Workplace Health and Well-being
Keywords: chronic low back pain, integrated care, return to work, sick leave, work disability, participatory ergonomics, workplace interventions, cognitive behavioral therapy, functional status, pain intensity, occupational health
MeSH terms: Adolescent, Adult, Aged, Chronic Disease, Female, Persons with Disabilities, Disabled Persons, Hospitalization, Humans, Male, Middle Aged, Occupational Health Services, Occupational Therapy, Patient Compliance, Surveys and Questionnaires, Rehabilitation, Vocational, Program Evaluation, Treatment Outcome, Low Back Pain, Delivery of Health Care, Integrated, Physical Therapy Modalities, Young Adult

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Randomised controlled trial of integrated care to reduce disability from chronic low back pain in working and private life

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