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Does early intervention with a light mobilization program reduce long-term sick leave for low back pain: a 3-year follow-up study.
Spine (Phila Pa 1976). 2003 Oct 15; 28(20):2309-15; discussion 2316.S

Abstract

STUDY DESIGN

A randomized clinical trial.

OBJECTIVES

To evaluate long-term clinical and economical effects of a light mobilization program on the duration of sick leave for patients with subacute low back pain.

SUMMARY OF BACKGROUND DATA

Twelve-month follow-up results from a previous study showed that early intervention with examination at a spine clinic, giving the patients information, reassurance, and encouragement to engage in physical activity as normal as possible had significant effect in reducing sick leave. At 12-month follow-up, 68.4% in the intervention group were off sick leave, as compared with 56.4% in the control group. Patients in this study were followed-up for a period of 3 years to investigate possible long-term effects.

MATERIALS AND METHODS

Four hundred fifty-seven patients placed on a sick list for 8 to 12 weeks for low back pain were randomized into two groups: an intervention group (n = 237) and a control group (n = 220). The intervention group was examined at a spine clinic and given information and advice to stay active. The control group was not examined at the clinic but was treated within the primary health care.

RESULTS

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). This difference is mainly caused by a more rapid return to work during the first year. There was no significant difference for the second or third year. In particular, there is no increased risk for reoccurrence of illness from early return to work. At 6-month follow-up, patients in the intervention group were less likely to use bed rest and more likely to use stretching and walking to cope with their back pain compared with the control group. This effect diminished. At 12-month follow-up, the only significant difference between the groups was in the use of stretching. Economic returns of the intervention were calculated in terms of increases in the net present value of production for the society because of the reduction in number of days on sick leave. Net benefits accumulated over 3 years of treating the 237 patients in the intervention group amount to approximately 2,822 dollars per person.

CONCLUSIONS

For patients with subacute low back pain, a brief and simple early intervention with examination, information, reassurance, and encouragement to engage in physical activity as normal as possible had economic gains for the society. The effect occurred during the first year after intervention. There were no significant long-term effects of the intervention. The initial gain obtained during the first year does not lead to any increased costs or increased risks for reoccurrence of illness over the next 2 years.

Authors+Show Affiliations

Spine Clinic, Hedmark Central Hospital, 2312 Ottestad, Norway. emhagen@ online.noNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

14560075

Citation

Molde Hagen, Eli, et al. "Does Early Intervention With a Light Mobilization Program Reduce Long-term Sick Leave for Low Back Pain: a 3-year Follow-up Study." Spine, vol. 28, no. 20, 2003, pp. 2309-15; discussion 2316.
Molde Hagen E, Grasdal A, Eriksen HR. Does early intervention with a light mobilization program reduce long-term sick leave for low back pain: a 3-year follow-up study. Spine (Phila Pa 1976). 2003;28(20):2309-15; discussion 2316.
Molde Hagen, E., Grasdal, A., & Eriksen, H. R. (2003). Does early intervention with a light mobilization program reduce long-term sick leave for low back pain: a 3-year follow-up study. Spine, 28(20), 2309-15; discussion 2316.
Molde Hagen E, Grasdal A, Eriksen HR. Does Early Intervention With a Light Mobilization Program Reduce Long-term Sick Leave for Low Back Pain: a 3-year Follow-up Study. Spine (Phila Pa 1976). 2003 Oct 15;28(20):2309-15; discussion 2316. PubMed PMID: 14560075.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Does early intervention with a light mobilization program reduce long-term sick leave for low back pain: a 3-year follow-up study. AU - Molde Hagen,Eli, AU - Grasdal,Astrid, AU - Eriksen,Hege R, PY - 2003/10/16/pubmed PY - 2005/6/14/medline PY - 2003/10/16/entrez SP - 2309-15; discussion 2316 JF - Spine JO - Spine (Phila Pa 1976) VL - 28 IS - 20 N2 - STUDY DESIGN: A randomized clinical trial. OBJECTIVES: To evaluate long-term clinical and economical effects of a light mobilization program on the duration of sick leave for patients with subacute low back pain. SUMMARY OF BACKGROUND DATA: Twelve-month follow-up results from a previous study showed that early intervention with examination at a spine clinic, giving the patients information, reassurance, and encouragement to engage in physical activity as normal as possible had significant effect in reducing sick leave. At 12-month follow-up, 68.4% in the intervention group were off sick leave, as compared with 56.4% in the control group. Patients in this study were followed-up for a period of 3 years to investigate possible long-term effects. MATERIALS AND METHODS: Four hundred fifty-seven patients placed on a sick list for 8 to 12 weeks for low back pain were randomized into two groups: an intervention group (n = 237) and a control group (n = 220). The intervention group was examined at a spine clinic and given information and advice to stay active. The control group was not examined at the clinic but was treated within the primary health care. RESULTS: 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). This difference is mainly caused by a more rapid return to work during the first year. There was no significant difference for the second or third year. In particular, there is no increased risk for reoccurrence of illness from early return to work. At 6-month follow-up, patients in the intervention group were less likely to use bed rest and more likely to use stretching and walking to cope with their back pain compared with the control group. This effect diminished. At 12-month follow-up, the only significant difference between the groups was in the use of stretching. Economic returns of the intervention were calculated in terms of increases in the net present value of production for the society because of the reduction in number of days on sick leave. Net benefits accumulated over 3 years of treating the 237 patients in the intervention group amount to approximately 2,822 dollars per person. CONCLUSIONS: For patients with subacute low back pain, a brief and simple early intervention with examination, information, reassurance, and encouragement to engage in physical activity as normal as possible had economic gains for the society. The effect occurred during the first year after intervention. There were no significant long-term effects of the intervention. The initial gain obtained during the first year does not lead to any increased costs or increased risks for reoccurrence of illness over the next 2 years. SN - 1528-1159 UR - https://www.unboundmedicine.com/medline/citation/14560075/Does_early_intervention_with_a_light_mobilization_program_reduce_long_term_sick_leave_for_low_back_pain:_a_3_year_follow_up_study_ L2 - https://doi.org/10.1097/01.BRS.0000085817.33211.3F DB - PRIME DP - Unbound Medicine ER -