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The effectiveness of high-intensity versus low-intensity back schools in an occupational setting: a pragmatic randomized controlled trial.
Spine (Phila Pa 1976). 2006 May 01; 31(10):1075-82.S

Abstract

STUDY DESIGN

Randomized controlled trial.

OBJECTIVES

To compare high- and low-intensity back schools with usual care in occupational health care.

SUMMARY OF BACKGROUND DATA

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.

METHODS

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.

RESULTS

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). The median number of sick-leave days was 68, 75, and 85 in the low-intensity back school, usual care, and high-intensity back school, respectively. Beneficial effects on functional status and kinesiophobia were found at 3 months in favor of the low-intensity back school. No substantial differences on pain and perceived recovery were found between groups.

CONCLUSIONS

The low-intensity back school was most effective in reducing work absence, functional disability, and kinesiophobia, and more workers in this group scored a higher perceived recovery during the 6-month follow-up.

Authors+Show Affiliations

Body@Work, Research Center Physical Activity, Work and Health, TNO-VUmc, Amsterdam, The Netherlands.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

16648740

Citation

Heymans, Martijn W., et al. "The Effectiveness of High-intensity Versus Low-intensity Back Schools in an Occupational Setting: a Pragmatic Randomized Controlled Trial." Spine, vol. 31, no. 10, 2006, pp. 1075-82.
Heymans MW, de Vet HC, Bongers PM, et al. The effectiveness of high-intensity versus low-intensity back schools in an occupational setting: a pragmatic randomized controlled trial. Spine (Phila Pa 1976). 2006;31(10):1075-82.
Heymans, M. W., de Vet, H. C., Bongers, P. M., Knol, D. L., Koes, B. W., & van Mechelen, W. (2006). The effectiveness of high-intensity versus low-intensity back schools in an occupational setting: a pragmatic randomized controlled trial. Spine, 31(10), 1075-82.
Heymans MW, et al. The Effectiveness of High-intensity Versus Low-intensity Back Schools in an Occupational Setting: a Pragmatic Randomized Controlled Trial. Spine (Phila Pa 1976). 2006 May 1;31(10):1075-82. PubMed PMID: 16648740.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The effectiveness of high-intensity versus low-intensity back schools in an occupational setting: a pragmatic randomized controlled trial. AU - Heymans,Martijn W, AU - de Vet,Henrica C W, AU - Bongers,Paulien M, AU - Knol,Dirk L, AU - Koes,Bart W, AU - van Mechelen,Willem, PY - 2006/5/2/pubmed PY - 2006/5/19/medline PY - 2006/5/2/entrez SP - 1075 EP - 82 JF - Spine JO - Spine (Phila Pa 1976) VL - 31 IS - 10 N2 - STUDY DESIGN: Randomized controlled trial. OBJECTIVES: To compare high- and low-intensity back schools with usual care in occupational health care. SUMMARY OF BACKGROUND DATA: 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. METHODS: 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. RESULTS: 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). The median number of sick-leave days was 68, 75, and 85 in the low-intensity back school, usual care, and high-intensity back school, respectively. Beneficial effects on functional status and kinesiophobia were found at 3 months in favor of the low-intensity back school. No substantial differences on pain and perceived recovery were found between groups. CONCLUSIONS: The low-intensity back school was most effective in reducing work absence, functional disability, and kinesiophobia, and more workers in this group scored a higher perceived recovery during the 6-month follow-up. SN - 1528-1159 UR - https://www.unboundmedicine.com/medline/citation/16648740/The_effectiveness_of_high_intensity_versus_low_intensity_back_schools_in_an_occupational_setting:_a_pragmatic_randomized_controlled_trial_ L2 - https://doi.org/10.1097/01.brs.0000216443.46783.4d DB - PRIME DP - Unbound Medicine ER -