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Biomechanical Changes Related to Low Back Pain: An Innovative Tool for Movement Pattern Assessment and Treatment Evaluation in Rehabilitation
Published on: December 13, 2024
Physical conditioning programs for improving work outcomes in workers with back pain.
Frederieke Schaafsma1, Eva Schonstein, Karyn M Whelan
1Faculty of Health Sciences, University of Sydney, Cumberland Campus, PO Box 170, Lidcombe, NSW, Australia, 1825.
The Cochrane Database of Systematic Reviews
|January 22, 2010
Summary
Physical conditioning programs show uncertain effectiveness for reducing sick leave in workers with back pain. Workplace involvement may improve outcomes for subacute and chronic cases, but acute cases see no benefit.
Area of Science:
- Occupational Health
- Rehabilitation Medicine
- Evidence-Based Practice
Background:
- Physical conditioning programs aim to enhance work status for employees on sick leave.
- This review updates previous Cochrane findings on work conditioning for back and neck pain.
Purpose of the Study:
- To evaluate the effectiveness of physical conditioning programs in minimizing work absence for individuals with back pain.
Main Methods:
- Systematic review and meta-analysis of randomized controlled trials (RCTs) and cluster RCTs.
- Searched multiple databases up to July 2008, including CENTRAL, MEDLINE, EMBASE, CINAHL, PsycINFO, and PEDro.
- Data extraction and risk of bias assessment performed independently by two reviewers.
Main Results:
- Twenty-three RCTs involving 3676 workers were included; 13 had a low risk of bias.
- No significant effect on sickness absence for acute back pain.
- Conflicting results for subacute back pain, but subgroup analysis indicated benefit with workplace involvement.
- Small long-term effect on sickness absence for chronic back pain (SMD: -0.18).
- No additional benefit from cognitive behavioral therapy combined with physical conditioning.
Conclusions:
- Effectiveness of physical conditioning for reducing sick leave in back pain patients remains uncertain compared to usual care or other exercises.
- Likely no effect on sick leave for acute back pain; potential positive effects for subacute and chronic back pain, especially with workplace involvement.
- Further research is needed to understand mechanisms and develop more effective return-to-work interventions.
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