Predictors of return to work after multidisciplinary rehabilitation program for patients with chronic low back pain
Stéphane Le Cam1, Violaine Foltz2, Bruno Fautrel1
1Rheumatology Department, Pitié-Salpêtrière Hospital, Assistance publique-Hôpitaux de Paris (AP-HP), 47-83, boulevard de l'Hôpital, 75013 Paris, France; Rheumatology Department, Institut Pierre-Louis d'Épidémiologie et de Santé Publique, Pharmacologie et évaluation des soins, Sorbonne Université, INSERM, Hôpital Pitié-Salpêtrière, AP-HP, 75013 Paris, France.
Introduction:
Patients with chronic low back pain face functional, psychological, social and professional difficulties. Multidisciplinary rehabilitation programs (MRP) can be an effective treatment to help these patients to improve their condition and return to work.
Objective:
To determine baseline predictors for return to work after an MRP for patients with chronic low back pain struggling to maintain their job.
Methods:
A monocentric cohort study was conducted. Patients who had followed a MRP between January 2015 and December 2020 were included. The program consisted of physical activities and different workshops inspired by behavioural therapy, at full time during one month. Pain, lifestyle, history of the disease, function, psychosocial characteristics were evaluated at baseline. Return to work at different possible time point after the MRP was collected. A bivariate and a multivariate analysis were performed to evaluate which factors were associated with return to work.
Results:
Overall, 251 patients were included. Professional status, duration off work, intensity of low back pain, self-perceived disability, fear-avoidance beliefs at work were associated with return to work after the MRP on bivariate analysis. Having worked in the past 6months and the absence of high fear-avoidance beliefs at work at baseline were associated with return to work on multivariate analysis.
Discussion:
This study suggests that patients with chronic low back pain and professional difficulties need to be included quickly in a MRP, with specific attention to beliefs about pain.
