The effectiveness of high-intensity versus low-intensity back schools in an occupational setting: A pragmatic randomized controlled trial

Heymans, Martijn, P. T., de Vet, Henrica C. W., Bongers, Paulien M., Knol, Dirk L., Koes, Bart W. and van Mechelen, Willem (2006) The effectiveness of high-intensity versus low-intensity back schools in an occupational setting: A pragmatic randomized controlled trial. Spine, 31 10: 1075-1082. doi:10.1097/01.brs.0000216443.46783.4d


Author Heymans, Martijn, P. T.
de Vet, Henrica C. W.
Bongers, Paulien M.
Knol, Dirk L.
Koes, Bart W.
van Mechelen, Willem
Title The effectiveness of high-intensity versus low-intensity back schools in an occupational setting: A pragmatic randomized controlled trial
Journal name Spine   Check publisher's open access policy
ISSN 0362-2436
1528-1159
Publication date 2006-05-01
Sub-type Article (original research)
DOI 10.1097/01.brs.0000216443.46783.4d
Open Access Status Not yet assessed
Volume 31
Issue 10
Start page 1075
End page 1082
Total pages 8
Place of publication Philadelphia, PA, United States
Publisher Lippincott Williams & Wilkins
Language eng
Subject 1103 Clinical Sciences
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.
Keyword Low back pain
Randomized controlled trial
Occupational health care
Back schools
Sick-leave
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Excellence in Research Australia (ERA) - Collection
School of Human Movement and Nutrition Sciences Publications
 
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