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Counselling low-back-pain patients in secondary healthcare: a randomised trial addressing experienced workplace barriers and physical activity
  1. Lone Donbæk Jensen1,
  2. Thomas Maribo2,
  3. Berit Schiøttz-Christensen3,
  4. Finn Hjorth Madsen4,
  5. Bigitte Gonge1,
  6. Michael Christensen1,
  7. Poul Frost1
  1. 1Danish Ramazzini Center, Department of Occupational Medicine, Aarhus University Hospital, Aarhus, Denmark
  2. 2Department of Physical Therapy and Occupational Therapy, Aarhus University Hospital, Aarhus, Denmark
  3. 3Aarhus Rheumatology Clinic, Aarhus, Denmark
  4. 4Department of Rheumatology Aarhus University Hospital, Aarhus, Denmark
  1. Correspondence to Dr Lone Donbæk Jensen, Danish Ramazzini Center, Department of Occupational Medicine, Aarhus University Hospital, Noerrebrogade 42, Building 2C, DK-8000 Aarhus C, Denmark; lonjesen{at}rm.dk

Abstract

Objective To assess if counselling by an occupational physician (OP) addressing experienced workplace barriers and physical activity integrated as a part of low-back pain (LBP) outpatient treatment influences pain, function and sick leave.

Methods Randomised controlled trial in the secondary healthcare sector with 3 months' follow-up. The participants were LBP patients who, independently of sick-leave status, expressed concerns about the ability to maintain their current job. Patients referred for surgery were excluded. The intervention consisted of two counselling sessions conducted by an OP addressing both workplace barriers and leisure-time physical activity. A workplace visit was performed if required. Pain, function and duration of sick leave due to LBP were primary outcomes.

Results A reduction in bodily pain and improvement in physical function both measured by the 36-item short-form health survey questionnaire in favour of the intervention group was found. The change in pain score was found to be clinically relevant. The risk of sick leave for at least 8 weeks due to LBP was significantly reduced in the intervention group. Two secondary outcomes, Fear Avoidance Beliefs about physical activity and maximum oxygen uptake, supported compliance and adherence to the part of the intervention focusing on enhanced physical activity.

Conclusion Two short counselling sessions by an OP combining advice on meeting workplace barriers and enhancing physical activity had a substantial effect on important prognostic factors for LBP patients with moderate to severe symptoms diagnosed in outpatient rheumatological clinics.

Trial registration Current Controlled Trials ISRCTN13071157

  • Randomised controlled intervention trial
  • workplace factors
  • leisure time physical activity
  • low back pain
  • function
  • sick leave
  • epidemiology
  • occupational health practice
  • back disorders
  • intervention studies
  • rehabilitation

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Footnotes

  • See Editorial, p 1

  • Funding Danish Research Fund for the Working Environment. Grant number 10-2005-09.

  • Competing interests None.

  • Patient consent Obtained.

  • Ethics approval Ethics approval was provided by the Danish Data Protection Agency, number 2006-41-6190, and notified to the Central Denmark Region Committees on Biomedical Research Ethics.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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