OBJECTIVES: Given the individual and economic burden of chronic work disability in low back pain patients, there is a need for effective preventive interventions. The aim of the present study was to investigate whether problem-solving therapy had a supplemental value when added to behavioral graded activity, regarding days of sick leave and work status. DESIGN: Randomized controlled trial. PATIENTS AND SETTING:Employees who were recently on sick leave as a result of nonspecific low back pain were referred to the rehabilitation center by general practitioner, occupational physician, or rehabilitation physician. Forty-five employees had been randomly assigned to the experimental treatment condition that included behavioral graded activity and problem-solving therapy (GAPS), and 39 employees had been randomly assigned to behavioral graded activity and group education (GAGE). OUTCOME MEASURES: Days of sick leave and work status. Data were retrieved from occupational health services. RESULTS: Data analyses showed that employees in the GAPS group had significantly fewer days of sick leave in the second half-year after the intervention. Moreover, work status was more favorable for employees in this condition, in that more employees had a 100% return-to-work and fewer patients ended up receiving disability pensions one year after the intervention. Sensitivity analyses confirmed these results. CONCLUSIONS: The addition of problem-solving therapy to behavioral graded activity had supplemental value in employees with nonspecific low back pain.
RCT Entities:
OBJECTIVES: Given the individual and economic burden of chronic work disability in low back painpatients, there is a need for effective preventive interventions. The aim of the present study was to investigate whether problem-solving therapy had a supplemental value when added to behavioral graded activity, regarding days of sick leave and work status. DESIGN: Randomized controlled trial. PATIENTS AND SETTING: Employees who were recently on sick leave as a result of nonspecific low back pain were referred to the rehabilitation center by general practitioner, occupational physician, or rehabilitation physician. Forty-five employees had been randomly assigned to the experimental treatment condition that included behavioral graded activity and problem-solving therapy (GAPS), and 39 employees had been randomly assigned to behavioral graded activity and group education (GAGE). OUTCOME MEASURES: Days of sick leave and work status. Data were retrieved from occupational health services. RESULTS: Data analyses showed that employees in the GAPS group had significantly fewer days of sick leave in the second half-year after the intervention. Moreover, work status was more favorable for employees in this condition, in that more employees had a 100% return-to-work and fewer patients ended up receiving disability pensions one year after the intervention. Sensitivity analyses confirmed these results. CONCLUSIONS: The addition of problem-solving therapy to behavioral graded activity had supplemental value in employees with nonspecific low back pain.
Authors: Frederieke G Schaafsma; Karyn Whelan; Allard J van der Beek; Ludeke C van der Es-Lambeek; Anneli Ojajärvi; Jos H Verbeek Journal: Cochrane Database Syst Rev Date: 2013-08-30
Authors: Jordan F Karp; Bruce L Rollman; Charles F Reynolds; Jennifer Q Morse; Frank Lotrich; Sati Mazumdar; Natalia Morone; Debra K Weiner Journal: Pain Med Date: 2012-02-07 Impact factor: 3.750
Authors: Daniel P Alford; Jane Liebschutz; Ian A Chen; Christina Nicolaidis; Mukta Panda; Karina M Berg; Jennifer Gibson; Michael Picchioni; Matthew J Bair Journal: J Gen Intern Med Date: 2008-03-11 Impact factor: 5.128
Authors: Anne M May; Irene Korstjens; Ellen van Weert; Bart van den Borne; Josette E H M Hoekstra-Weebers; Cees P van der Schans; Ilse Mesters; Jan Passchier; Diederick E Grobbee; Wynand J G Ros Journal: Support Care Cancer Date: 2008-10-25 Impact factor: 3.603