OBJECTIVE: To identify subgroups of workers absent from work due to low back pain who are more or less likely to return to work earlier as a result of a graded activity intervention, and to investigate whether this intervention is effective in reducing pain-related fears and if so, whether these reductions in pain-related fears mediate return to work. METHODS: A subgroup analysis was conducted on data from a previous randomized controlled trial of 134 Dutch airline workers, which found that a behaviorally-oriented graded activity intervention was more effective than usual care in stimulating return to work. The subgroup analyses added interaction terms to a Cox regression model that described the relationship between treatment allocation and return to work over 12 months of followup. Furthermore, we studied the effects of graded activity on pain-related fears and added variables indicating a reduction in pain-related fears to the model in order to investigate their influence on return to work. RESULTS: Statistically significant interactions were found for disability, fear-avoidance beliefs about physical activity, and fear-avoidance beliefs about work. No indication was found that the reduction in pain-related fears in the graded activity group mediated more favorable return-to-work results in this group. CONCLUSION: Workers who perceive their disability to be moderate and workers with moderate scores for fear-avoidance beliefs return to work more rapidly as a result of the graded activity intervention than workers with higher scores. The return to work of workers receiving the graded activity intervention is possibly independent from the reductions in pain-related fears caused by this intervention.
RCT Entities:
OBJECTIVE: To identify subgroups of workers absent from work due to low back pain who are more or less likely to return to work earlier as a result of a graded activity intervention, and to investigate whether this intervention is effective in reducing pain-related fears and if so, whether these reductions in pain-related fears mediate return to work. METHODS: A subgroup analysis was conducted on data from a previous randomized controlled trial of 134 Dutch airline workers, which found that a behaviorally-oriented graded activity intervention was more effective than usual care in stimulating return to work. The subgroup analyses added interaction terms to a Cox regression model that described the relationship between treatment allocation and return to work over 12 months of followup. Furthermore, we studied the effects of graded activity on pain-related fears and added variables indicating a reduction in pain-related fears to the model in order to investigate their influence on return to work. RESULTS: Statistically significant interactions were found for disability, fear-avoidance beliefs about physical activity, and fear-avoidance beliefs about work. No indication was found that the reduction in pain-related fears in the graded activity group mediated more favorable return-to-work results in this group. CONCLUSION: Workers who perceive their disability to be moderate and workers with moderate scores for fear-avoidance beliefs return to work more rapidly as a result of the graded activity intervention than workers with higher scores. The return to work of workers receiving the graded activity intervention is possibly independent from the reductions in pain-related fears caused by this intervention.
Authors: Keith T Palmer; Elizabeth C Harris; Cathy Linaker; Mary Barker; Wendy Lawrence; Cyrus Cooper; David Coggon Journal: Rheumatology (Oxford) Date: 2011-03-16 Impact factor: 7.580
Authors: Hanneke Poort; Constans A H H V M Verhagen; Marlies E W J Peters; Martine M Goedendorp; A Rogier T Donders; Maria T E Hopman; Maria W G Nijhuis-van der Sanden; Thea Berends; Gijs Bleijenberg; Hans Knoop Journal: BMC Cancer Date: 2017-01-28 Impact factor: 4.430
Authors: K L Cullen; E Irvin; A Collie; F Clay; U Gensby; P A Jennings; S Hogg-Johnson; V Kristman; M Laberge; D McKenzie; S Newnam; A Palagyi; R Ruseckaite; D M Sheppard; S Shourie; I Steenstra; D Van Eerd; B C Amick Journal: J Occup Rehabil Date: 2018-03