Return to work following an aquafitness and muscle strengthening program for the low back injured.

Our purpose, in this prospective clinical study, was to identify the best predictors of 2-month return to work or retraining for a group of low back injured subjects (n = 40) who completed at least 8 weeks of a community-based rehabilitation program that combined aerobic and flexibility exercise conducted in the water (aquafitness) with muscle strength and endurance training. Baseline demographic characteristics and changes in physical fitness, pain, disability, and psychological well-being during the course of program participation were compared between two groups of low back injured subjects: those who returned to work (RTW) [n = 24], and those who did not (N-RTW) [n = 16]. Subjects in both groups showed comparable improvement in measures of physical fitness at 8 weeks. However, multivariate analyses showed significant between-group differences in self-report measures. The RTW group showed significant improvement in measures of pain, disability, anxiety, and vigor while self-esteem and affect remained stable. The N-RTW group displayed no change in pain and disability variables and had significant deterioration in mean overall psychological well-being over time. The best predictors of return to work using logistic regression analyses were a first injury rather than a repeat injury to the lower back, and stability in self-esteem. Suggestions are offered for further research to examine the benefits of aquafit exercise for the low back injured, for additional interventions for those with a reinjury, and for maintaining or enhancing self-esteem as a treatment goal.