Predictors of return to work after multidisciplinary rehabilitation program for patients with chronic low back pain

IF 3.8 3区 医学 Q1 RHEUMATOLOGY Joint Bone Spine Pub Date : 2024-12-26 DOI:10.1016/j.jbspin.2024.105840
Stéphane Le Cam , Violaine Foltz , Bruno Fautrel , Florian Bailly
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Abstract

Introduction

Patients with chronic low back pain face functional, psychological, social and professional difficulties. Multidisciplinary rehabilitation programs (MRP) can be an effective treatment to help these patients to improve their condition and return to work.

Objective

To determine baseline predictors for return to work after an MRP for patients with chronic low back pain struggling to maintain their job.

Methods

A monocentric cohort study was conducted. Patients who had followed a MRP between January 2015 and December 2020 were included. The program consisted of physical activities and different workshops inspired by behavioural therapy, at full time during one month. Pain, lifestyle, history of the disease, function, psychosocial characteristics were evaluated at baseline. Return to work at different possible time point after the MRP was collected. A bivariate and a multivariate analysis were performed to evaluate which factors were associated with return to work.

Results

Overall, 251 patients were included. Professional status, duration off work, intensity of low back pain, self-perceived disability, fear-avoidance beliefs at work were associated with return to work after the MRP on bivariate analysis. Having worked in the past 6 months and the absence of high fear-avoidance beliefs at work at baseline were associated with return to work on multivariate analysis.

Discussion

This study suggests that patients with chronic low back pain and professional difficulties need to be included quickly in a MRP, with specific attention to beliefs about pain.
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慢性腰痛患者多学科康复计划后重返工作岗位的预测因素。
慢性腰痛患者面临着功能、心理、社会和专业方面的困难。多学科康复项目(MRP)是一种有效的治疗方法,可以帮助这些患者改善病情并重返工作岗位。目的:确定慢性腰痛患者努力维持工作的MRP后重返工作的基线预测因素。方法:采用单中心队列研究。纳入了2015年1月至2020年12月期间接受MRP的患者。该项目包括一个月的全天体育活动和受行为疗法启发的不同工作坊。在基线时评估疼痛、生活方式、病史、功能、心理社会特征。在MRP收集后的不同时间点返回工作岗位。进行了双变量和多变量分析,以评估哪些因素与重返工作岗位有关。结果:共纳入251例患者。双变量分析显示,职业状态、休息时间、腰痛强度、自我感知残疾、工作恐惧回避信念与MRP后重返工作岗位相关。多变量分析表明,过去6个月的工作经历和在基线时不存在高度恐惧回避信念与重返工作岗位有关。讨论:本研究表明,慢性腰痛和专业困难的患者需要迅速纳入MRP,特别注意对疼痛的信念。
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来源期刊
Joint Bone Spine
Joint Bone Spine 医学-风湿病学
CiteScore
4.50
自引率
11.90%
发文量
184
审稿时长
25 days
期刊介绍: Bimonthly e-only international journal, Joint Bone Spine publishes in English original research articles and all the latest advances that deal with disorders affecting the joints, bones, and spine and, more generally, the entire field of rheumatology. All submitted manuscripts to the journal are subjected to rigorous peer review by international experts: under no circumstances does the journal guarantee publication before the editorial board makes its final decision. (Surgical techniques and work focusing specifically on orthopedic surgery are not within the scope of the journal.)Joint Bone Spine is indexed in the main international databases and is accessible worldwide through the ScienceDirect and ClinicalKey platforms.
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