A Multidisciplinary Rehabilitation Programme for Patients with Chronic Low Back Pain: A Prospective Study

• Published in: Journal of orthopaedic surgery (Hong Kong) Vol. 18; no. 2; pp. 131 - 138
• Main Authors: Luk, Keith Dip Kei, Wan, Thomas Wai Man, Wong, Yat Wa, Cheung, Kenneth Man Chee, Chan, Keith Ying Kei, Cheng, Aldous Chun Shing, Kwan, Mike Wing Wang, Law, Karlen Kar Pui, Lee, Peter Wing Ho, Cheing, Gladys Lai Ying
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01.08.2010; Sage Publications Ltd; SAGE Publishing
• Subjects: Adult; Back pain; Chronic Disease; Cultural differences; Disability Evaluation; Disabled Persons - rehabilitation; Exercise Therapy - methods; Female; Follow-Up Studies; Humans; Low Back Pain - rehabilitation; Male; Medical research; Middle Aged; Orthopedics; Pain Measurement; Prospective Studies; Quality of life; Rehabilitation; Rehabilitation, Vocational - methods; Time Factors; Treatment Outcome; Young Adult; rehabilitation, vocational; resistance training; muscle stretching exercises; exercise therapy; back injuries; low back pain
• ISSN: 1022-5536; 2309-4990
• DOI: 10.1177/230949901001800201

Purpose. To examine the effectiveness of a multidisciplinary rehabilitation programme for patients with chronic low back pain in Hong Kong, and to identify factors associated with work resumption. Methods. 57 men and 8 women aged 20 to 56 (mean, 39) years who had a >3-month history of low back pain and were unresponsive to >6 months of conventional treatment participated in a 14-week multidisciplinary rehabilitation programme involving physical conditioning, work conditioning, and work readiness. Training protocols entailed flexibility and endurance training, hydrotherapy, weight lifting, and work stimulation. Patients were assessed at baseline (week 1), week 7, week 14, and month 6 with regard to the intensity of low back pain, self-perceived disability, range of lumbar motion, isoinertial performance of the trunk muscles, and depression level. Patient demographics that influenced work resumption were identified using a prediction model. Patients who did and did not return to work were compared. Results. Of the 54 patients who completed all follow-up assessments, 28 returned to work and 26 did not. The latter was significantly older (37 vs. 42 years, p=0.038) and absent from work longer (11 vs. 22 months, p=0.029) than the former. The rehabilitation programme helped patients regain physical function and the ability to work. Patients who returned to work showed greater improvement in self-perceived disability and physical function. Conclusion. This rehabilitation programme facilitated regain of physical functioning and the ability to return to work. The pre-programme employment status, duration of absence from work, and patient age were the most important predictors for work resumption.