Document Detail


Physical exercise interventions to improve disability and return to work in low back pain: current insights and opportunities for improvement.
MedLine Citation:
PMID:  16254751     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: There is a body of literature that indicates that physical exercise interventions, with a primary focus on improvement of functioning instead of pain relief, might be effective to stimulate return to work and improve function in workers who are absent from work due to low back pain (LBP). Successful application and implementation of these interventions however, depends on multiple factors that need to be addressed carefully in clinical practice as well as research. METHODS: Descriptive literature review, to identify an overview of current knowledge with respect to the safety, content- and context-related aspects of physical exercise interventions, issues relating to timing, the influence of treatment confidence and patient expectations, and the process of changing provider and employer behavior. RESULTS: Physical exercises are not associated with an increased risk for recurrences. The effects of interventions may vary depending on content-related factors (i.e., type of exercises, dosage, frequency, skills of the healthcare providers, etc.) and contextual factors (i.e., treatment setting, compensation system, etc.). Treatment confidence and patients' expectations also significantly influence outcomes of physical exercise interventions. Timing is also important; interventions targeting return to work, applied during the acute phase of work absenteeism, compete with a high rate of spontaneous recovery and may therefore be inefficient. CONCLUSIONS: Despite numerous studies, more quantitative and qualitative investigations are needed to further clarify the requirements for a successful application and implementation of physical exercise interventions for disabled workers with low back pain.
Authors:
J Bart Staal; James Rainville; Julie Fritz; Willem van Mechelen; Glenn Pransky
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Journal of occupational rehabilitation     Volume:  15     ISSN:  1053-0487     ISO Abbreviation:  J Occup Rehabil     Publication Date:  2005 Dec 
Date Detail:
Created Date:  2005-10-28     Completed Date:  2006-01-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9202814     Medline TA:  J Occup Rehabil     Country:  United States    
Other Details:
Languages:  eng     Pagination:  491-505     Citation Subset:  IM    
Affiliation:
Department of Epidemiology, Maastricht University, 6200 MD, PO Box 616, Maastricht, The Netherlands. Bart.Staal@epid.unimaas.nl
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MeSH Terms
Descriptor/Qualifier:
Attitude to Health
Chronic Disease
Exercise*
Health Plan Implementation
Humans
Low Back Pain / rehabilitation*
Motivation
Occupational Diseases / rehabilitation*
Research

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