Article Text

AB1103 Multidisciplinary rehabilitation in chronic lumbar pain: Long-term effect on work status
  1. M. Norberg1,2,
  2. C. Schindler1
  1. 1Rehabilitation, Lavey Medical, Lavey-les-Bains
  2. 2DAL, CHUV, Lausanne, Switzerland


Background Chronic lumbar pain rests an expensive condition including direct and indirect costs. The most costly patients are them with a long sick-leave for more than 6 months, and with increasing time it is more and more difficult it is to bring them back to work.

In this situation, several treatment possibilities exist, but with long standing work absences a multidisciplinary group program has the best possibilities to function. When treating on the deconditioning situation there should be an increase of the return to work.

Objectives The aim of this study is to analyze the return to work, considering the psychological changes and the work status.

Methods We have studied the results of 300 of our patients that have accomplished a multi-disciplinary program and that have been followed over 24 months. The program contained physical training, occupational work hardening the hole in a cogntivo-comportemental approach.

We have analyzed the relationship between to the work capacity and its correlation with different pain questionnaires (VAS, Oswestry; Roland –Morris, Dallas pain questionnaire; SF-36, HADS and FABQ).

Results The first and most important parameter was the work capacity, comparing it before inclusion and at 24 months after completing the program. There was a clear increase, from 48% to 80.4% (p<0.01). Associated with this work capacity, we saw a real decrease in apprehensions and pain functioning.

There were a positive relationship between on pain questionnaires, with an Oswestry going from 36 to 14% at 24 months.

The return to work was not associated to an increase in physical performances but in an increase in apprehension.

Conclusions In chronic low back patients, with repeated work absences, a multidisciplinary rehabilitation program, with 72% that returned to work, with a global work capacity of 80.4%. The correlation was presented on the psychological part, with less apprehension and also increased global SF 36 values.

Then an increase in body confidence rests the important factor in these functional programs.

Disclosure of Interest None Declared

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