Article Text

SAT0426 Decreased Apprehension in Chronic Lumbar Pain : Accelerates Return to Work
  1. M. Norberg1,2,
  2. C. Schindler3
  1. 1Rehabilitation, Medical Center, Lavey-les-Bains
  2. 2DAL, CHUV, Lausanne
  3. 3rehabilitation, Lavey Medical, Lavey-les-Bains, Switzerland


Background Chronic lumbar pain is expensive according direct and indirect costs. The most costly patients are them with sick-leave of more than 6 months. Several studies have showed grooving interest in rehabilitation models working on increased self confidence in these patients: one possibility is a multidisciplinary rehabilitation program. It treats the deconditioning situation on a interdisciplinary way.

Objectives The aim of this study is to analyze the impact of a decrease of apprehension and its impact on work capacity over 2 years.

Methods We have studied the results of 520 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 evolution of apprehension during time according to different pain and apprehension questionnaires (FABQ and Tampa scale (TSK); PACT evaluating the subjective work capacity).

Results We saw a clear increase in the global work capacity, 24 months after completing the program: passing from 40 to 80.4%. In parallel there was an increase in the subjective sensation of physical capacity (Pact). This increase was correlated with a decrease in fear-avoidance evaluation according to the Fabq, and in the TSK.

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

Conclusions In chronic low back patients, with repeated work absences, a multidisciplinary rehabilitation program, has a positive effect on the apprehension. This correlation was presented on the psychological part, with less apprehension and also increased global SF 36 values. It brings a clear increase in work ability.

In fact an increase in body confidence rests the important factor in these functional restoration programs.

Disclosure of Interest None Declared

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