A multidisciplinary functional restoration program for patients with chronic back pain

Abstract

INTRODUCTION: To examine the effectiveness of a multidisciplinary functional restoration program for patients with chronic low back pain and to identify factors that can predict the vocational outcomes. METHODS: Sixty-five chronic low back pain subjects who have been off work for 16.6 ± 21.4 months (range: 0 to 20 months) participated in a 12-week multidisciplinary treatment program. Assessment was conducted at the start (baseline), midway, end of the program, and at a 6-month follow-up. Based on their vocational outcomes, the subjects were classified into the return-to-work and the not-return-to-work groups. Demographic data and baseline measurements were identified and tested as outcome predictors. RESULTS: No significant pain reduction or improvement in the psychological performance was demonstrated during the training period. Interestingly, significant pain reduction was observed at the 6-month follow-up. The rehabilitation program effectively helped regain physical function and the ability to work. 52% of the program graduates returned to work after the 6-month follow-up, and they showed more improvement in self-perception of disability and physical function compared to the not-return-to-work group. The pre-program employment status and age of the participants were the most important predictors for the vocational outcomes. The prediction model correctly classified 71% and 77% of the program graduates who returned or did not return to work, respectively. DISCUSSION: The rehabilitation program was effective in regaining the physical function and the ability to return to work. The pre-program employment status and age of the participants were the most important predictors for the vocational outcomes of the program graduates.