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Open Access Predictors of return to work in patients sick listed for sub-acute low back pain: a 12-month follow-up study

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Objective: To investigate whether personal and work-related factors, physical performance and back-specific questionnaires predict return to work. Design: A prospective study identifying prognostic factors for return to work. Subjects: Ninety-three patients sick-listed for 8–12 weeks for non-specific sub-acute low back pain included in a randomized controlled trial. Methods: Patients were examined with regard to demographic variables, a battery of back-specific questionnaires and physical tests before entering a randomized controlled trial. A stepwise backward Cox regression model was established to identify the most powerful predictors. Results: During follow-up 78.5% of the patients have returned to full-time work. Fear-avoidance beliefs for work (relative risk (RR) for 1 SD change 0.49; 95% confidence interval (CI) 0.38–0.64), disability (RR 1.39, 95% CI 1.02–1.88) and cardiovascular fitness (RR 1.42, 95% CI 1.12–1.79) were identified as the best predictors for return to work. The prevalence of correct predictions was 69.3%. Conclusion: The predictors identified in the present study may reflect personal risk factors in a patient who gets acute low back pain. On the other hand, they may support that fear of pain and injury may be more disabling than pain itself, and that deconditioning is a result of altered behaviour reflecting attitudes towards low back pain in society, and information and advice given in primary healthcare.
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Keywords: long-term disability; low back pain; prognostic factors; return to work; sick leave; sub-acute

Document Type: Research Article

Affiliations: 1: Department of Sport Medicine, Norwegian School of Sport Sciences, Oslo, Norway 2: National Hospital, Oslo, Norway

Publication date: 2005-11-01

More about this publication?
  • Journal of Rehabilitation Medicine is the international peer-reviewed journal published in English, with at least 10 issues published per year.

    Original articles, reviews, case reports, short communications, special reports and letters to the editor are published, as also are editorials and book reviews. The journal strives to provide its readers with a variety of topics including: functional assessment and intervention studies, clinical studies in various patient groups, methodology in physical and rehabilitation medicine, epidemiological studies on disabling conditions and reports on vocational and sociomedical aspects of rehabilitation.

    The journal is read by a wide group of healthcare professionals including specialists in rehabilitation medicine, neurology, clinical neurophysiology, general medicine, psychologists, physiotherapists, occupational therapists and social workers.

    Contributions from all parts of the world and from different professions in rehabilitation are welcome.

    ISI Impact Factor 2009: 1.882.

    Owned by Foundation of Rehabilitation Information.

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