Karjalainen K, Malmivaara A, van Tulder M, Roine R, Jauhiainen M, Hurri H, Koes B
Finnish Institute of Occupational Health, Helsinki, Finland.
Spine (Phila Pa 1976). 2001 Feb 1;26(3):262-9. doi: 10.1097/00007632-200102010-00011.
A systematic review of randomized controlled trials was performed.
To evaluate the effectiveness of multidisciplinary biopsychosocial rehabilitation for subacute low back pain among working-age adults.
Multidisciplinary biopsychosocial rehabilitation programs are widely applied for patients with chronic low back pain. The multidisciplinary biopsychosocial approach for prolonged low back pain could be considered to prevent chronicity. Work site visits and a close relationship with occupational health care might produce results in terms of patients working ability.
Reviewed randomized controlled trials as well as controlled trials were identified from electronic bibliographic databases, reference checking, and consultation with experts in the rehabilitation field. Four blinded reviewers selected the trials. Two rehabilitation specialists evaluated the clinical relevance. Two other blinded reviewers extracted the data and assessed the main results along with the methodologic quality of the studies. A qualitative analysis was performed to evaluate the level evidence.
Of 1808 references, only 2 relevant studies were included. Both were considered to be methodologically low-quality randomized controlled trials. The clinical relevance of the studies was sufficient. The level of scientific evidence was moderate, showing that multidisciplinary rehabilitation involving work site visit or more comprehensive occupational health care intervention helps patients return to work faster, makes sick leaves less, and alleviates subjective disability.
There is moderate evidence showing that multidisciplinary rehabilitation for subacute low back pain is effective, and that work site visit increases the effectiveness, but because the analyzed studies had some methodologic shortcomings, an obvious need still exists for high-quality trials in this field.
进行了一项对随机对照试验的系统评价。
评估多学科生物心理社会康复对工作年龄成年人亚急性下背痛的有效性。
多学科生物心理社会康复计划广泛应用于慢性下背痛患者。对于持续性下背痛的多学科生物心理社会方法可被视为预防慢性化。工作场所访视以及与职业健康护理的密切关系可能会在患者工作能力方面产生成效。
从电子书目数据库、参考文献核对以及与康复领域专家咨询中识别出经过评审的随机对照试验以及对照试验。四名盲法评审员筛选试验。两名康复专家评估临床相关性。另外两名盲法评审员提取数据并评估主要结果以及研究的方法学质量。进行了定性分析以评估证据水平。
在1808篇参考文献中，仅纳入了2项相关研究。两者均被认为是方法学质量较低的随机对照试验。研究的临床相关性充分。科学证据水平为中等，表明涉及工作场所访视或更全面职业健康护理干预的多学科康复有助于患者更快重返工作岗位，减少病假，并减轻主观残疾。
有中等证据表明多学科康复对亚急性下背痛有效，且工作场所访视可提高有效性，但由于所分析的研究存在一些方法学缺陷，该领域仍明显需要高质量试验。
