Schonstein Eva, Kenny D, Keating J, Koes B, Herbert R D
School of Physiotherapy, Faculty of Health Sciences, The University of Sydney, New South Wales, Australia.
Spine (Phila Pa 1976). 2003 Oct 1;28(19):E391-5. doi: 10.1097/01.BRS.0000092482.76386.97.
To determine the effect on time lost from work of physical conditioning programs for workers with back and neck pain. DATA SOURCES Randomized trials were located by searching MEDLINE, EMBASE, CINAHL, PsycINFO, the Cochrane Controlled Trial Register, and PEDro.
Two reviewers independently extracted data and assessed trial quality. Where data could be pooled, meta-analysis was performed. Based on cost considerations, we nominated a mean saving of 10 sick days per year or a number needed to treat to return 1 person to work of 10 as the smallest treatment effects that would be clinically worthwhile.
Nineteen trials in 21 publications yielded 23 contrasts relevant to this review. These trials provide evidence that physical conditioning programs that included a cognitive-behavioral approach could produce a clinically worthwhile reduction in the number of sick days taken at 12 months (average of 45 days; 95% confidence interval 3-88) when compared to general practitioner care or advice for workers with chronic back pain. There was little evidence of an effect on time lost from work of specific exercise programs that did not include a cognitive-behavioral component.
Physical conditioning programs that incorporate a cognitive-behavioral approach reduce the number of sick days for workers with chronic back pain when compared to usual care.
确定针对背痛和颈痛工人的体能训练计划对工作缺勤时间的影响。数据来源 通过检索MEDLINE、EMBASE、CINAHL、PsycINFO、Cochrane对照试验注册库和PEDro找到随机试验。
两名综述员独立提取数据并评估试验质量。在数据可以合并的情况下，进行荟萃分析。基于成本考虑，我们将每年平均节省10个病假或使1人恢复工作所需治疗人数为10作为临床上值得的最小治疗效果。
21篇出版物中的19项试验产生了23项与本综述相关的对比。这些试验提供的证据表明，与针对慢性背痛工人的全科医生护理或建议相比，包含认知行为方法的体能训练计划在12个月时可使病假天数在临床上显著减少（平均45天；95%置信区间3 - 88）。几乎没有证据表明不包含认知行为成分的特定锻炼计划对工作缺勤时间有影响。
与常规护理相比，纳入认知行为方法的体能训练计划可减少慢性背痛工人的病假天数。
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