Bontoux L, Roquelaure Y, Billabert C, Dubus V, Sancho P O, Colin D, Brami L, Moisan S, Fanello S, Penneau-Fontbonne D, Richard I
Services de médecine physique et de réadaptation, CRRRF-CHU, 49103 Angers, France.
Ann Readapt Med Phys. 2004 Oct;47(8):563-72. doi: 10.1016/j.annrmp.2004.03.006.
Evaluation of 1-year outcome after patients with chronic low back pain participated in an intensive functional restoration program associated with an ergonomic intervention on the workplace. Study of the factors predicts a return to work.
Prospective study of a cohort of 87 patients face major difficulties due to low back pain at work. Patients who visited a multidisciplinary clinic were included. Parameters, evaluating physical and psychological status, quality of life, presence at work, length of sick leaves, were determined before and after the program and at 6 and 12 months' followup. The correlation between these parameters and presence at work at 1 year was studied.
A total of 86 patients completed the program; three were lost to followup at 1 year. Ergonomic interventions were tried in 53 patients. All parameters were improved at the end of the program and remained significantly improved at 12 months. A total of 90% of the patients returned to work at the end of the program, whereas only 17% were at work before; 72% were at work in 1 year. The number of sick leave days decreased by 60%. The Dallas index at the beginning and the end of the program, the number of sick leave days before the program and score on the item "feels able to work" correlated with the presence at work in 1 year. There was no correlation between presence at work and physical parameters.
This study shows the effect of the program and determines factors predictive of successful return to work for patients with chronic low back pain. Further data are necessary to discuss the specific effect of ergonomic interventions.
评估慢性下背痛患者参加与工作场所人体工程学干预相关的强化功能恢复计划一年后的结果。研究预测重返工作岗位的因素。
对87名因工作中腰背痛而面临重大困难的患者进行前瞻性队列研究。纳入到多学科诊所就诊的患者。在计划前后以及随访6个月和12个月时，确定评估身体和心理状况、生活质量、工作出勤情况、病假时长的参数。研究这些参数与1年后工作出勤情况之间的相关性。
共有86名患者完成了该计划；3名患者在1年随访时失访。对53名患者进行了人体工程学干预。计划结束时所有参数均有所改善，并在12个月时仍显著改善。共有90%的患者在计划结束时重返工作岗位，而之前只有17%的患者在工作；72%的患者在1年后工作。病假天数减少了60%。计划开始和结束时的达拉斯指数、计划前的病假天数以及“感觉能够工作”项目的得分与1年后的工作出勤情况相关。工作出勤情况与身体参数之间无相关性。
本研究显示了该计划的效果，并确定了慢性下背痛患者成功重返工作岗位的预测因素。需要更多数据来讨论人体工程学干预的具体效果。
