Department of Occupational and Environmental Medicine, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Denmark.
Department of Occupational and Social Medicine, Copenhagen University Hospital, Holbaek, Denmark.
Spine (Phila Pa 1976). 2021 Mar 15;46(6):347-355. doi: 10.1097/BRS.0000000000003793.
Randomized controlled trial with 1-year follow up.
The aim of this study was to assess whether people with low back pain (LBP) and self-reported physically demanding jobs, benefit from an occupational medicine intervention, in addition to a single hospital consultation and a magnetic resonance imaging, at 1 year of follow-up. Secondly, to examine whether the positive health effects, found in both groups at 6 months, persist at 1-year follow-up.
The prevalence of LBP is high in the working population, resulting in a substantial social and economic burden. Although there are many guidelines available on the management of LBP, including multidisciplinary biopsychosocial rehabilitation, they provide limited guidance on the occupational medicine aspects.
As reported previously, 305 participants with LBP and self-reported physically demanding jobs were enrolled in the randomized controlled study and randomly allocated to clinical care with additional occupational medicine intervention or clinical care alone. Data were collected at baseline, 6 months, and 1 year. Outcomes included in the present 1-year follow-up study are changes in neuropathic pain (painDETECT questionnaire), severity of pain (0-10 numerical rating scale), disability (Roland Morris Disability Questionnaire), fear-avoidance beliefs (FABQ), physical, and mental quality of life (short-form 36).
The study showed no effect of an occupational intervention on neuropathic pain, fear-avoidance beliefs, physical and mental quality of life nor disability measured after 1 year. The positive effects found at 6 months in both groups, remained at 1-year follow-up.
The results suggest that a thorough clinical consultation, with focus on explaining the cause of pain and instructions to stay active, can promote long-lasting physical and mental health in individuals with LBP. Therefore, additional occupational interventions could focus on altering occupational obstacles on a structural level.Level of Evidence: 2.
随机对照试验，随访 1 年。
本研究旨在评估腰痛（LBP）患者和自我报告体力要求高的工作者是否能从职业医学干预中获益，该干预在 1 年随访时除了单次医院就诊和磁共振成像（MRI）外还增加了职业医学干预。其次，检查在 6 个月时两组均发现的积极健康效应是否在 1 年随访时持续存在。
腰痛在工作人群中的发病率很高，导致了巨大的社会和经济负担。尽管有许多关于腰痛管理的指南，包括多学科生物心理社会康复，但它们对职业医学方面的指导有限。
如前所述，305 名腰痛且自我报告体力要求高的工作者参加了这项随机对照研究，并被随机分配到临床护理加额外的职业医学干预或仅临床护理组。数据在基线、6 个月和 1 年时收集。本 1 年随访研究包括变化的神经性疼痛（疼痛 DETECT 问卷）、疼痛严重程度（0-10 数字评分量表）、残疾（Roland Morris 残疾问卷）、恐惧回避信念（FABQ）、身体和心理健康（短式 36）。
该研究显示职业干预对神经性疼痛、恐惧回避信念、身体和心理健康或残疾在 1 年后没有影响。两组在 6 个月时发现的积极影响在 1 年随访时仍然存在。
结果表明，彻底的临床咨询，重点是解释疼痛的原因和保持活动的指导，可以促进腰痛患者的身心健康的长期改善。因此，额外的职业干预可以集中在改变结构性的职业障碍上。
2 级。
