Indahl A, Haldorsen E H, Holm S, Reikerås O, Ursin H
Spine Clinic, Ostfold Central Hospital, Fredrikstad, Norway.
Spine (Phila Pa 1976). 1998 Dec 1;23(23):2625-30. doi: 10.1097/00007632-199812010-00018.
A controlled clinical trial.
To examine the long-term effect of an informative approach to low back pain.
In management and prevention of low back pain, back school based on an ergonomic approach have played in important role. The effect of such informative interventions is not clear.
A 5-year follow-up study was done on patients included in a previous study. The outcome was measured by return to work or still on sick leave. The patients were allocated to an intervention group (n = 245) and a control group (n = 244). Only the intervention group was called in for examination and intervention and answered a battery of tests for psychological and health factors. The intervention apart from the clinical examination consisted of education in an "mini back school." The program was based on a new medical model for low back pain.
Forty-seven (19%) of the patients in the intervention group, compared with 84 patients (34%) in the control group, were still on sick leave after 5 years (P < 0.001). There were fewer recurrences of sick leave (P < 0.03) in the intervention group than in the control group. Based on Internal Health Locus of Control, number of children, and income, 75% were correctly classified as nonreturners in the intervention group.
This study indicates that subchronic low back pain may be managed successfully with an approach that includes clinical examination combined with information for patients about the nature of the problem, provided in a manner designed to reduce fear and give them reason to resume light activity.
一项对照临床试验。
探讨一种针对腰痛的信息告知方法的长期效果。
在腰痛的管理和预防中,基于人体工程学方法的康复培训发挥了重要作用。此类信息干预的效果尚不清楚。
对先前研究中纳入的患者进行了为期5年的随访研究。通过重返工作岗位或仍在休病假来衡量结果。将患者分为干预组(n = 245)和对照组(n = 244)。仅干预组被召集进行检查和干预,并回答一系列心理和健康因素测试。除临床检查外,干预措施包括在“小型康复培训”中进行教育。该项目基于一种新的腰痛医学模型。
5年后,干预组中有47名患者(19%)仍在休病假,而对照组中有84名患者(34%)仍在休病假(P < 0.001)。干预组的病假复发率低于对照组(P < 0.03)。根据内控性、子女数量和收入情况,干预组中75%的患者被正确分类为未重返工作岗位者。
本研究表明,亚慢性腰痛可以通过一种包括临床检查以及向患者提供有关问题性质的信息的方法成功管理,提供信息的方式旨在减少恐惧并让他们有理由恢复轻度活动。