6533b7ddfe1ef96bd12748e1

RESEARCH PRODUCT

Effectiveness of training in guideline-oriented biopsychosocial management of low-back pain in occupational health services – a cluster randomized controlled trial

Jaro KarppinenAnna Sofia SimulaKatja RyynänenNeill BoothMikko LausmaaRiikka HolopainenMaija PaukkunenPetteri OuraJouko RemesAntti Malmivaara

subject

Biopsychosocial modelmedicine.medical_specialtytyöterveyshuoltocluster randomized controlled trialOccupational Health Servicespsykososiaaliset tekijätrisk stratificationoccupational health servicebiopsychosocialOccupational safety and healthlaw.inventionlow-back painRandomized controlled trialselkäsairaudetimplementation researchlawSurveys and QuestionnairesmedicineHumanspainSjukgymnastikPhysiotherapyPain Measurementtrainingbusiness.industryimplementation research; risk stratification; STarT Back Tool; Orebro Musculoskeletal Pain Screening Questionnairestart back toolPublic Health Environmental and Occupational HealthGuidelinemedicine.diseaseLow back pain3142 Public health care science environmental and occupational healthConfidence intervalExercise TherapyOswestry Disability IndexRadicular painoccupational healthPhysical therapykrooninen kipuörebro musculoskeletal pain screening questionnaireOriginal ArticlekuntoutusPublic aspects of medicineRA1-1270medicine.symptombusinessLow Back PainSTarT Back ToolÖrebro Musculoskeletal Pain Screening Questionnaire

description

Objective This study aimed to investigate the effectiveness of brief training in the guideline-oriented biopsychosocial management of low-back pain (LBP) in occupational health services using a cluster-randomized design. A small sample of physiotherapists and physicians from the intervention units (N=12) were given three- to seven-day training focusing on the biopsychosocial management of LBP, while professionals in the control units (N=15) received no such training. Methods Eligible patients with LBP, with or without radicular pain, aged 18-65, were invited to participate. A web-based questionnaire was sent to all recruited patients at baseline, three months and one year. The primary outcome measure was disability (Oswestry Disability Index, ODI) over one year. Between-group differences were analyzed using linear and generalized linear mixed models adjusted for baseline-response delay as well as variables showing between-group imbalance at baseline. Results The final study sample comprised 234 and 81 patients in the intervention and control groups, respectively at baseline, and 137 and 47 patients, respectively, at one year. At baseline, the mean duration of pain was longer in the intervention group (P=0.017), and pain-related fear concerning physical activity was lower (P=0.012). We observed no significant difference between the groups primary outcome measure (adjusted one-year mean difference in the ODI: 2.3; 95% confidence interval -1.0-5.7; P=0.175) or most secondary outcomes. Conclusions Brief training in guideline-oriented biopsychosocial management of LBP for occupational health professionals did not appear to be effective in reducing patients symptom over one-year follow-up compared to treatment as usual. Funding Agencies|Finnish Work Environment Fund; Finnish Institute of Occupational Health; Rokua Health and Rehabilitation Foundation; University of Oulu, Oulu, Finland

yearjournalcountryeditionlanguage
2021-01-01Scandinavian Journal of Work, Environment & Health
https://doi.org/10.5271/sjweh.3959