Effectiveness of three interventions for secondary prevention of low back pain in the occupational health setting - A randomised controlled trial with a natural course control

dc.contributorAalto-yliopistofi
dc.contributorAalto Universityen
dc.contributor.authorRantonen, J.en_US
dc.contributor.authorKarppinen, J.en_US
dc.contributor.authorVehtari, A.en_US
dc.contributor.authorLuoto, S.en_US
dc.contributor.authorViikari-Juntura, E.en_US
dc.contributor.authorHupli, M.en_US
dc.contributor.authorMalmivaara, A.en_US
dc.contributor.authorTaimela, S.en_US
dc.contributor.departmentDepartment of Computer Scienceen
dc.contributor.groupauthorHelsinki Institute for Information Technology (HIIT)en
dc.contributor.groupauthorProfessorship Vehtari Akien
dc.contributor.groupauthorProbabilistic Machine Learningen
dc.contributor.organizationUniversity of Helsinkien_US
dc.contributor.organizationSouth Karelia Social and Health Care Districten_US
dc.contributor.organizationFinnish Institute of Occupational Healthen_US
dc.contributor.organizationFinnish Institute for Health and Welfareen_US
dc.contributor.organizationUniversity of Ouluen_US
dc.date.accessioned2018-06-18T09:22:10Z
dc.date.available2018-06-18T09:22:10Z
dc.date.issued2018-12en_US
dc.description.abstractBackground: We assessed the effectiveness of three interventions that were aimed to reduce non-acute low back pain (LBP) related symptoms in the occupational health setting. Methods: Based on a survey (n = 2480; response rate 71%) on LBP, we selected a cohort of 193 employees who reported moderate LBP (Visual Analogue Scale VAS > 34 mm) and fulfilled at least one of the following criteria during the past 12 months: sciatica, recurrence of LBP ≥ 2 times, LBP ≥ 2 weeks, or previous sickness absence. A random sample was extracted from the cohort as a control group (Control, n = 50), representing the natural course of LBP. The remaining 143 employees were invited to participate in a randomised controlled trial (RCT) of three 1:1:1 allocated parallel intervention arms: multidisciplinary rehabilitation (Rehab, n = 43); progressive exercises (Physio, n = 43) and self-care advice (Advice, n = 40). Seventeen employees declined participation in the intervention. The primary outcome measures were physical impairment (PHI), LBP intensity (Visual Analogue Scale), health related quality of life (QoL), and accumulated sickness absence days. We imputed missing values with multiple imputation procedure. We assessed all comparisons between the intervention groups and the Control group by analysing questionnaire outcomes at 2 years with ANOVA and sickness absence at 4 years by using negative binomial model with a logarithmic link function. Results: Mean differences between the Rehab and Control groups were - 3 [95% CI -5 to - 1] for PHI, - 13 [- 24 to - 1] for pain intensity, and 0.06 [0.00 to 0.12] for QoL. Mean differences between the Physio and Control groups were - 3 [95% CI -5 to - 1] for PHI, - 13 [- 29 to 2] for pain intensity, and 0.07 [0.01 to 0.13] for QoL. The main effects sizes were from 0.4 to 0.6. The interventions were not effective in reducing sickness absence. Conclusions: Rehab and Physio interventions improved health related quality of life, decreased low back pain and physical impairment in non-acute, moderate LBP, but we found no differences between the Advice and Control group results. No effectiveness on sickness absence was observed. Trial registration: Number NCT00908102 Clinicaltrials.gov.en
dc.description.versionPeer revieweden
dc.format.mimetypeapplication/pdfen_US
dc.identifier.citationRantonen, J, Karppinen, J, Vehtari, A, Luoto, S, Viikari-Juntura, E, Hupli, M, Malmivaara, A & Taimela, S 2018, ' Effectiveness of three interventions for secondary prevention of low back pain in the occupational health setting - A randomised controlled trial with a natural course control ', BMC Public Health, vol. 18, no. 1, 598 . https://doi.org/10.1186/s12889-018-5476-8en
dc.identifier.doi10.1186/s12889-018-5476-8en_US
dc.identifier.issn1471-2458
dc.identifier.otherPURE UUID: fb1b59e5-19f1-4ae0-8cec-87240fb7ce64en_US
dc.identifier.otherPURE ITEMURL: https://research.aalto.fi/en/publications/fb1b59e5-19f1-4ae0-8cec-87240fb7ce64en_US
dc.identifier.otherPURE LINK: http://www.scopus.com/inward/record.url?scp=85046655514&partnerID=8YFLogxKen_US
dc.identifier.otherPURE FILEURL: https://research.aalto.fi/files/21520925/SCI_Rantonen_Effectiveness_of_three_BMCpublic_Health.pdfen_US
dc.identifier.urihttps://aaltodoc.aalto.fi/handle/123456789/31967
dc.identifier.urnURN:NBN:fi:aalto-201806183385
dc.language.isoenen
dc.relation.ispartofseriesBMC Public Healthen
dc.relation.ispartofseriesVolume 18, issue 1en
dc.rightsopenAccessen
dc.subject.keywordDisabilityen_US
dc.subject.keywordEarly managementen_US
dc.subject.keywordGraded activityen_US
dc.subject.keywordLBPen_US
dc.subject.keywordMultidisciplinaryen_US
dc.subject.keywordNatural course of LBPen_US
dc.subject.keywordPopulation baseden_US
dc.subject.keywordQuasi-randomised designen_US
dc.subject.keywordRCTen_US
dc.subject.keywordRehabilitationen_US
dc.subject.keywordSickness absenceen_US
dc.subject.keywordUsual careen_US
dc.titleEffectiveness of three interventions for secondary prevention of low back pain in the occupational health setting - A randomised controlled trial with a natural course controlen
dc.typeA1 Alkuperäisartikkeli tieteellisessä aikakauslehdessäfi
dc.type.versionpublishedVersion
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