Subacute and Chronic, Non-specific Back and Neck Pain: Cognitive-behavioral Rehabilitation Compared With Traditional Primary Care Concerning Sick-listing and Health-care Visits. A Randomized Controlled Trial, 18-month Follow-up
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 125
- 试验地点
- 2
- 主要终点
- Return-to-work=the proportion of patients who during 1-18 months regained a degree of work ability>0 for at least 30 days in succession.
研究概览
简要总结
BACKGROUND
Non-specific back and neck pain (BNP) dominates sick-listing. A program of cognitive-behavioral rehabilitation for subacute and chronic BNP was compared, with 18-month follow-up, with traditional primary care concerning sick-listing and health-care visits.
METHODS
After stratification to age (44 (years) and younger/45 and older) and subacute/chronic BNP (= full-time sick-listed 43-84/85-730 days respectively), 125 primary-care patients were randomized to a rehabilitation center or continued health-center care. Outcome measures were Return-to-work (=the proportion who regained work ability for at least 30 consecutive days), the proportion with Work ability at different time points, Total sick-listing (expressed in whole days) and the total number of Visits (to physicians, physiotherapists etc.) 1-18 months and corresponding six-month periods. For the analyses were used t-test, z-test, generalized estimating equations and a mixed, linear model.
详细描述
Numbers within parenthesis refers to the place of order in the citation list and within brackets in the link list below.
B A C K G R O U N D
In Sweden, as all over the industrial world, unspecific back and neck pain (BNP) dominates sick-listing (1). Primary care is the appropriate source of treatment of most patients with BNP (2). However, the Swedish traditional primary care lacks the capacity of such an assignment [1]. While the number of practicing physicians is in line with OECD standards, Sweden has, relatively seen, few physicians within primary care. Our overall aim was to compare a program of cognitive-behavioral-rehabilitation at a rehabilitation center for patients with subacute and chronic BNP with traditional primary care. The specific aim of this study was to answer the question: Will the outcome, with an 18-month follow-up, differ concerning sick-listing and number of health-care visits?
M E T H O D S
PARTICIPANTS: One-hundred-and-twenty-five patients were recruited by 42 family doctors at 12 health centers.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 59 Years（Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Working age up to and including 59 years.
- •Sick-listed full-time for BNP for at least 42 days and at most 730 days.
- •Able to manage tolerably well to fill in forms.
排除标准
- •Temporary disability pension or disability pension being paid or in preparation.
- •A primary need of action by a hospital specialist.
- •Pregnancy and diseases which would probably make rehabilitation impracticable (for example, advanced pulmonary disease).
- •Whiplash-associated disorders as a primary obstacle to working.
- •Previous rehabilitation at the rehabilitation centre.
- •Other multidisciplinary rehabilitation going on or planned.
结局指标
主要结局
Return-to-work=the proportion of patients who during 1-18 months regained a degree of work ability>0 for at least 30 days in succession.
时间窗: 18 months.
次要结局
- Work ability (=the proportion with work ability>0). Total sick-listing=the sum of sick-listing of any degree, expressed in whole days. Visits=the total number of consultations to different health-care staff, for example, physicians or physiotherapists.(Work ability: 18 months. Total sick-listing: 36 months (18 months preceding and after inclusion). Visits: 18 months.)