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An Educational and Exercise Program as Secondary Prevention of Recurrent Lower Back Pain in Healthcare Workers

Not Applicable
Completed
Conditions
Acute Low Back Pain
Interventions
Other: educational program
Other: exercise program
Other: Self-led exercises
Registration Number
NCT00782925
Lead Sponsor
Hospices Civils de Lyon
Brief Summary

At Lyon University Medical Center, back problems are the leading cause of sick leave. The course of lower back pain is usually relatively short (recovery occurs within 4 to 6 weeks in 90% of cases). However, about 5-10% develop chronic lower back pain. Although this is a relatively small group, the economic consequences are enormous (accounting for 70 to 80% of the total cost of lower back pain).

Nowadays, some very general training sessions are offered to workers at Lyon University Medical Center, irrespective of their lower back pain status. These very general training sessions are mostly preventive and primary in nature (like back school program) despite the fact that these people already have a history of lower back pain, the main risk factor of recurrence and chronic pain.

Since the 1980, some multidisciplinary functional restoration programs have been advised as a strategy for secondary and tertiary prevention of lower back pain.

The purpose of this randomized controlled trial is to assess the effectiveness of physical exercise combined with an educational program and self-led exercise for Lyon University Medical Center workers with lower back pain. We hope this intervention will reduce the risk of recurrence and chronic lower back pain.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
351
Inclusion Criteria
  • All healthcare workers in the 4 hospital sites
  • History of acute or subacute lower back pain in the 3 past years
Exclusion Criteria
  • History of surgery for spinal fractures
  • History of lumbosacral arthrodesis
  • History of surgical intervention or discal hernia, more than 2 levels or more than twice
  • Radiculalgia with sign of motor deficit, or radiculalgia with a positive Lasègue sign
  • Eligible for enrollement in a functional restoration program for lower back pain
  • Ongoing low back pain (lumbago)
  • Psychosocial or behavioural impairment
  • Unstable cardiac disease
  • Inability to fill out the questionnaires and scales (inability to understand French)
  • Pregnancy

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
1Self-led exercisesStudy intervention: * A face/profile X-ray of their entire spine at baseline * Educational program * Exercise program * Self-led exercises * A follow-up at 12 and 24 months with their occupational therapist. * A follow-up at 18 months with a physical therapist. * Workers received also at the end of the educational program written standardized information about back pain ("the back book", an information booklet) 1. 1. Coudeyre E., Tubach F., Rannou F. \& all, Effect of simple information booklet on pain persistance after an acute episode of low back pain: a non- randomised trial in a primary care setting. PLoS ONE. 2007 ; 2 : e706
1educational programStudy intervention: * A face/profile X-ray of their entire spine at baseline * Educational program * Exercise program * Self-led exercises * A follow-up at 12 and 24 months with their occupational therapist. * A follow-up at 18 months with a physical therapist. * Workers received also at the end of the educational program written standardized information about back pain ("the back book", an information booklet) 1. 1. Coudeyre E., Tubach F., Rannou F. \& all, Effect of simple information booklet on pain persistance after an acute episode of low back pain: a non- randomised trial in a primary care setting. PLoS ONE. 2007 ; 2 : e706
1exercise programStudy intervention: * A face/profile X-ray of their entire spine at baseline * Educational program * Exercise program * Self-led exercises * A follow-up at 12 and 24 months with their occupational therapist. * A follow-up at 18 months with a physical therapist. * Workers received also at the end of the educational program written standardized information about back pain ("the back book", an information booklet) 1. 1. Coudeyre E., Tubach F., Rannou F. \& all, Effect of simple information booklet on pain persistance after an acute episode of low back pain: a non- randomised trial in a primary care setting. PLoS ONE. 2007 ; 2 : e706
Primary Outcome Measures
NameTimeMethod
Percentage of patients with recurrence(s) of lower back pain (number of related days of sick leave) over 12 months and 24 months12 and 24 months
Secondary Outcome Measures
NameTimeMethod
Recurrences of lower back painAt baseline, 12 and 24 months after intervention
Percentage of patients with a chronic lower back pain (sick leave days>3 months)At baseline, 12 and 24 months after intervention
Participant compliance with the global prevention program (self-led exercises)At 6 and 12 months after intervention
Depression and anxiety (HAD scale)At baseline, 12 and 24 months after intervention
Delay before a recurrence of lower back painAt baseline, 12 and 24 months after intervention
Fear-avoidance beliefs(FABQ scale)At baseline, 12 and 24 months after intervention
Quality of life (SF-12 scale)At baseline, 12 and 24 months after intervention
Lower back functionAt baseline, 12 and 24 months after intervention
Pain : characteristics, intensity (Quebec Back Pain Disability Scale)At baseline, 12 and 24 months after intervention
sagittal alignement of the spine (X-ray)At baseline

Trial Locations

Locations (1)

Hospices Civils de Lyon

🇫🇷

Lyon, France

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