Managing Psychosocial Contributors in Low Back Pain Patients—A Randomised Controlled Trial

IntroductionThe efficacy of integrated physiotherapy work rehabilitation program to occupational non-specific low back pain (NSLBP) patients triaged by Orebro Musculoskeletal Pain Questionnaire (OMPQ) for psychosocial risks was investigated.Methods47 subjects were recruited and randomly allocated to either the integrated physiotherapy group or the conventional group. Red flags signs were screened out. The range of the age of the patients was between 18 and 55. They either had history injuries at work or were on sick leave upon recruitment with moderate psychosocial risk.ResultsStatistics was performed on an intention-to-treat analysis. At discharge, the patients of integrated physiotherapy group displayed significant improvement of work recovery expectation, pain self-efficacy, overall subjective progress and satisfaction in comparison with the conventional group (p < 0.05). Both groups demonstrated significant improvement of all outcome measures except the recovery expectation showed no difference in the conventional group.ConclusionThe work related treatment components of integrated physiotherapy group adopted a cognitive behavioral approach may contribute to better improvement.

中文摘要介紹為探討綜合工作復康物理治療方案，對治療透過由厄勒布魯肌肉筋骨痛楚問卷 (Orebro Musculoskeletal Pain Questionnaire)分類為附有心理社會促成因素的職業非特定性下腰痛患者之成效。方法共邀請了47名患者作研究，隨機分配接受綜合工作復康物理治療或常規物理治療。有 “紅旗” 徵兆風險的疾病已被排除，患者的年齡介乎18至55歲，他們不是有工傷病史的就是正在放病假及附有中度的心理社會促成因素。結果統計採用了治療意向分析法 (intention to treat)。治療後, 綜合工作復康物理治療小組的患者在康復期望、疼痛的自我效能感、整體進展及滿意程度，與常規物理治療小組比較，都有顯著的改善(p < 0.05)。另外，除了常規物理治療小組對康復期望沒有顯著的差別外，兩組在其他治療成效的測量上同樣展示了明顯的改善。結論綜合工作復康物理治療方案，是以行為認知方式並加入和工作相關的治療內容，這可能是其獲得更好改善的原因。