A multidisciplinary rehabilitation programme for patients with chronic low back pain: a prospective study

PURPOSE

To examine the effectiveness of a multidisciplinary rehabilitation programme for patients with chronic low back pain in Hong Kong, and to identify factors associated with work resumption.

METHODS

57 men and 8 women aged 20 to 56 (mean, 39) years who had a more than 3-month history of low back pain and were unresponsive to more than 6 months of conventional treatment participated in a 14-week multidisciplinary rehabilitation programme involving physical conditioning, work conditioning, and work readiness. Training protocols entailed flexibility and endurance training, hydrotherapy, weight lifting, and work stimulation. Patients were assessed at baseline (week 1), week 7, week 14, and month 6 with regard to the intensity of low back pain, self-perceived disability, range of lumbar motion, isoinertial performance of the trunk muscles, and depression level. Patient demographics that influenced work resumption were identified using a prediction model. Patients who did and did not return to work were compared.

RESULTS

Of the 54 patients who completed all follow-up assessments, 28 returned to work and 26 did not. The latter was significantly older (37 vs. 42 years, p=0.038) and absent from work longer (11 vs. 22 months, p=0.029) than the former. The rehabilitation programme helped patients regain physical function and the ability to work. Patients who returned to work showed greater improvement in self-perceived disability and physical function.

CONCLUSION

This rehabilitation programme facilitated regain of physical functioning and the ability to return to work. The pre-programme employment status, duration of absence from work, and patient age were the most important predictors for work resumption.

Isokinetic and isometric lifting capacity of Chinese in relation to the physical demand of job

The aim of the study was to formulate normative data for the lifting capacities of a normal Chinese population, in order to establish a basic foundation for further studies and to investigate the relationship between individual attributes including age, gender, height, weight, job physical demand and each type of lifting capacity. Isokinetic and isometric lifting strength at low, waist and shoulder assessment levels were measured using the LIDO Workset II based on a sample of 93 normal Chinese adults (63 men and 30 women) between the ages of 21-51. The 50th percentile score for adult Chinese female's lifting strength was 17.71% lower than the American female while the adult Chinese male's lifting strength was 14.94% lower than the American male. Lifting forces were higher in the 20-40 year age group. The isometric work mode had considerable impact on the lifting capacities, with shoulder level having the highest lifting capacities. The gender and body weight had a significant positive correlation to lifting capacity while job physical demand had a moderate correlation. Age and body heights were weakly correlated to lifting capacity.