Does a multidisciplinary intervention, with or without workplace intervention, have an impact on pain, functional status and return to work in employees suffering from (sub)acute low back pain? A systematic review
Year: 2022
Type: conference-paper
Study design: Systematic Review
Abstract: Background: Low back pain (LBP) is highlighted globally as the leading cause of disability and is characterised by enormous costs for society originating from e.g. healthcare use and work absenteeism. Early interventions with a multidisciplinary approach are recommended in the (sub)acute stage and integrating health and workplace management seems essential in reducing sick leave. Nevertheless, there are some uncertainties regarding recommendations for (sub)acute LBP and this may be due to the absence of multiple direct comparisons of the available multidisciplinary interventions. Purpose: The objective was to examine the effectiveness of a multidisciplinary intervention, with or without additional workplace intervention (WPI), for (sub)acute LBP among adults, with a focus on pain, functional status, return to work (RTW), or sick leave. Study design: Systematic Review. Methods: A comprehensive search in six electronic databases was completed (last search in June 2021). The methodological quality was assessed by using the RoB 2-tool for RCT studies and the ROBIS-tool for a systematic review. Relevant information was extracted from each included article and presented in an evidence table and a narrative synthesis of results was conducted. Results: A total of 12 studies were included of which 11 RCT studies and one systematic review. A multidisciplinary intervention has beneficial effects with regard to pain scores and functional status when compared to usual care. When compared with another intervention or an additional work intervention, the results were contradictory. Conflicting results were found with respect to work-related outcomes when compared to usual care. When compared with another intervention, the results do not appear to be more favourable but when an additional work intervention is considered, it might result in earlier work resumption compared to usual care. Lastly, subdividing patients at baseline is beneficial to assign them to the most effective therapy in order to favour early RTW. Discussion: Most important limitations of this study include: 3 articles with coherent samples, the lack of articles containing an additional WPI upon a multidisciplinary intervention and the difficulty to compare results due to high clinical heterogeneity in population and/or intervention. Conclusions: A multidisciplinary intervention has favourable effects compared with usual care regarding pain scores and functional status. Furthermore, adding a WPI to usual care as well as subdividing patients based on work-related characteristics might be beneficial for RTW. The evidential value of the conclusions is often not strong enough due to low evidence or too few studies. Future studies should focus more on investigating the effects of a multidisciplinary intervention in patients with (sub)acute LBP in combination with interventions at work.
Authors: Bernaers, Lisa, Cnockaert, Elise, Braeckman, Lutgart, Mairiaux, Philippe, Poot, Olivier, Willems, Tine
Language: English
Field: Health Professions
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7065383846