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Functional multidisciplinary rehabilitation versus outpatient physiotherapy for non-specific low back pain: randomised controlled trial
INTRODUCTION: In recent decades the treatment of non-specific low back pain has turned to active modalities, some of which were based on cognitive-behavioural principles. Non-randomised studies clearly favour functional multidisciplinary rehabilitation over outpatient physiotherapy. However, systematic reviews and meta-analysis provide contradictory evidence regarding the effects on return to work and functional status. The aim of the present randomised study was to compare long-term functional and work status after 3-week functional multidisciplinary rehabilitation or 18 supervised outpatient...
Therapeutic Engagement: A Proposed Model of Engagement in Medical Rehabilitation
A major goal of physical medicine and rehabilitation is the recovery of function after an injury or the underlying medical condition that has caused impairment in one's daily functioning. The rehabilitation process involves a complex interplay of many factors that influence how well a person benefits from medical rehabilitation. There is burgeoning evidence that for patients to maximize rehabilitation benefits, they must be actively involved or engaged in the process. In this article, the construct of therapeutic engagement is defined, and a theoretical model is proposed to illustrate how and...
Long-term return to work after a functional restoration program for chronic low-back pain patients: a prospective study
Low-back pain is a major health and socio economic problem. Functional restoration programs (FRP) have been developed to promote the socio-professional reintegration of patients with important work absenteeism. The aim of this study was to determine the long-term effectiveness of FRP in a group of 105 chronic low-back pain patients and to determine the predictive factors of return to work. One hundred-and-five chronic LBP patients with over 1 month of work absenteeism were included in a FRP. Pain, professional status, quality of life, functional disability, psychological impact, and fear and avoidance...
Physical conditioning program for improving work outcomes in workers with back pain
The main goal of physical conditioning programs, sometimes called work conditioning, work hardening or functional restoration/exercise programs, is to return injured or disabled workers to work or improve the work status for workers performing modified duties. Such programs either simulate or duplicate work, functional tasks, or both, in a safe, supervised environment. These tasks are structured and progressively graded to increase psychological, physical and emotional tolerance and improve endurance and work feasibility. In such environments, injured workers learn appropriate job performance skills...
Can workers with chronic back pain shift from pain elimination to function restore at work?
Workers with chronic low back pain (LBP) mean a heavy human and social-economic burden. Their medical histories often include different treatments without attention to work-relatedness or communication with occupational health providers, leaving them passive and medicalized in (outpatient) health care. So we developed and implemented an innovative, patient-activating alternative: the multidisciplinary outpatient care (MOC) programme, including work(place) intervention and graded activity. It aims at function restore (instead of pain elimination), return to work (RTW) and coordinated communication...
Patients With Chronic Disabling Occupational Musculoskeletal Disorder Failing to Complete Functional Restoration: Analysis of Treatment-Resistant Personality Characteristics
To identify the risk factors for noncompletion of a functional restoration program for patients with chronic disabling occupational musculoskeletal disorders. Prospective cohort study. Consecutive patients undergoing functional restoration treatment in a regional rehabilitation referral center. A sample of 3052 consecutive patients, classified as either completers (n=2367) or noncompleters (n=685), who entered a functional restoration program. The measures used included medical evaluations, demographic data, Diagnostic and Statistical Manual of Mental Disorders psychiatric diagnoses, the Minnesota...

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