Managing Non-acute Low Back Symptoms in Occupational Health: Two Trials
Recruitment status was Active, not recruiting
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Purpose
The purpose of this study is:
- Epidemiological part: characteristics of low back pain patients from a forestry company in Finland. Data is collected from occupational health databases and self administered questionnaires.
- Intervention: To determine the effectiveness and cost-effectiveness of several different interventions in subacute low back pain (LBP) patients in occupational health (OH).
| Condition | Intervention | Phase |
|---|---|---|
|
Low Back Pain, Recurrent Low Back Pain |
Behavioral: Back book Behavioral: Back book and Advice Behavioral: Physical Medicine Unit Behavioral: Documentation based care |
Phase 3 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Factorial Assignment Masking: Double Blind (Subject, Investigator, Outcomes Assessor) Primary Purpose: Prevention |
| Official Title: | The Prevalence of Low Back Symptoms in a Finnish Forestry Company - Effectiveness of Primary Care Interventions for Non-acute Low Back Symptoms in Occupational Health. Two Separate RCT's of Various Levels. |
- Sickness absence days (Low back (LB) specific, other than LB, total) [ Time Frame: 6, 12, 24, 36, 48 months ] [ Designated as safety issue: No ]
- Low back pain (VAS) [ Time Frame: 0, 3, 6, 12, 24 months ] [ Designated as safety issue: No ]
- Disability (Roland Morris 18) [ Time Frame: 0, 3, 6, 12, 24 months ] [ Designated as safety issue: No ]
- Quality of Life (15-D) [ Time Frame: 0, 3, 6, 12, 24 months ] [ Designated as safety issue: No ]
- Sickness absence periods [ Time Frame: 6, 12, 24, 36, 48 months ] [ Designated as safety issue: No ]
- Disability (Oswestry's index) [ Time Frame: 3, 6, 12, 24 months ] [ Designated as safety issue: No ]
| Enrollment: | 505 |
| Study Start Date: | September 2001 |
| Estimated Study Completion Date: | September 2010 |
| Estimated Primary Completion Date: | September 2008 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Mild low back pain
A two level intervention with long-term effectiveness was executed for patients suffering from non-acute mild level LBP in occupational health. Patients were selected by using a self-administered postal questionnaire.
|
Behavioral: Back book
Subjects received the back book, which is an self-information booklet about managing low back symptoms.
Other Name: BB
Behavioral: Back book and Advice
Subjects received a back book booklet and also oral advice based on the back book by the occupational health professional. Intervention was also used as a control at the moderate arm. Other Name: BBA
|
|
Moderate low back pain
A two level active intervention with two control groups was executed for patients suffering from non-acute, moderate LBP in occupational health. Patients were selected by using a self-administered postal questionnaire.
|
Behavioral: Back book
Subjects received the back book, which is an self-information booklet about managing low back symptoms.
Other Name: BB
Behavioral: Back book and Advice
Subjects received a back book booklet and also oral advice based on the back book by the occupational health professional. Intervention was also used as a control at the moderate arm. Other Name: BBA
Behavioral: Physical Medicine Unit
An intensive, multidisciplinary LBP rehabilitation program was carried out in a physical medicine out-patient unit at the local Central Hospital. The program included a 3-week pre-course of 1,5 hour session at 3 days per week, closely followed by a 3-week intensive rehabilitation course of 6.5 hours per day for 5 days per week. A personal graded activity training program was made for each subject and patients were later called for follow-up visit within 1 year of the initial course.
Other Name: PMU
Behavioral: Documentation based care
A graded activity back school program was carried out in a physiotherapy out-patient clinic that consisted of one-hour session twice or three times per week, lasting for 12 weeks, supervised by a specially trained physiotherapist.
Other Name: DBC
|
Detailed Description:
Eligible subjects were divided into two randomised controlled trials with the name of "mild" or "moderate" low back pain trials.
Pain, disability and quality of life were collected up to 2 years by self-administered questionnaires and sickness absences were gathered from electronical records for at least 4 year's follow up time.
Eligibility| Ages Eligible for Study: | 18 Years to 56 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- age 18-56 years
- present employment at the company
at least one criteria out the following qualified for the study:
- nonspecific LBP with the duration of 2 weeks or more
- radiating, present low back pain
- recurrent LBP (2 or more episodes per year)
- work absence because of LBP
- included subjects also responded having low back pain during preceding week prior to the questionnaire (VAS ≥ 10 mm, Visual Analogue Scale 0-100 mm)
According to pain level, patients were later divided into two separate RCT's, "mild": VAS 10mm - 34mm, "moderate": VAS 35mm or more.
Exclusion Criteria:
- retirement
- acute nerve root compression symptoms
- malignant tumor
- recent fracture
- severe osteoporosis
- other specific disease preventing participation in the follow-up
Contacts and Locations| Finland | |
| University of Helsinki | |
| Helsinki, Finland, 00100 | |
| Study Director: | Simo Taimela, MD, docent | Evalua Finland Co. |
| Study Director: | Jaro Karppinen, MD,professor | University of Oulu |
| Study Director: | Markku Hupli, MD, PhD | South Karelian Central Hospital |
| Principal Investigator: | Jarmo O Rantonen, MD | Helsinki University |
| Study Director: | Antti Malmivaara, MD, PhD | National Institute for Health and Welfare, Finland |
| Study Director: | Satu Luoto, MD | South Karelian Central Hospital |
More Information
No publications provided by Helsinki University
Additional publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
| Responsible Party: | Jarmo Rantonen, MD, University of Helsinki |
| ClinicalTrials.gov Identifier: | NCT00908102 History of Changes |
| Other Study ID Numbers: | A18/01 |
| Study First Received: | May 19, 2009 |
| Last Updated: | November 12, 2009 |
| Health Authority: | Finland: Ministry of Social Affairs and Health |
Keywords provided by Helsinki University:
|
low back pain recurrent subacute secondary prevention |
primary care occupational health back book rehabilitation |
Additional relevant MeSH terms:
|
Back Pain Low Back Pain Pain |
Neurologic Manifestations Nervous System Diseases Signs and Symptoms |
ClinicalTrials.gov processed this record on May 23, 2013