| Study |
n |
Patients |
Setting |
Treatment (t) |
Controls (c) |
Outcomes |
Results |
| Lindequist et al 1984 |
56 |
acute LBP +/- referred leg pain |
family practice Sweden |
Back school, physio training program, encourage phys activity despite LBP |
analgesics PRN advice not to strain back |
initial pain recovery 1 year sick leave pt satisfaction with treatment |
NS dif initial pain recovery or time off work further 1 yr work oss: t 16% av 44 days, c 31% av 42 days NS t more satisfied p <.05 |
| Fordyce et al 1986 |
107 |
acute LBP (1-10 days) |
family practice, emergency room, ortho OP U.S. |
time-contingent analgesics and programmed restoration of activity |
traditional analgesics as required, 'let pain be your guide' |
1 yr claimed impairment (C1), activity level, sickness' & health care use (HCU) |
NS difs at 6/52 1 yr C1 t return to normal, c increased p <.05 NS dif activity levels c more 'sick' at 9-12 months p < .05 1 yr HCU: t fell c increased p < .01 |
| Philips et al 1991 |
117 |
acute LBP first episode <15 days |
family practice or emergency room Canada |
Graded reactivation +/- behavioural counselling |
Normal 'let pain guide' return to normal (factorial design) |
pain at 6/12 (no rating of severity or disability) exercise level |
NS dif pain at 6/12 begin exer by 3 days: t 86% c 55% p <.01 |
| Lindstrom et al 1992a&b |
103 |
sub-acute LBP 8-12/52 |
industrial blue collar workers Sweden |
graded activity prog, work-place behav principles |
tradit med care by own physician |
pain, disab, mobility, strength fitness, work loss |
NS dif pain, 1 yr disab p<.01 t better 1 yr mobility & fitness but NS RTW t 10 weeks c 15.1 weeks p .01 work loss in second FU year- t 12.1 weeks c 19.6 weeks p .05 |
| Linton et al 1993 |
198 |
acute back & neck pain a) PH back pain b) first attack |
primary care & occup health Sweden |
'early activation' einforce healthy behav, maintain daily activities, training |
'treatment as usual' analgesics, rest & sick leave |
pain disability, satisfaction, 1 year sick leave |
a) NS difs b) NS difs pain or disab t more satisfied p <.05 t signif less sick-listing t 8 X less likely to devel chronic sick leave (> 200 days) |
| Malmivaara et al 1995 |
186 |
acute LBP (av 5 days) |
occupational health clinics Finland |
Ordinary Activity' avoid bed rest continue routine activ as normally as pos |
c1 back mobilising exer c2, 2 days bed rest |
3 & 12/52 pain, disability lumbar flexion and days off work |
t significantly fewer days and ess severe pain, ess disability, fewer days off work, lowest costs |
| Wilkinson 1995 |
42 |
acute LBP (<7 days) |
family practice UK |
Stay mobile and no daytime rest |
48 hours strict bed rest |
7 & 28 days pain, disability, lumbar flexion & SLR |
t tended to earlier recovery but no significant differences |
| Indahl et al 1995 |
975 |
LBP off work 8 weeks |
population based (Nat insur claims) Norway |
Intense personal advice, reduce fear, activity, normal walking, reduce sick |
'conventional medical system' |
return to work |
still on sick leave at 200 days t 30% c 60% p <.001 |
