Sj. Scheer et al., RANDOMIZED CONTROLLED TRIALS IN INDUSTRIAL LOW-BACK-PAIN RELATING TO RETURN TO WORK .1. ACUTE INTERVENTIONS, Archives of physical medicine and rehabilitation, 76(10), 1995, pp. 966-973
Employers and insurers are interested in being able to use cost-effect
ive interventions for returning injured workers to the workplace. Unfo
rtunately, truly objective information is lacking. The purpose of this
and two subsequent review articles was to perform thorough scrutiny a
nd methodologic comparison among all obtainable, published randomized
and controlled studies on low back pain (LBP) interventions leading to
return to work. The study was confined to English language articles p
ublished from 1975 through 1993. Of more than 4,000 LBP citations, mor
e than 500 were chosen for review. Of that number, 35 articles met the
selection criteria of randomization, reasonable controls, and work re
turn comparisons. This paper focuses on the 10 articles relating to in
terventions for acute (less than 4 weeks) LBP, and considers bed rest,
exercise, spinal manipulation, back school, and case management. A 26
-point quality system was used to compare the methodologic rigor of ea
ch article. This literature survey demonstrated the meager scientific
foundations on which our industrial rehabilitation programs are based.
(C) 1995 by the American Congress of-Rehabilitation Medicine and the
American Academy of Physical Medicine and Rehabilitation