Managing Non-acute Low Back Symptoms in Occupational Health: Two Trials

NCT ID: NCT00908102

Last Updated: 2015-03-18

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

505 participants

Study Classification

INTERVENTIONAL

Study Start Date

2001-09-30

Study Completion Date

2016-12-31

Brief Summary

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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).

Detailed Description

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Eligible subjects were divided into two randomised controlled trials with the name of "mild" or "moderate" low back pain trials (interventions) and also mild vs natural course (NC) and moderate vs. NC interventions.

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.

Conditions

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Low Back Pain, Recurrent Low Back Pain

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

TRIPLE

Participants Investigators Outcome Assessors

Study Groups

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BB

Subjects received the back book booklet, which is an self-information booklet about managing low back symptoms.

Included in the Mild and Mild vs. NC interventions.

Group Type ACTIVE_COMPARATOR

Mild

Intervention Type OTHER

A one level intervention with long-term effectiveness and cost-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.

Mild vs. NC

Intervention Type OTHER

A two level intervention with long-term effectiveness and cost-effectiveness was executed for patients suffering from non-acute mild level LBP in occupational health. Intervention arms were compared to NC - no intervention group.

BB+A

Subjects received a back book booklet and also oral advice based on the back book by the occupational health professional (OH Nurse or OH Physician in mild or moderate intervention, respectively).

Included in the Mild and Mild vs. NC interventions. Arm was also used as a control at the Moderate and Moderate vs. NC interventions.

Group Type EXPERIMENTAL

Moderate

Intervention Type OTHER

A two level active intervention with a control group was executed for patients suffering from non-acute, moderate LBP in occupational health. Patients were selected by using a self-administered postal questionnaire.

Mild

Intervention Type OTHER

A one level intervention with long-term effectiveness and cost-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.

Mild vs. NC

Intervention Type OTHER

A two level intervention with long-term effectiveness and cost-effectiveness was executed for patients suffering from non-acute mild level LBP in occupational health. Intervention arms were compared to NC - no intervention group.

Moderate vs. NC

Intervention Type OTHER

A three level intervention with two control groups was executed for patients suffering from non-acute, moderate LBP in occupational health. RCT intervention groups were compared to NC group - i.e. no intervention.

DBC

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. Arm is included in the MOderate and Moderate vs. NC interventions.

Group Type EXPERIMENTAL

Moderate

Intervention Type OTHER

A two level active intervention with a control group was executed for patients suffering from non-acute, moderate LBP in occupational health. Patients were selected by using a self-administered postal questionnaire.

Moderate vs. NC

Intervention Type OTHER

A three level intervention with two control groups was executed for patients suffering from non-acute, moderate LBP in occupational health. RCT intervention groups were compared to NC group - i.e. no intervention.

PMU

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. Arm is included in the MOderate and Moderate vs. NC interventions.

Group Type EXPERIMENTAL

Moderate

Intervention Type OTHER

A two level active intervention with a control group was executed for patients suffering from non-acute, moderate LBP in occupational health. Patients were selected by using a self-administered postal questionnaire.

Moderate vs. NC

Intervention Type OTHER

A three level intervention with two control groups was executed for patients suffering from non-acute, moderate LBP in occupational health. RCT intervention groups were compared to NC group - i.e. no intervention.

NC

Natural course of low back pain

Group Type PLACEBO_COMPARATOR

Mild vs. NC

Intervention Type OTHER

A two level intervention with long-term effectiveness and cost-effectiveness was executed for patients suffering from non-acute mild level LBP in occupational health. Intervention arms were compared to NC - no intervention group.

Moderate vs. NC

Intervention Type OTHER

A three level intervention with two control groups was executed for patients suffering from non-acute, moderate LBP in occupational health. RCT intervention groups were compared to NC group - i.e. no intervention.

Interventions

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Moderate

A two level active intervention with a control group was executed for patients suffering from non-acute, moderate LBP in occupational health. Patients were selected by using a self-administered postal questionnaire.

Intervention Type OTHER

Mild

A one level intervention with long-term effectiveness and cost-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.

Intervention Type OTHER

Mild vs. NC

A two level intervention with long-term effectiveness and cost-effectiveness was executed for patients suffering from non-acute mild level LBP in occupational health. Intervention arms were compared to NC - no intervention group.

Intervention Type OTHER

Moderate vs. NC

A three level intervention with two control groups was executed for patients suffering from non-acute, moderate LBP in occupational health. RCT intervention groups were compared to NC group - i.e. no intervention.

Intervention Type OTHER

Eligibility Criteria

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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
Minimum Eligible Age

18 Years

Maximum Eligible Age

56 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Oulu

OTHER

Sponsor Role collaborator

Juho Vainio Foundation

OTHER

Sponsor Role collaborator

Finnish Cultural Foundation

OTHER

Sponsor Role collaborator

Yrjo Jahnsson Foundation

OTHER

Sponsor Role collaborator

Finnish Work Environment Fund

OTHER

Sponsor Role collaborator

University of Helsinki

OTHER

Sponsor Role lead

Responsible Party

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Jarmo Rantonen

MD

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Simo Taimela, MD, docent

Role: STUDY_DIRECTOR

Evalua Finland Co.

Jaro Karppinen, MD,professor

Role: STUDY_DIRECTOR

University of Oulu

Markku Hupli, MD, PhD

Role: STUDY_DIRECTOR

South Karelian Central Hospital

Jarmo O Rantonen, MD

Role: PRINCIPAL_INVESTIGATOR

University of Helsinki

Antti Malmivaara, MD, PhD

Role: STUDY_DIRECTOR

Finnish Institute for Health and Welfare

Satu Luoto, MD

Role: STUDY_DIRECTOR

South Karelian Central Hospital

Locations

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University of Helsinki

Helsinki, , Finland

Site Status

Countries

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Finland

References

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Rantonen J, Karppinen J, Vehtari A, Luoto S, Viikari-Juntura E, Hupli M, Malmivaara A, Taimela S. Effectiveness of three interventions for secondary prevention of low back pain in the occupational health setting - a randomised controlled trial with a natural course control. BMC Public Health. 2018 May 8;18(1):598. doi: 10.1186/s12889-018-5476-8.

Reference Type DERIVED
PMID: 29739371 (View on PubMed)

Rantonen J, Karppinen J, Vehtari A, Luoto S, Viikari-Juntura E, Hupli M, Malmivaara A, Taimela S. Cost-effectiveness of providing patients with information on managing mild low-back symptoms in an occupational health setting. BMC Public Health. 2016 Apr 12;16:316. doi: 10.1186/s12889-016-2974-4.

Reference Type DERIVED
PMID: 27068751 (View on PubMed)

Rantonen J, Vehtari A, Karppinen J, Luoto S, Viikari-Juntura E, Hupli M, Malmivaara A, Taimela S. Face-to-face information combined with a booklet versus a booklet alone for treatment of mild low-back pain: a randomized controlled trial. Scand J Work Environ Health. 2014 Mar;40(2):156-66. doi: 10.5271/sjweh.3398. Epub 2013 Nov 1.

Reference Type DERIVED
PMID: 24185642 (View on PubMed)

Rantonen J, Luoto S, Vehtari A, Hupli M, Karppinen J, Malmivaara A, Taimela S. The effectiveness of two active interventions compared to self-care advice in employees with non-acute low back symptoms: a randomised, controlled trial with a 4-year follow-up in the occupational health setting. Occup Environ Med. 2012 Jan;69(1):12-20. doi: 10.1136/oem.2009.054312. Epub 2011 May 20.

Reference Type DERIVED
PMID: 21602539 (View on PubMed)

Other Identifiers

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A18/01

Identifier Type: -

Identifier Source: org_study_id

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