The Amsterdam 'Sherbrooke model' Evaluation Study (ASE study): effective prevention of chronic low back pain by integration of ergonomic measures, social medical guidance and early return to work
09 / 1999 - 12 / 2004
OBJECTIVES: The objective of this study is to implement and evaluate the effect of a multi-component prevention programme in occupational health care that aims at early return to work for workers with low back pain. METHODS: The prevention programme is modelled on the Canadian Sherbrooke programme, and consists of 2 interventions. The first intervention involves adaptations of the work and the workplace after 2-6 weeks of absenteeism from work, combined with a protocol for communication between the occupational physician and the general practitioner. The second intervention consists of a graded activity programme starting after 8 weeks of absenteeism from work. A combination of these interventions is also being investigated. The study will be conducted among approximately 200 workers who have been on sick leave for a minimum of 2 weeks and a maximum of 6 weeks as a result of low back pain. The study will be a 4-group randomized controlled trial; one usual care group will serve as a control group, the second group will receive the intervention after 2-7 weeks absenteeism from work, the third group will receive the graded activity programme starting after 8 weeks of absenteeism from work, and the fourth group will receive all interventions. For each individual, the intervention will have a maximum duration of 6 months. Measurements will take place at baseline and 10, 26 and 52 weeks after the first day of sick leave. Outcome measures in this study are: return to work, back-specific functional disability, low back pain, kinesiophobia, coping with pain and satisfaction with the protocols. RESULTS: 8 occupational health services, 103 occupational physicians, 34 ergonomics / occupational health nurses / occupational therapists and 49 physiotherapists have been trained in the protocols used in this study. The patient recruitment started in October 2000 and ended in November 2002, after the inclusion of 200 workers who met the criteria. There will be a 1-year follow-up. The results are expected in 2003.