The PRESLO study: evaluation of a global secondary low back pain prevention program for health care personnel in a hospital setting. Multicenter, randomized intervention trial

Abstract

BackgroundCommon low back pain represents a major public health problem in terms of its direct cost to health care and its socio-economic repercussions. Ten percent of individuals who suffer from low back pain evolve toward a chronic case and as such are responsible for 75 to 80% of the direct cost of low back pain. It is therefore imperative to highlight the predictive factors of low back pain chronification in order to lighten the economic burden of low back pain-related invalidity. Despite being particularly affected by low back pain, Hospices Civils de Lyon (HCL) personnel have never been offered a specific, tailor-made treatment plan. The PRESLO study (with PRESLO referring to Secondary Low Back Pain Prevention, or in French, PREvention Secondaire de la LOmbalgie), proposed by HCL occupational health services and the Centre Médico-Chirurgical et de Réadaptation des Massues – Croix Rouge Française, is a randomized trial that aims to evaluate the feasibility and efficiency of a global secondary low back pain prevention program for the low back pain sufferers among HCL hospital personnel, a population at risk for recurrence and chronification. This program, which is based on the concept of physical retraining, employs a multidisciplinary approach uniting physical activity, cognitive education about low back pain and lumbopelvic morphotype analysis. No study targeting populations at risk for low back pain chronification has as yet evaluated the efficiency of lighter secondary prevention programs.Methods/DesignThis study is a two-arm parallel randomized controlled trial proposed to all low back pain sufferers among HCL workers, included between October 2008 and July 2011 and followed over two years. The personnel following their usual treatment (control group) and those following the global prevention program in addition to their usual treatment (intervention group) are compared in terms of low back pain recurrence and the impairments measured at the beginning and the end of the study. The global prevention program is composed of a two-hour information session about low back pain and pain pathways, followed by five weekly 90-min exercise sessions with one physiotherapist per group of eight to ten personnel. A booklet for home use with patient-managed exercise instructions and information (The Back Book) is given to each participant at the end of the program.An X-ray assessment of the entire spinal column of each participant (in both the control and intervention groups) is performed at the onset of the study in order to analyze sagittal spinopelvic balance as well as lombopelvic morphotype.DiscussionThe results of this study, which is innovative and unique in France, will be available in 2014 and will make it possible to draw conclusions regarding the program’s impact on the risk of recurrence and chronification of low back pain.Trial registrationhttp://www.clinicaltrials.gov # NCT00782925

Occupational low back pain prevention capacity of nurses in China: A multicenter cross-sectional study

“…This study also found that among nurses with a history of low back pain, those who had attended prevention training had a higher ability to prevent occupational low back pain than those who had not. Like Denis et al ( 48 ) opinion, this finding indicated that targeted training is positive for nurses with recurrence and chronicity risk of occupational low back pain. Low back pain often recurs among nurses ( 5 ).…”

Long-term effectiveness of an educational and physical intervention for preventing low-back pain recurrence: a randomized controlled trial

“…The relevant authorities (Ethics Committee, DirectorateGeneral for Health and Consumers, National Commission for Data Protection and Liberties -CNIL France) approved the study, which was authorized by the direction of the Hospices Civils de Lyon, and the Committees for Health, Safety and Working Conditions (CHSCT) of each participating hospital. The study was registered in ClinicalTrials.gov (NCT00782925) and its protocol has been published elsewhere (18).…”

“…The exercise therapy program comprised three steps (18). First, a 2-hour education session was delivered to the participants about LBP, pain pathways, fear-avoidance beliefs and coping.…”

German Translation and Cross-Cultural Adaptation of the STarT Back Screening Tool

“…Low back pain (LBP) has a high prevalence and incidence in Switzerland [ 1 ] and Germany [ 2 ] with estimates suggesting a 4 week prevalence of 43% among the Swiss population in 2007 [ 3 ]. Of all back pain patients with acute problems, 6 to 17% are sliding into chronicity [ 4 ] [ 5 ]. These problems frequently lead to a reduction in patients’ quality of life and working ability.…”