Intensive spa and exercise therapy program for returning to work for low back pain patients: a randomized controlled trial

Christelle Nguyen, Isabelle Boutron, Christopher Rein, Gabriel Baron, Katherine Sanchez, Clémence Palazzo, Arnaud Dupeyron, Jean-Max Tessier, Emmanuel Coudeyre, Bénédicte Eschalier, Romain Forestier, Christian-François Roques-Latrille, Ygal Attal, Marie-Martine Lefèvre-Colau, François Rannou, Serge Poiraudeau, Christelle Nguyen, Isabelle Boutron, Christopher Rein, Gabriel Baron, Katherine Sanchez, Clémence Palazzo, Arnaud Dupeyron, Jean-Max Tessier, Emmanuel Coudeyre, Bénédicte Eschalier, Romain Forestier, Christian-François Roques-Latrille, Ygal Attal, Marie-Martine Lefèvre-Colau, François Rannou, Serge Poiraudeau

Abstract

We aimed to determine whether a 5-day intensive inpatient spa and exercise therapy and educational program is more effective than usual care in improving the rate of returning to work at 1 year for patients with subacute and chronic low back pain (LBP) on sick leave for 4 to 24 weeks. We conducted a 12-month randomized controlled trial. LBP patients were assigned to 5-day spa (2 hr/day), exercise (30 min/day) and education (45 min/day) or to usual care. The primary outcome was the percentage of patients returning to work at 1 year after randomization. Secondary outcomes were pain, disability and health-related quality of life at 1 year and number of sick leave days from 6 to 12 months. The projected recruitment was not achieved. Only 88/700 (12.6%) patients planned were enrolled: 45 in the spa therapy group and 43 in the usual care group. At 1 year, returning to work was 56.3% versus 41.9% (OR 1.69 [95% CI 0.60-4.73], p = 0.32) respectively. There was no significant difference for any of the secondary outcomes. However, our study lacked power.

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Figure 1
Figure 1
Enrollment, randomization, and follow-up.

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