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

Christelle Nguyen (1, 2, 3, 4, 5, 6, 7) , Isabelle Boutron (8, 9, 3, 4, 5) , Christopher Rein (5, 4, 3) , Gabriel Baron (9) , Katherine Sanchez (5, 3, 4) , Clémence Palazzo (1, 10, 11) , Arnaud Dupeyron (12, 13) , Jean-Max Tessier (14) , Emmanuel Coudeyre (15) , Benedicte Eschalier (15) , Romain Forestier (14) , Christian-François Roques-Latrille (16) , Ygal Attal (14) , Marie Martine Lefèvre-Colau (1, 10, 4, 3, 5) , Francois Rannou (1, 2, 3, 4, 5, 7) , Serge Poiraudeau (1, 10, 11, 3, 4, 5)

1 Service de rééducation et de réadaptation de l'appareil locomoteur et des pathologies du rachis [CHU Cochin]
2 T3S - UMR_S 1124 - Toxicité environnementale, cibles thérapeutiques, signalisation cellulaire
3 USPC - Université Sorbonne Paris Cité
4 UPD5 - Université Paris Descartes - Paris 5
5 UPD5 Médecine - Université Paris Descartes - Faculté de Médecine
6 Hôpital Cochin [AP-HP]
7 UPD5 Sciences - Université Paris Descartes - Faculté des Sciences Fondamentales et Biomédicales
8 Centre d'épidémiologie Clinique [Hôtel-Dieu]
9 CRESS - U1153 - Equipe 5 : METHODS - Méthodes de l’évaluation thérapeutique des maladies chroniques
10 CRESS - U1153 - Equipe 4 : ECaMO - Épidémiologie clinique appliquée aux maladies rhumatismales et musculo-squelettiques
11 IFRH / RFRH - Institut fédératif de recherche sur le handicap / Réseau fédératif de recherche sur le handicap
12 CHU Nîmes - Centre Hospitalier Universitaire de Nîmes
13 EuroMov - Euromov
14 Auteur indépendant
15 CHU Clermont-Ferrand
16 UT3 - Université Toulouse III - Paul Sabatier

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.

Domaines: Médecine humaine et pathologie

Christelle Nguyen, Isabelle Boutron, Christopher Rein, Gabriel Baron, Katherine Sanchez, et al.. Intensive spa and exercise therapy program for returning to work for low back pain patients: a randomized controlled trial. Scientific Reports, 2017, 7 (1), pp.17956. ⟨10.1038/s41598-017-18311-z⟩. ⟨hal-01891215⟩