• Nathalie Jousset, Serge Fanello, Luc Bontoux, Valérie Dubus, Colette Billabert, Bruno Vielle, Yves Roquelaure, Dominique Penneau-Fontbonne, and Isabelle Richard.
• Département de Santé Publique, UFR Médecine, 1 rue Haute de Reculée, 49045 Angers cedex 01, France.
• Spine. 2004 Mar 1;29(5):487-93; discussion 494.

Study DesignRandomized parallel-group comparative trial with a 6-month follow-up period.ObjectiveTo compare, in chronic low back pain patients, the effectiveness of a functional restoration program, including intensive physical training, occupational therapy, and psychological support to an active individual therapy consisting of 3 hours physical therapy per week during 5 weeks.Summary Of Background DataControlled studies conducted in the United States showed a benefit of functional restoration in patients with low back pain, especially on return to work. Randomized Canadian and European trials had less favorable results. In France, there has been up to now no randomized study. Controlled studies suggested a positive effect of functional restoration programs.MethodsEighty-six patients with low back pain were randomized to either the functional restoration (44 patients) or the active individual therapy (42 patients) program. One person in each group never started the program. Two patients did not complete the functional restoration program, and one was lost to follow-up at 6 months. The mean number of sick-leave days in the 2 previous years was 6 months.ResultsAfter adjustment on the variable "workplace enrolled in an ergonomic program", the mean number of sick-leave days was significantly lower in the functional restoration group. Physical criteria and treatment appreciation were also better. There was no significant difference in the intensity of pain, the quality of life and functional indexes, the psychological characteristics, the number of contacts with the medical system, and the drug intake.ConclusionsThis study demonstrates the effectiveness of a functional restoration program on important outcome measures, such as sick leave, in a country that has a social system that protects people facing difficulties at work.

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