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October/November 2013 (vol. 10/3)
The evidence that physical conditioning – also known as work hardening – as part of a return-to-work strategy to reduce sick leave in workers with back pain is inconclusive, according to this updated Cochrane systematic review (41 papers reporting 25 randomised controlled trials, covering 4,404 participants). Physical conditioning simulates or duplicates work or functional tasks in a safe and supervised environment, preparing the injured or disabled worker for a return to work in a structured and graded programme. The number of sessions and the content of the included studies varied considerably. Risk of bias varied from low (16 studies) to high. There were conflicting results on the effect of physical conditioning compared with usual care or exercise treatment. For workers with acute low back pain, there is low quality evidence that neither light nor intensive conditioning have any impact on absence duration compared with usual care. For workers with chronic back pain, there is moderate quality evidence that intense conditioning slightly reduces absence duration compared with usual care, but only at long-term follow-up.
Occupational Health at Work October/November 2013 (vol. 10/3) pp41