AN EASY FUNCTIONAL CAPACITY EVALUATION IN CHRONIC LOW BACK PAIN

Background: Back pain is a common problem in our society. Chronic low back pain is a pain lasting for more than 3 months, touching up to 80% of the population [1]. Lifting is said to be one of the major risk factors for the onset of low back pain, different measures have been used to study this. In order to guide the return to work, we have to had recommendations for the work capacity that could be expected. The work capacity evaluations tests are time consuming. We therefore wanted to have an easy and feasible program to propose in order to guide our rehabilitation. Objectives: The aim of our study is to present a simplified Work Capacity Evaluation Program in Back Bain (WCEPBP). We will compare the results with the PILE evaluation. The results of the patients are compared to a normal population Methods: We have at our institutions a 3 week (100 hours) functional restoration program proposed to patients with long standing (more than 3 months) low back pain. It is a structured program including exercises training the global cardiovascular endurance associated with more specific training for the lumbar muscles. There is also an ergonomic education program and a psycho-educative part. The WCEPBP-test consists of 8 different lifting and carrying tasks commonly tested in a functional evaluation context: floor-hip, hip-shoulder, 5 meter carrying, one-arm carrying pushing and tiring and the global weight bearing during the 50 minutes test. The patient decided load and its increase. This functional evaluation was done at the end of our rehabilitation program, in order to give information to the patient, but also to the GP, about the actual work capacity. We determined the workload for each task and the global workload. All of our results were compared to the lifting capacity following the Progressive isoinertial lifting evaluation (Pile) by Mayer [6]. In this study we included 500 patients (202 women and 298 men) and 25 controls. We also asked the patients to fill out a subjective scale according the work-load (Pact-score). Results: Mean age was 43.6 years for the women and 44.2 years for the men. We studied the carrying from floor-hip, hip-shoulder, 5 meter carrying pushing and tiring and the global weight. We found this global value to be of 827 kg for the men and 565 kg for the women suffering from chronic low back pain. There where no relationship between the total workload and age, weight or height of the patient. There was a relationship between genders. The total workload was clearly related to the lumbar capacity. The increase in this value had a clear incidence in a greater work capacity and work ability. On the other hand, patients with an increase in these scores achieved a clearly better result, with faster return to work. Conclusion: We were able to develop a lifting capacity program that is easy to reproduce and not expensive, with an idea on how to reorient the patient –if necessary- according to their work places and their capacities. We would also have information of work performance. These results indicate promising results for the future but they have to be validated in different work categories. References: 1. Walker BF J Spinal Disorder 13(3):205-217, 2000 2. Pengel LHM, Herbert RD, Maher CG et al: BJM 327:323-30, 2003 3. Van Tulder MW, Malmivaara A, Esmail R et al The Cochrane Review 2002 4. Mayer T: JAMA 258(13): 1763-7, 1987 5. Norberg M, Belgrand L: Swiss Congress of rhumatology, Locarno 2004 6. Mayer T., Barnes D.,Kishino ND et al: Spine 13(9):993-97, 1988 Disclosure of Interest: None declaredCitation: Annals of the Rheumatic Diseases, volume 68, supplement 3, year 2009, page 700Session: Back pain, mechanical musculoskeletal problems, local soft tissue disorders (Poster Presentations )