Neuromuscular exercise and counseling for treating recurrent low back pain in female healthcare workers—Findings from a 24‐month follow‐up study of a randomized controlled trial

Abstract

AbstractBackgroundFemale healthcare workers have a high prevalence of low back pain (LBP)‐related sickness absence. Here, we report findings of a 24‐month follow‐up of a previously published 6‐month randomized controlled trial (RCT).MethodsBy adopting an RCT with 6 months of intervention and follow‐up at 6, 12, and 24 months, we assessed the maintenance of changes in the effectiveness (LBP and fear of pain) of the interventions (neuromuscular exercise [NME], back‐care counseling, both combined) using a generalized linear mixed model adjusted for baseline covariates. The incremental cost‐effectiveness ratio was calculated in terms of quality‐adjusted life years (QALY). A bootstrap technique was used to estimate the uncertainty around a cost‐effectiveness acceptability curve.ResultsOf the 219 females, 71% had data at 24 months. Between 6 and 24 months, LBP intensity (primary outcome) remained low in all intervention arms (−20% to −48%) compared to the control (−10% to −16%). Pain interfering with work remained low in the combined and exercise arms for up to 24 months. At 24 months, the total costs were lowest in the combined arm (€484 vs. €613–948, p < 0.001), as were the number of back‐related sickness absence days (0.16 vs. 1.14–3.26, p = 0.003). The analysis indicated a 95% probability of the combined arm to be cost‐effective per QALY gained at €1120.ConclusionsSix months of weekly NME combined with four counseling sessions was cost‐effective for treating LBP and the effect was maintained over 24 months.Trial registrationClinicalTrials.gov, NCT01465698, 7/11/2011, prospective.