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Evidence-Based Resource Summary

Strength of Evidence: 
4 out of 4
4 out of 4
Year Published: 

Cochrane Summary – Physical Conditioning Program for Improving Work Outcomes in Workers With Back Pain

Description of Resource: 
The main goal of physical conditioning programs, sometimes called work conditioning, work hardening, or functional restoration/exercise programs, is to return injured or disabled workers to work or improve the work status for workers performing modified duties. Such programs either simulate or duplicate work, functional tasks, or both in a safe, supervised environment. Based on 23 included studies, researchers analyzed 8 comparisons of physical conditioning programs versus care as usual or other types of interventions such as standard exercise therapy for different durations of back pain and followup times. Researchers divided physical conditioning programs into light or intense programs depending on their intensity and duration. Results showed that light physical conditioning programs have no significant effect on sickness absence duration for workers with subacute or chronic back pain. Conflicting results were found for intense physical conditioning programs for workers with subacute back pain. Further analysis suggested a positive effect on sick leave when the workplace was involved in the intervention. Physical conditioning programs probably have a small effect on return-to-work for workers with chronic back pain. Conflicting results were found for intense physical conditioning programs compared with other exercise therapy in the first 2 years of sick leave. No difference in effect was found between a light or an intense physical conditioning program. Cognitive behavioral therapy was found to probably have no value as an alternative therapy or in addition to physical conditioning programs.

Evidence-Based Resource Details

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Developed By: 
Cochrane Collaboration
Developer Type: 
Non-Federal Government
Healthy People 2020 Topic Area(s): 
Arthritis, Osteoporosis, and Chronic Back Conditions
Healthy People 2020 Objectives: 
Resource Type: 
Systematic Review
Schaafsma F, Whelan K, van der Beek AJ, van der Es-Lambeek LC, Ojajärvi A, Verbeek JH. Physical conditioning as part of a return to work strategy to reduce sickness absence for workers with back pain. Cochrane Database of Systematic Reviews [Internet]. 2013 Aug 30 [cited 2015 June 29]. Available from: