Introduction
Methods
Sample and Procedure
Interventions
Primary Outcome Measure, Cluster Level
Secondary Outcomes, Individual Level
Sample Size
Randomization
Ethics
Statistical Methods
Results
MAW | OAW | Total | ||||
---|---|---|---|---|---|---|
n | Mean (SD) | n | Mean (SD) | n | Mean (SD) | |
Continuous variables | ||||||
Age | 434 | 40.4 (10.4) | 454 | 40.9 (10.9) | 888 | 40.7 (10.6) |
Musculoskeletal complaints (0–24) | 406 | 4.56 (4.27) | 437 | 4.46 (3.86) | 843 | 4.51 (4.06) |
Pseudoneurological complaints (0–21) | 406 | 2.90 (2.96) | 436 | 2.87 (2.80) | 842 | 2.88 (2.87) |
n | % | n | % | n | % | |
---|---|---|---|---|---|---|
Categorical variables | ||||||
Female | 435 | 93.3 | 458 | 92.1 | 893 | 92.7 |
Higher education | 435 | 51.7 | 458 | 49.1 | 893 | 50.4 |
Substantial low back pain | 407 | 23.8 | 438 | 21 | 845 | 22.4 |
Substantial anxiety | 406 | 4.7 | 436 | 4.6 | 842 | 4.6 |
Substantial depression | 406 | 4.7 | 436 | 6.4 | 842 | 5.6 |
Primary Outcome
N | Baseline | 1 year | Change within group | Change between groups | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Days agreed | Days lost | % sick leave | Days agreed | Days lost | % sick leave | % | % points | IRR | 95% CI | P-value | IRR | 95% CI | P-value | ||
MAW | 45 | 154,028 | 13,529 | 8.8 | 160,160 | 13,349 | 8.3 | − 5.7 | − 0.5 | 1.06 | (0.86–1.28) | 0.550 | 0.97 | (0.76–1.24) | 0.829 |
OAW | 47 | 171,488 | 13,677 | 8.0 | 177,056 | 15,262 | 8.6 | 7.5 | 0.6 | 1.08 | (0.93–1.27) | 0.282 | 1 |
Secondary Outcomes
Musculoskeletal and Pseudoneurological Complaints
MAW | OAW | Between groups | |||||||
---|---|---|---|---|---|---|---|---|---|
Baseline | 1 year | Baseline | 1 year | p-value | |||||
n | Mean (SD) | Mean (SD) | p-value | n | Mean (SD) | Mean (SD) | p-value | ||
Musculoskeletal complaints (0–24) | 252 | 5.03 (4.32) | 4.58 (4.13) | 0.055 | 258 | 4.29 (3.69) | 4.42 (4.12) | 0.521 | 0.254 |
Pseudoneurological complaints (0–21) | 252 | 3.06 (3.02) | 3.03 (3.29) | 0.850 | 258 | 2.88 (2.79) | 2.97 (2.91) | 0.600 | 0.763 |
Coping (1–4) | 253 | 3.37 (0.40) | 3.40 (0.38) | 0.202 | 261 | 3.36 (0.39) | 3.41 (0.39) | 0.097 | 0.741 |
Helplessness (1–4) | 253 | 1.59 (0.62) | 1.66 (0.69) | 0.082 | 259 | 1.60 (0.68) | 1.62 (0.63) | 0.598 | 0.413 |
Hopelessness (1–4) | 253 | 1.65 (0.53) | 1.65 (0.51) | 0.915 | 258 | 1.62 (0.52) | 1.66 (0.52) | 0.134 | 0.460 |
Nondirective social support (1–5) | 266 | 3.72 (0.76) | 3.79 (0.74) | 0.064 | 269 | 3.76 (0.71) | 3.85 (0.69) |
0.037
| 0.614 |
Directive social support (1–5) | 265 | 2.24 (0.70) | 2.24 (0.72) | 0.945 | 268 | 2.36 (0.73) | 2.34 (0.73) | 0.623 | 0.397 |
Job satisfaction (1–5) | 276 | 4.32 (0.64) | 4.28 (0.75) | 0.342 | 274 | 4.36 (0.62) | 4.36 (0.65) | 0.907 | 0.382 |
Coping, Job Satisfaction and Social Support
Statements About Back Pain and Mental Health Complaints
MAW | OAW | Between groups | |||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Baseline | 1 year | Changea | Baseline | 1 year | Changea | p-value | |||||||||
Total n | Agreed % | Agreed % | p-value | Negative % | Same % | Positive % | Total n | Agreed % | Agreed % | p-value | Negative % | Same % | Positive % | ||
Statements about back pain | |||||||||||||||
If you have a slipped disc you must have surgery | 284 | 8.1 | 3.9 |
0.036
| 2.8 | 90.1 | 7.0 | 288 | 13.5 | 2.4 | < 0.001 | 0.7 | 87.5 | 11.8 |
0.038
|
Radiographs and newer imaging tests can always identify the cause of pain | 284 | 20.8 | 15.1 | 0.056 | 8.1 | 78.2 | 13.7 | 288 | 25.4 | 10.1 | < 0.001 | 5.2 | 74.3 | 20.5 |
0.014
|
If your back hurts, you should take it easy until the pain goes away | 285 | 6.0 | 3.9 | 0.286 | 2.8 | 92.3 | 4.9 | 289 | 4.8 | 2.8 | 0.238 | 2.1 | 93.8 | 4.2 | 0.803 |
Most back pain is caused by injuries or heavy lifting | 284 | 26.8 | 9.2 | < 0.001 | 2.5 | 72.4 | 25.1 | 288 | 34.4 | 9.0 | < 0.001 | 1.4 | 65.2 | 33.5 | 0.073 |
Back pain is usually disabling | 283 | 3.9 | 1.8 | 0.180 | 1.4 | 95.1 | 3.5 | 287 | 6.6 | 1.1 | < 0.001 | 0.7 | 93.0 | 6.3 | 0.209 |
Everyone with back pain should have a spine radiograph | 283 | 19.8 | 11.0 |
0.001
| 5.3 | 80.6 | 14.1 | 288 | 21.9 | 8.3 | < 0.001 | 3.5 | 79.5 | 17.0 | 0.346 |
Bed rest is the mainstay of therapy | 286 | 0.7 | 0.7 | 1.000 | 3.9 | 95.4 | 0.7 | 288 | 1.7 | 0.4 | 0.219 | 2.4 | 95.8 | 1.7 | 0.432 |
Statements about mental health complaints | |||||||||||||||
Having mental health complaints is embarrassing | 288 | 9.4 | 8.0 | 0.557 | 3.8 | 91.0 | 5.2 | 287 | 11.2 | 9.1 | 0.418 | 5.6 | 86.8 | 7.7 | 0.286 |
In most cases, mental health complaints will not passR | 288 | 22.2 | 15.3 |
0.008
| 5.6 | 81.9 | 12.5 | 287 | 25.1 | 14.6 | < 0.001 | 5.2 | 79.1 | 15.7 | 0.559 |
It is uncommon to experience depressionR | 288 | 8.3 | 5.9 | 0.311 | 4.9 | 87.9 | 7.3 | 287 | 11.2 | 5.9 |
0.020
| 3.8 | 87.1 | 9.1 | 0.580 |
It is uncommon to experience anxietyR | 288 | 17.4 | 9.7 |
0.004
| 5.6 | 81.3 | 13.2 | 286 | 17.5 | 10.8 |
0.007
| 4.6 | 84.3 | 11.2 | 0.600 |
Depression is to a great extent hereditary | 287 | 16.7 | 13.2 | 0.223 | 8.0 | 80.5 | 11.5 | 286 | 10.1 | 16.4 |
0.010
| 10.8 | 84.6 | 4.6 |
0.001
|
Anxiety is to a great extent hereditary | 286 | 12.9 | 7.3 |
0.017
| 5.9 | 83.3 | 10.8 | 284 | 7.8 | 10.9 | 0.188 | 7.7 | 86.0 | 6.3 | 0.113 |
Depression is best treated with medication | 288 | 3.1 | 1.7 | 0.388 | 7.6 | 89.6 | 2.8 | 287 | 2.1 | 1.1 | 0.508 | 8.7 | 89.6 | 1.7 | 0.624 |
Anxiety is best treated with medication | 288 | 1.7 | 1.7 | 1.000 | 8.0 | 90.3 | 1.7 | 285 | 2.8 | 0.7 | 0.070 | 8.7 | 88.8 | 2.5 | 0.819 |
Depression is a sign of low willpower | 288 | 3.1 | 2.1 | 0.581 | 1.7 | 95.5 | 2.8 | 286 | 1.1 | 3.9 |
0.039
| 3.5 | 95.8 | 0.7 | 0.094 |