135 Prognostic factors for duration of sick leave in patients with chronic low back pain, a systematic review

Objectives If a worker hurts his/her back, many people want to know how long it will take before he/she returns to work (RTW). The worker wants to know because being off work can lead to insecurity and anxiety. The workplace wants to know whether it should make alternate work arrangements. Compensation agencies want to know, to guide intervention decisions for early and safe RTW. The objective of this review is to determine the factors that predict RTW from the sub-acute and chronic stage of a low back pain related episode of time away from work. The current review is an expansion of a review published in 2005 that examined the acute stage.

Methods A search of PubMed, EMBASE and PsycINFO from inception to February 2012 was conducted. Retrieved references will be screened for relevancy independently by two reviewers and when consensus cannot be reached a third reviewer will be consulted. Reviewers will not assess articles they are an author on. Quality appraisal and data extraction forms developed by the research team will be used. Analysis of the results will involve Levels of Evidence and, if possible, results will be pooled.

Results Of the 5027 references that were retrieved 117 relevant prognosis studies and 72 relevant intervention studies were found. Prognosis studies will be used to identify prognostic factors for RTW and intervention studies will be referred to in final reports as possible ways to address identified prognostic factors. The findings from this review will be used to create a handbook for clinicians involved in the RTW process and will be shared in four different workshops to various stakeholder groups.

Conclusions This review will provide insight into the factors that affect RTW among individuals at the sub-acute and chronic stages of time away from work due to low back pain.