Ready and EVIDENCE BASED PRACTICE
|Work Ready is fully aware of its responsibility to provide quality, proven rehabilitation
for injured workers and to this end, the Work Ready programme is based on sound research.
In the current climate,
evidence based practice is the talk of the town and should replace mythology, faith and
habit. Clients feel confident when the foundation of Work Readys success is evidence based practice.
If you would like to follow up on some of
this international and local research, have a look below.
first paper (Lindstrom) proves Work Readys
The second paper (Reilly) demonstrates Work Readys philosophy of individualised and carefully supervised
methods are the best available to achieve the client's goals we all need motivation
to achieve goals!
The third paper (Bendix) supports Work Readys intensive programme design. When clients come to Work
Ready, they work hard and get results!
The fourth paper (OSullivan) shows another aspect of Work Readys programme to be on target. Specificity of exercise is the
key to regaining normal movement and reducing dysfunctional and painful activity.
The next two papers by Grundwell and Linton support the secondary
prevention strategies inbuilt in the Work Ready programme.
There is no point in repairing the damage if instructions and strategies are not adopted
for maintaining the gains!
|Pop into the Work
Ready Website regularly and keep up to date with research literature
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Lindstrom I, Ohlund C, Eek C, Wallin L,
Peterson L, Fordyce W, Nachemson A Effect of Graded Activity on Patients with Subacute
Low Back Pain: A Randomised Prospective Clinical Study with Operant-Conditioning
Behavioural Approach. Physical Therapy 1992, Vol 72, No 4: 279-293
The aim of this study was to determine whether graded activity restored
occupational function in industrial blue collar workers who were sick-listed for 8 weeks
because of non-specific subacute mechanical low back pain. The experimental group had four
parts, viz functional capacity assessment, a workplace visit, back education,
individualised, submaximal graded activity programme with an operant-conditioning
behavioural approach. The control group had traditional care as ordered by their
The activity group had returned to work and were work ready significantly earlier than
the control group and had less number of appointments to the physical therapist and less
number of sick days in the following year than the control group
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K Reilly, MA; Lovejoy B, Williams and Roth H: Differences
between a Supervised and Independent Strength and Conditioning Program with Chronic Low
Back Pain Syndromes. Journal of Occupational Medicine 1989; Vol 31 No. 6 June
The purpose of this randomly controlled, prospective trial was to
evaluate the physiological parameters seen in a group of patients with chronic low back
syndrome assigned to a supervised or independent exercise programme. Forty male and female
subjects were evenly matched for age, sex, months of pain, exercise experience and
surgical procedures before being assigned randomly to two groups. The study period was 6
months (96 sessions).
Results showed the experimental (supervised
exercise) group had markedly greater strength and endurance than the control (independent
exercise) group and had an average of 50 points lower in intensity of self reported pain.
The experimental group also had a significantly lower percentage body fat composition,
lower resting heart rate and lower diastolic blood pressure. The experimental group
reported only an average of 0.25 relapses to the control groups 3.05.
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Bendix AF, Bendix T, Ostenfeld S, Bush E,
Andersen A. Active treatment programs for patients with chronic low back pain: a
prospective, randomized, observer-blinded study. European Spine Journal; 1995:
The aim of this study was to evaluate the rehabilitation outcome of
three different active programmes in terms of (1) work readiness, (2) days of sick leave,
(3) health care contacts, (4) pain and disability scores and (5) staying physically
active. A blinded observer assessed them, 4 months after the completion of the programme.
Group (1) had 39 hours of multidisciplinary input including a large
component of exercise and education over 6 weeks; group (2) had 24 hours of exercise and
education and group (3) had an active combined psycho-physical programme. Results showed
group one to be superior in work readiness rate, back and leg pain perception and
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OSullivan P, Twomey L and
Allison G. Evaluation of Specific Stabilizing Exercise in the Treatment of Chronic Low
Back Pain with Radiologic Diagnosis of Spondylolysis and Spondylolisthesis. Spine
1997, Vol 22, No 24: 2959-2967
Physiotherapy management of back pain has been focused on specifically
developing the deep abdominal and deep spinal muscles with special exercises to stabilise
Two randomly selected groups underwent either a 10 week specific
exercise programme for these muscles or the usual treatment from their treating
practitioner. The experimental (specific exercise) group showed a statistically
significant reduction in pain intensity and functional disability that was maintained at a
30 month follow up.
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Gundewall B, Liljeqvist M, and Hansson Y. Primary
Prevention of Back Symptoms and Absence from Work. A Prospective Randomised Study
Among Hospital Employees. Spine l993, Vol 18 No 5: 587-594
The personnel at a geriatric hospital were randomly assigned to either
an exercise group participating in work hours or a group that did not receive any further
advice or information.
At a 13 month followup, there was a significant increase in strength,
decrease in absence from work due to back pain (experimental group = 1 person off for 28
days; control group = 12 people off for 155 days), decrease in back pain complaints and in
the intensity of back pain.
The cost benefit ratio was greater than 10, with one hour spent by the
physiotherapist reducing the work absence amongst the participants by 1.3 days.
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Linton SJ, Bradley LA, Jensen I, Spangfort E
and Sundell L. The secondary prevention of low back pain: a controlled study with
The current investigation studied the effectiveness of a secondary
prevention program for nurses with back problems who are deemed at risk of developing a
chronic problem. The randomly assigned treatment group received a physical and behavioural
management package, the control group was placed on a waiting list.
The treatment group had a significantly greater improvement than the
control group in pain intensity, anxiety, sleep quality and fatigue ratings, observed pain
behaviour, activities, mood and helplessness. These differences were generally maintained
at the 6 month follow up. In addition, the treatment group broke a trend for increasing
amounts of pain related absenteeism whilst the control group did not. The conclusion is
that a secondary prevention programme is an effective method for dealing with
musculoskeletal problems progressing to a chronic stage.
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