Workplace program speeds up return to work

In brief

  • A workplace program consisting of a workplace assessment, modifications and case management is recommended for employees on sick leave due to low-back pain because it may help them return to work sooner. In fact, this approach has been adopted in current Dutch guidelines.
  • The effect of the program on other work-related absences, such as those due to mental health issues, should be studied.

Why was this study done?

There is a need for high quality studies that show effective approaches, both clinically and in the workplace, to treat workers with low-back pain and reintegrate them into their jobs. This study looked at the effects of a workplace program, an exercise program and both programs together on reducing sick leave for workers with low-back pain.

How was the study done?

The study took place in the Netherlands. Researchers recruited 196 employees on sick leave due to low-back pain. In the Netherlands, injured workers usually receive care that involves case management by an occupational physician and care from other clinicians if required. In the study, workers were randomly assigned to go through a workplace program or receive usual care. The workplace program consisted of a workplace assessment, work modifications and case management. After eight weeks, the 112 workers who were still on sick leave were randomly assigned to participate in a graded activity exercise program or receive usual care. The exercise program was based on cognitive-behavioural principles. This approach aims to change people’s assumptions, beliefs and behaviours about their condition and abilities in a positive way.

What did the researchers find?

Workers who participated in the workplace program fully returned to work almost a month sooner than those who didn’t receive it. Those in the program group were back at work a median of 77 days after the first day of sick leave, compared with 104 days for those receiving usual care. Participating in the graded activity exercise program expedited the return to work. Most of workers in the study came from health-care, office, industrial or transportation settings.

What are some strengths and weaknesses of the study?

This study took place in workplace settings, which shows that the program was practical as well as effective. While this is a strength, it may also be a weakness as researchers were not able to have full control over how the program was implemented.

Publication Information


A workplace intervention, graded activity, or both to prevent long-term sick leave for subacute back pain? A randomized controlled study.


Steenstra I, Anema JR, Bongers PM, de Vet H, Knol DL, Loisel P, van Mechelen W


Fysiotherapie, 2007: vol. 6, no. 117, pp. 207-215