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An Objective Assessment Procedure

Tom G. Mayer, MD; Robert J. Gatchel, PhD; Holly Mayer, RN, MPH; Nancy D. Kishino, OTR/L, CVE; Janice Keeley, PT; Vert Mooney, MD

JAMA. 1987;258(13):1763-1767.

Abstract
One hundred sixteen consecutive patients entered a functional restoration treatment program for chronic low back pain and were compared with 72 patients not treated. A two-year follow-up survey reached more than 85% of both groups; its findings were compared with earlier results of a five-month and one-year follow-up. Analysis demonstrated that 87% of the treatment group was actively working after two years, as compared with only 41% of the nontreatment comparison group. Moreover, about twice as many of the comparison group patients had additional spine surgery relative to the treatment group. The comparison group continued with an approximately five times higher rate of patient visits to health professionals in the second year as the treatment group. Also, treatment group reinjury rates were no higher than those expected in the general population, while nontreatment subjects had a higher incidence of reinjury. Finally, a small treatment "dropout" group did poorest of all, with results in almost all areas even worse than those of the comparison group patients.

(JAMA 1987;258:1763-1767)

Author Affiliations
From the Departments of Orthopedic Surgery (Drs Mayer and Mooney) and Psychiatry (Dr Gatchel), University of Texas Health Science Center, Dallas, and the Productive Rehabilitation Institute of Dallas for Ergonomics (Mss Mayer, Kishino, and Keeley).

Footnotes
Reprint requests to Department of Orthopedic Surgery, University of Texas Health Science Center at Dallas, 5323 Harry Hines Blvd, Dallas, TX 75235 (Dr Mayer).

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