Poster Presentation 50th International Society for the Study of the Lumbar Spine Annual Meeting 2024

Functional Disability and Work Ability in Workers affected by Low Back Pain: An Innovative Multidisciplinary Approach (#178)

Fabrizio Russo 1 , Gianluca Vadala 1 , Luca Ambrosio 1 , Giuseppe Francesco Papalia 1 , Cristina Di Tecco 2 , Sergio Iavicoli 2 , Rocco Papalia 1 , Vincenzo Denaro 1
  1. Operative Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
  2. Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL—Italian Workers' Compensation Authority, Rome, Italy

INTRODUCTION

Low Back Pain (LBP) stands out as a prevalent musculoskeletal issue, representing a significant global health challenge and a leading cause of disability. Given its multifaceted origins, addressing LBP necessitates a comprehensive understanding. Multidisciplinary approaches may help reduce the burden of pain and disability and improve job continuity and reintegration at work. This study examines the interplay between functional disability and work ability in workers affected by LBP through an analysis of correlations between the Oswestry Disability Index (ODI) and Work Ability Index (WAI). Additionally, the study assesses the impact of personal and work-related factors on levels of functional disability and work ability.

METHODS

A cohort of 264 patients affected by LBP due to degenerative disc disease were included in a clinical diagnostic/therapeutic trial aiming at rehabilitation and return to work through an integrated investigation protocol. Data collection occurred during the initial medical examination, utilizing anamnestic tools to evaluate occupational and health-related characteristics, along with assessments of WAI and the ODI. Statistical analyses were conducted using Stata v. 16.0 (StataCorp LP, College Station, TX, USA). Descriptive statistics were computed for demographic, work, and clinical features. The degree of association between ODI and WAI was assessed using Pearson's correlation coefficient with a bootstrap method for confidence interval determination. Univariate odds ratios (OR) were also employed to explore the relationship between WAI and ODI scores. Additionally, multivariate binary logistic regression analyses were introduced to examine the associations between occupational and health-related characteristics and WAI and ODI scores.

RESULTS

The final sample consists of 252 patients, with 57.1% being male, 44.0% engaged in blue-collar occupations, 46.4% holding a high school degree, and 45.6% being married. The WAI and ODI exhibited a negative and fair correlation (r = -0.454; p = .000) (Figure 1). Notably, chronic LBP is associated with a reduced likelihood of severe disability compared to acute LBP. However, it is also linked to a diminished probability of enhanced work ability. The presence of depressive symptoms significantly influences the levels of work ability. White-collar workers without depressive symptoms reported higher work ability, even in the context of chronic disability conditions.

DISCUSSION

This study underscores the multifaceted nature of LBP, revealing that ODI and WAI are correlated yet encapsulate distinct facets of disability associated with individual, environmental, and occupational factors. A comprehensive assessment and therapeutic model that prioritizes a multidisciplinary approach emerge as optimal for effectively addressing LBP. This approach not only facilitates treatment but also promotes employability and sustained participation in the workforce.

 

Figure 1. Oswestry Disability Index distribution by Work Ability Index category.

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