What is functional restoration and how is it used in the treatment of low back pain (LBP)?

Updated: Aug 22, 2018
  • Author: Jasvinder Chawla, MD, MBA; Chief Editor: Stephen A Berman, MD, PhD, MBA  more...
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Mayer et al devised functional restoration (FR) to address deconditioning syndrome, an inevitable companion to LBP disability. FR is best described as a sports-medicine approach to industrial back injuries, involving a program of physical training to restore normal flexibility, strength, and endurance. FR programs are highly structured and interdisciplinary and consist of daily intensive physical, psychological, and behavioral reconditioning. Patients participate in progressively increasing levels of task-oriented rehabilitation and work simulation and undergo objective measurements of their physical and functional improvement.

Most programs couple this physical training with cognitive-behavioral support, which includes didactic sessions regarding the nature of the pain, spinal care, pain management, and disability avoidance. Programs usually conclude with an exit evaluation that provides the individual with measures of his or her physical and functional capacity, guidelines for postures and activities to avoid, and weight limits on material-handling. These outcomes are measured so that parameters correlated with the consistency of effort can be determined. These physical and functional parameters can then be used to establish return-to-work guidelines.

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