A Cochrane review included 9 studies with a total of 981 subjects.
In MBR compared to usual care for subacute LBP, individuals receiving MBR had less pain (four studies with 336 participants; SMD -0.46, 95% CI -0.70 to -0.21) and less disability (three studies with 240 participants; SMD -0.44, 95% CI -0.87 to -0.01), as well as increased likelihood of return-to-work (three studies with 170 participants; OR 3.19, 95% CI 1.46 to 6.98) and fewer sick leave days (two studies with 210 participants; SMD -0.38 95% CI -0.66 to -0.10) at 12-month follow-up. The effect sizes for pain and disability were low in terms of clinical meaningfulness, whereas effects for work-related outcomes were in the moderate range.
However, when comparing MBR to other treatments (i.e. brief intervention with features from a light mobilization program and a graded activity program, functional restoration, brief clinical intervention including education and advice on exercise, and psychological counselling), no differences were found between the groups in terms of pain (two studies with 336 participants; SMD -0.14, 95% CI -0.36 to 0.07), functional disability (two studies with 345 participants; SMD -0.03, 95% CI -0.24 to 0.18), and time away from work (two studies with 158 participants; SMD -0.25 95% CI -0.98 to 0.47). Return-to-work was not reported in any of the studies.
In the first study, the patients in the intervention group returned to work sooner: average time before returning to work was 10.0 weeks (SD 12.7) in the intervention group and 15.1 weeks (SD 15.6) in the control group. In the year after the intervention, the intervention group had fewer sick leaves than the control group (mean difference -7.5 days, 95% CI -15.06 to 0.06). There was no statistically significant difference in pain intensity between the intervention and control group, but subjective disability had decreased significantly more in the intervention group than in the control group (mean difference -1,2, 95% CI -1.984 to - 0.416). In the other study the median duration of absence from regular work was 60 days for the group with a combination of occupational and clinical intervention, 67 days with the occupational intervention group, 131 days with the clinical intervention group and 120.5 days with the usual care group (p=0.04). Return to work was 2.4 times faster in the group with both an occupational and clinical intervention (95%CI 1.19 to 4.89) than the usual care group and 1.91 times faster in the two groups with occupational intervention than the two groups without occupational interventions (95% CI 1.18 to 3.1). At the one-year follow-up, the only significant reduction was in the Oswestry scores between the group having had both an occupational and clinical intervention, and the group receiving usual care (10.73; p=0.020).Comment: The quality of evidence is downgraded by study quality and by imprecise results (few patients and wide confidence intervals).