BACKGROUND: In developed countries, chronic low back pain (LBP) is one the most common reasons for disability and work-time loss. Conventional treatments have not slowed the increasing prevalence of chronic LBP. Therefore, in a search for new solutions to the problem, functional restoration programs were developed. OBJECTIVE: To synthesize the literature on the efficacy of functional restoration programs for LBP. METHODS: We performed a systematic literature search of the MedLINE database using the keywords LBP, functional restoration, work-hardening program, exercise therapy, rehabilitation, aerobic, and cognitive behavioral therapy. SYNTHESIS: The term "functional restoration" has been associated with a full-day multidisciplinary program lasting from 3 to 6 weeks. Results of most published controlled studies on the efficacy of functional restoration programs are positive regarding the return-to-work rate. Maintaining job status with the pre-injury employer is often best accomplished by the provision of suitable modified duties. Finally, results of functional restoration programs in terms of return-to-work rate probably depend strongly on the social security system of the country where the program was developed.

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