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Evidence summaries

Back Injury Prevention Interventions in the Workplace

Programmes aiming at prevention of back injury in the workplace (especially back schools and exercise training programmes) may be effective. Level of evidence: "C"

A narrative systematic review 1 including 7 true experiments and 8 quasi-experimental studies was abstracted in DARE.

Theoretically consistent associations between interventions and outcome were found in 3/4 back belt programmes (1 statistically significant), 5/6 back school programmes (2 statistically significant), 6/6 exercise/flexibility programmes (5 statistically significant) and 2/3 education programmes (both statistically significant).

Another systematic review 2 including 11 studies was abstracted in DARE. 3 RCTs with 783 participants and 2 non-randomised CCTs with 326 participants evaluated the effectiveness of lumbar supports, 4 RCTs with 1074 participants and 2 non-randomised CCTs with 555 participants evaluated the effectiveness of a back school program. Three RCTs with 313 participants evaluated the effectiveness of exercise. The quality scores of the primary studies were low. There was no evidence for or against the effectiveness of lumabar supports due to contradictory outcomes. Five of the 6 studies on education reported no effect on incidence of back pain or absenteeism. Three studies on exercise reported a combined positive effect (Effect size 0.53, 95% CI 0.26 to 0.79). Two of the exercise studies produced a combined ES of 0.56 (95% CI 0.22 to 0.90) in reduction of sick leave.

Comment: The quality of evidence is downgraded by study limitations and inconsictency of results.

    References

    • Karas BE, Conrad KM. Back injury prevention interventions in the workplace: an integrative review. AAOHN J 1996 Apr;44(4):189-96. [PubMed][DARE]
    • van Poppel MN, Koes BW, Smid T, Bouter LM. A systematic review of controlled clinical trials on the prevention of back pain in industry. Occup Environ Med 1997 Dec;54(12):841-7. [PubMed][DARE]

Primary/Secondary Keywords