Lumbar supports and education for the prevention of low back pain in industry: a randomized controlled trial.
BACKGROUND
Low back pain is a frequent and costly health problem. Prevention of low back pain is important both for the individual patient and from an economic perspective.


OBJECTIVE
To assess the efficacy of lumbar supports and education in the prevention of low back pain in industry.


METHODS
A randomized controlled trial with a factorial design.


METHODS
The cargo department of an airline company in the Netherlands.


METHODS
A total of 312 workers were randomized, of whom 282 were available for the 6-month follow-up.


METHODS
Subjects were randomly assigned to 4 groups: (1) education (lifting instructions) and lumbar support, (2) education, (3) lumbar support, and (4) no intervention. Education consisted of 3 group sessions on lifting techniques with a total duration of 5 hours. Lumbar supports were recommended to be used during working hours for 6 months.


METHODS
Low back pain incidence and sick leave because of back pain during the 6-month intervention period.


RESULTS
Compliance with wearing the lumbar support at least half the time was 43%. In the 282 subjects for whom data were available, no statistically significant differences in back pain incidence (48 [36%] of 134 with lumbar support vs 51 [34%] of 148 without, P=.81) or in sick leave because of low back pain (mean, 0.4 days per month with lumbar support vs 0.4 days without, P=.52) were found among the intervention groups. In a subgroup of subjects with low back pain at baseline, lumbar supports reduced the number of days with low back pain per month (median, 1.2 vs 6.5 days per month; P=.03).


CONCLUSIONS
Overall, lumbar supports or education did not lead to a reduction in low back pain incidence or sick leave. The results of the subgroup analysis need to be confirmed by future research. Based on our results, the use of education or lumbar supports cannot be recommended in the prevention of low back pain in industry.
van Poppel
M N
MN
Institute for Research in Extramural Medicine, Vrije Universiteit, Amsterdam, The Netherlands. mnm.vanvpoppel.emgo@med.vu.nl
Koes
B W
BW
van der Ploeg
T
T
Smid
T
T
Bouter
L M
LM
D000041:Absenteeism; D000328:Adult; D001915:Braces; D006266:Health Education; D006801:Humans; D015994:Incidence; D017116:Low Back Pain / Q000453:epidemiology / Q000517:prevention & control*; D016272:Occupational Health; D018709:Statistics, Nonparametric; D016896:Treatment Outcome