title: Lumbar supports to prevent recurrent low back pain among home care workers: a randomized trial.
abstract: BACKGROUND
  People use lumbar supports to prevent low back pain. Secondary analyses from primary preventive studies suggest benefit among workers with previous low back pain, but definitive studies on the effectiveness of supports for the secondary prevention of low back pain are lacking.
  
  
  OBJECTIVE
  To determine the effectiveness of lumbar supports in the secondary prevention of low back pain.
  
  
  METHODS
  Randomized, controlled trial.
  
  
  METHODS
  Home care organization in the Netherlands.
  
  
  METHODS
  360 home care workers with self-reported history of low back pain.
  
  
  METHODS
  Short course on healthy working methods, with or without patient-directed use of 1 of 4 types of lumbar support.
  
  
  METHODS
  Primary outcomes were the number of days of low back pain and sick leave over 12 months. Secondary outcomes were the average severity of low back pain and function (Quebec Back Pain Disability scale) in the previous week.
  
  
  RESULTS
  Over 12 months, participants in the lumbar support group reported an average of -52.7 days (CI, -59.6 to -45.1 days) fewer days with low back pain than participants who received only the short course. However, the total sick days in the lumbar support group did not decrease (-5 days [CI, -21.1 to 6.8 days]). Small but statistically significant differences in pain intensity and function favored lumbar support.
  
  
  CONCLUSIONS
  Study participants were unblinded, and a substantial amount of missing data required imputation. Objective data on sick days due to low back pain were not available.
  
  
  CONCLUSIONS
  Adding patient-directed use of lumbar supports to a short course on healthy working methods may reduce the number of days when low back pain occurs, but not overall work absenteeism, among home care workers with previous low back pain. Further study of lumbar supports is warranted.
authors.affiliation: Department of General Practice, Erasmus Medical Center, University Medical Center, Rotterdam, The Netherlands. p.roelofs@erasmusmc.nl
authors.forename: Pepijn D D M
authors.initials: PD
authors.lastname: Roelofs
authors.forename: Sita M A
authors.initials: SM
authors.lastname: Bierma-Zeinstra
authors.forename: Mireille N M
authors.initials: MN
authors.lastname: van Poppel
authors.forename: Petra
authors.initials: P
authors.lastname: Jellema
authors.forename: Sten P
authors.initials: SP
authors.lastname: Willemsen
authors.forename: Maurits W
authors.initials: MW
authors.lastname: van Tulder
authors.forename: Willem
authors.initials: W
authors.lastname: van Mechelen
authors.forename: Bart W
authors.initials: BW
authors.lastname: Koes
mesh_terms: D000041:Absenteeism; D000328:Adult; D005260:Female; D015438:Health Behavior; D018576:Home Health Aides; D006801:Humans; D017116:Low Back Pain / Q000517:prevention & control*; D008161:Lumbosacral Region; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000517:prevention & control*; D009989:Orthotic Devices; D010147:Pain Measurement; D010353:Patient Education as Topic