title: What constitutes effective manual handling training? A systematic review.
abstract: BACKGROUND
  Injuries caused by manual handling are a major burden to society. Manual handling training programmes have been designed to reduce the likelihood of injury among the workforce; however, concerns have been raised over the efficacy of current manual handling training methods.
  
  
  OBJECTIVE
  To undertake a systematic review of the literature examining the effectiveness of different approaches to training in manual handling.
  
  
  METHODS
  Peer-reviewed publications along with published conference proceedings published in English, between 1980 and 2009, on the topic of manual handling training comprised the search criteria. A published checklist for reviewing papers was selected, which formed the basis for assessing the quality of the papers reviewed.
  
  
  RESULTS
  A total of 1827 papers were located. Following elimination of duplicates, 221 papers were collected and reviewed. Of these, 53 papers were intervention studies with the primary aim of investigating the effectiveness of manual handling training. The review identified little evidence supporting the effectiveness of both technique- and educational-based manual handling training. In addition, there was considerable evidence supporting the idea that the principles learnt during training are not applied in the working environment. Strength and flexibility training shows promise; however, further research is needed to ascertain whether such an intervention is sustainable over the long term.
  
  
  CONCLUSIONS
  The evidence collected indicates that manual handling training is largely ineffective in reducing back pain and back injury. High priority should be given to developing and evaluating multidimensional interventions, incorporating exercise training to promote strength and flexibility, which are tailored to the industrial sector.
authors.affiliation: Work and Health Research Centre, Loughborough University, Loughborough, Leicestershire LE11 3TU, UK. s.a.clemes@lboro.ac.uk
authors.forename: Stacy A
authors.initials: SA
authors.lastname: Clemes
authors.forename: Cheryl O
authors.initials: CO
authors.lastname: Haslam
authors.forename: Roger A
authors.initials: RA
authors.lastname: Haslam
mesh_terms: D019567:Back Injuries / Q000503:physiopathology / Q000517:prevention & control*; D016206:Databases, Bibliographic; D006804:Ergonomics / Q000379:methods*; D015444:Exercise; D006801:Humans; D007318:Inservice Training / Q000379:methods*; D017116:Low Back Pain / Q000503:physiopathology / Q000517:prevention & control*; D055805:Moving and Lifting Patients / Q000009:adverse effects / Q000451:nursing; D009740:Nursing Staff; D009784:Occupational Diseases / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D012107:Research Design; D017751:Safety Management / Q000458:organization & administration; D017132:Workplace / Q000458:organization & administration