title: Identification of modifiable personal factors that predict new-onset low back pain: a prospective study of female nursing students.
abstract: OBJECTIVE
  Prevention of occupational low back pain (LBP) in nurses is a research priority. Recent research suggests intervening before commencing nursing employment is ideal; however, identification of modifiable risk factors is required. The objective of this study was to investigate modifiable personal characteristics that predicted new-onset LBP in nursing students.
  
  
  METHODS
  This prospective study was conducted on female nursing students (n=117) without LBP at baseline to predict new-onset LBP (an episode of significant LBP during the follow-up period). At the 12-month follow-up, participants with (n=31) and without new-onset LBP (n=76) were compared across baseline social or lifestyle, psychologic (distress, back pain beliefs, coping strategies, and catastrophising), and physical (spinal postures and spinal kinematics in functional tasks, leg and back muscle endurance, spinal repositioning error, and cardiovascular fitness) characteristics.
  
  
  RESULTS
  Participants response rate at follow-up was excellent (91%). After controlling for earlier LBP, age, and BMI, regression analysis showed that modifiable social or lifestyle, psychologic and physical characteristics (namely, smoking, increased physical activity, higher stress, reduced back muscle endurance, greater posterior pelvic rotation in slump sitting, and more accurate spinal repositioning in sitting) were significant and independent predictors of new-onset LBP at follow-up. Inclusion of these factors in multivariate logistic regression analysis, with significant new-onset LBP as the outcome, resulted in a substantial model R of 0.45.
  
  
  CONCLUSIONS
  Modifiable personal characteristics across multiple domains are associated with new-onset LBP in female nursing students. These findings may have implications for the development of prevention and management interventions for LBP in nurses.
authors.affiliation: School of Physiotherapy, Curtin University of Technology, Western Australia. ditim@ozemail.com.au
authors.forename: Tim
authors.initials: T
authors.lastname: Mitchell
authors.forename: Peter B
authors.initials: PB
authors.lastname: O'Sullivan
authors.forename: Angus
authors.initials: A
authors.lastname: Burnett
authors.forename: Leon
authors.initials: L
authors.lastname: Straker
authors.forename: Anne
authors.initials: A
authors.lastname: Smith
authors.forename: Jenny
authors.initials: J
authors.lastname: Thornton
authors.forename: Cobie J
authors.initials: CJ
authors.lastname: Rudd
mesh_terms: D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D001696:Biomechanical Phenomena; D005260:Female; D006801:Humans; D008019:Life Style; D017116:Low Back Pain / Q000209:etiology* / Q000523:psychology*; D015233:Models, Statistical; D009784:Occupational Diseases / Q000209:etiology* / Q000523:psychology*; D010147:Pain Measurement / Q000379:methods; D010551:Personality; D011187:Posture / Q000502:physiology; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012307:Risk Factors; D012919:Social Behavior; D013338:Students, Nursing / Q000523:psychology*; D011795:Surveys and Questionnaires; D055815:Young Adult