title: Neuromuscular exercise and counseling decrease absenteeism due to low back pain in young conscripts: a randomized, population-based primary prevention study.
abstract: METHODS
  Controlled intervention with group randomization.
  
  
  OBJECTIVE
  To investigate the effectiveness of a 6-month neuromuscular exercise and counseling program for reducing the incidence of low back pain (LBP) and disability in young conscripts, with a healthy back at the beginning of their compulsory military service.
  
  
  BACKGROUND
  Basic military training is physically demanding on the back and requires adequate physical fitness. LBP causes significant morbidity and absence from military service.
  
  
  METHODS
  Participants were conscripts of 4 successive age cohorts (n = 1409). In the prestudy year, before adoption of the intervention, 2 successive cohorts of conscripts of 4 companies (n = 719) were followed prospectively for 6 months to study the baseline incidence of different categories of LBP. In the intervention year, conscripts (n = 690) of 2 new cohorts of the same companies (intervention group: antitank, engineer; control group: signal, mortar) were followed for 6 months. The intervention program aimed to improve conscripts' control of their lumbar neutral zone and specifically to avoid full lumbar flexion in all daily tasks.
  
  
  RESULTS
  Total number and incidence of off-duty days due to LBP were significantly decreased in the intervention companies compared with controls (adjusted hazard ratio = 0.42, 95% confidence interval = 0.18-0.94, P = 0.035). The number of LBP cases, number of health clinic visits due to LBP, and number of the most severe cases showed a similar decreasing trend but without statistical significance.
  
  
  CONCLUSIONS
  These findings provide evidence that exercise and education to improve control of the lumbar neutral zone have a prophylactic effect on LPB-related off-duty service days in the military environment when implemented as part of military service among young healthy men.
authors.affiliation: UKK Institute for Health Promotion Research, Tampere, Finland. jaana.h.suni@uta.fi
authors.forename: Jaana H
authors.initials: JH
authors.lastname: Suni
authors.forename: Henri
authors.initials: H
authors.lastname: Taanila
authors.forename: Ville M
authors.initials: VM
authors.lastname: Mattila
authors.forename: Olli
authors.initials: O
authors.lastname: Ohrankämmen
authors.forename: Petteri
authors.initials: P
authors.lastname: Vuorinen
authors.forename: Harri
authors.initials: H
authors.lastname: Pihlajamäki
authors.forename: Jari
authors.initials: J
authors.lastname: Parkkari
mesh_terms: D000041:Absenteeism; D001696:Biomechanical Phenomena; D003131:Combined Modality Therapy; D017281:Cost of Illness; D003376:Counseling; D004185:Disability Evaluation; D005081:Exercise Therapy; D005387:Finland / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D017116:Low Back Pain / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology / Q000517:prevention & control*; D008159:Lumbar Vertebrae / Q000503:physiopathology; D008297:Male; D008887:Military Medicine; D008889:Military Personnel; D010147:Pain Measurement; D011322:Primary Prevention / Q000379:methods*; D016016:Proportional Hazards Models; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult