Mnm. Vanpoppel et al., A SYSTEMATIC REVIEW OF CONTROLLED CLINICAL-TRIALS ON THE PREVENTION OF BACK PAIN IN INDUSTRY, Occupational and environmental medicine, 54(12), 1997, pp. 841-847
Objective-To assess the effectiveness of lumbar supports, education, a
nd exercise in the prevention of back pain in industry. Methods-A comp
uterised search for controlled clinical trials was conducted. A. crite
ria list was used to assess the methodological quality of the studies.
The available evidence for the effectiveness of the interventions was
graded with a rating system for the level of evidence. Effect sizes o
f individual studies were combined if the studies were sufficiently si
milar. Results-11 studies were identified for the review. The methodol
ogical quality of all studies was low, with a maximum score of three o
ut of seven for internal validity. There was no evidence for the effec
tiveness of lumbar supports due to contradictory outcomes of the studi
es. Five of the six studies on education reported no effect. Thus ther
e is limited evidence that education does not help to prevent back pai
n. All three studies on exercise reported a positive result, indicatin
g limited evidence for the effectiveness of exercise. The combined eff
ect size for exercise was 0.53, which is a medium sized effect. Conclu
sions-Although widely used, there is little evaluative research on the
preventive measures studied here. The review showed that there is lim
ited evidence that exercise has some effect in the prevention of back
pain and that education is not effective. No conclusive evidence was f
ound for or against the effectiveness of lumbar supports. Research of
higher methodological quality is needed before firm conclusions on the
effectiveness of lumbar supports, education, and exercise in the prev
ention of back pain in industry can be drawn.