A SYSTEMATIC REVIEW OF CONTROLLED CLINICAL-TRIALS ON THE PREVENTION OF BACK PAIN IN INDUSTRY

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.