LUMBAR SUPPORTS AND EDUCATION FOR THE PREVENTION OF LOW-BACK-PAIN IN INDUSTRY - A RANDOMIZED CONTROLLED TRIAL

Context.-Low back pain is a frequent and costly health problem. Preven tion of low back pain is important both for the individual patient and from an economic perspective, Objective.-To assess the efficacy of lu mbar supports and education in the prevention of low back pain in indu stry. Design.-A randomized controlled trial with a factorial design, S etting.-The cargo department of an airline company in the Netherlands. Participants.-A total of 312 workers were randomized, of whom 282 wer e available for the 6-month follow-up. Interventions.-Subjects were ra ndomly assigned to 4 groups: (1) education (lifting instructions) and lumbar support, (2) education, (3) lumbar support, and (4) no interven tion. Education consisted of 3 group sessions on lifting techniques wi th a total duration of 5 hours. Lumbar supports were recommended to be used during working hours for 6 months, Main Outcome Measures.-Low ba ck pain incidence and sick leave because of back pain during the 6-mon th intervention period. Results.-Compliance with wearing the lumbar su pport at least half the time was 43%. In the 282 subjects for whom dat a were available, no statistically significant differences in back pai n incidence (48 [36%] of 134 with lumbar support vs 51 [34%] of 148 wi thout, P=.81) or in sick leave because of low back pain (mean, 0.4 day s per month with lumbar support vs 0.4 days without, P=.52) were found among the intervention groups. In a subgroup of subjects with low bac k pain at baseline, lumbar supports reduced the number of days with lo w back pain per month (median, 1,2 vs 6.5 days per month; P=.03). Conc lusions.-Overall, lumbar supports or education did not lead to a reduc tion in low back pain incidence or sick leave, The results of the subg roup analysis need to be confirmed by future research. Based on our re sults, the use of education or lumbar supports cannot be recommended i n the prevention of low back pain in industry.