Schneider S, Zoller S
Mannheimer Insitut für Public Health, Medizinische Fakultät der Universität Heidelberg, 68167, Heidelberg, Deutschland.
Orthopade. 2009 Oct;38(10):943-55. doi: 10.1007/s00132-009-1529-0.
Physical activity is an important component of primary and secondary prevention of orthopedic complaints such as back pain as well as for many other syndromes. This epidemiologic research project investigated the multifactorial interaction between physical leisure activities and back pain and also the question whether regular physical activity at the workplace can be equated with the effect of regular leisure activity. From a patients point of view this could be construed as an"excuse" to refrain from leisure and fitness sports. Within the framework of a cooperative project between the Orthopedic University Clinic in Heidelberg and the Robert-Koch Institute in Berlin, representative data were gathered for the first time in Germany on physical activity at the workplace and in leisure time as well as the prevalence of back pain. Within the first national health survey a random sample of 3,488 employed German citizens aged 18-69 years old was investigated with multiple logistic regression analyses.The prevalence of 7-day back pain in Germany was 34% and the prevalence for 1-year was 60%. Physical activity at the workplace was associated with a significantly higher risk for back pain whilst leisure sport activity was accompanied by a lower prevalence of back pain. Although 39% of all persons who were inactive in sport and physical activities claimed to have felt back pain at least once in a retrospective 7-day period, the corresponding values for persons active in sport were 33% (1-2 h sport/week), 27% (2-4 h sport/week) and 30% (>4 h sport/week).This study provides population-based epidemiologic data on the prevalence of back pain among employed German citizens for the first time since the reunification. Although causal conclusions cannot principally be derived from cross-sectional data, the results of this analysis allow the multifactorial conditional structure to be unraveled. Our data demonstrate that manual physical employment does not represent a substitute for fitness leisure sports, but physically demanding working conditions themselves represent a significant risk factor for back pain.
体育活动是预防诸如背痛等骨科疾病以及许多其他综合征的一级和二级预防的重要组成部分。这个流行病学研究项目调查了体育休闲活动与背痛之间的多因素相互作用，以及工作场所的定期体育活动是否能等同于定期休闲活动的效果。从患者的角度来看，这可能被解释为不参加休闲和健身运动的“借口”。在海德堡大学骨科诊所和柏林罗伯特·科赫研究所合作项目的框架内，首次在德国收集了关于工作场所和休闲时间的体育活动以及背痛患病率的代表性数据。在第一次全国健康调查中，对3488名年龄在18 - 69岁的德国在职公民进行了随机抽样，并进行了多元逻辑回归分析。德国7天背痛的患病率为34%，1年的患病率为60%。工作场所的体育活动与背痛风险显著较高相关，而休闲体育活动则伴随着较低的背痛患病率。尽管在回顾性的7天内，所有不参加体育和身体活动的人中39%声称至少感到过一次背痛，但参加体育活动的人的相应比例分别为33%（每周运动1 - 2小时）、27%（每周运动2 - 4小时）和30%（每周运动超过4小时）。这项研究首次提供了德国统一后在职德国公民背痛患病率的基于人群的流行病学数据。虽然原则上不能从横断面数据得出因果结论，但该分析结果有助于揭示多因素条件结构。我们的数据表明，体力劳动工作不能替代健身休闲运动，但本身要求较高的工作条件是背痛的一个重要风险因素。
