Research Department Lifestyle and Health, University of Applied Sciences, PO Box 85182, 3508 AD Utrecht, The Netherlands.
Eur Spine J. 2011 Jun;20(6):826-45. doi: 10.1007/s00586-010-1680-7. Epub 2011 Jan 9.
The objective of the study is to systematically evaluate the available evidence on the association between physical activity (i.e. occupational load and non-occupational physical activities) and low back pain (LBP). A systematic approach was used to explore the literature between 1999 and 2009. Studies were selected for inclusion following a comprehensive search of Medline, Embase and CINAHL. The methodological quality of each study was assessed. Studies were considered to be of 'high quality' if they met the cut-off criterion of 60% of the maximum available quality score. Thirty-six cohort or case-control studies were retrieved. Heavy workload and the accumulation of loads or frequency of lifts were moderate to strong risk factors for LBP. Strong associations were found for flexed, rotated and the awkward positions of the lumbar spine. Inconsistent results were found for leisure time physical activities, sports and physical exercise. Studies focusing on daily habitual physical activities (e.g. domestic activities and commuting) in association with LBP are lacking. In conclusion, the occurrence of LBP is related to the nature and intensity of the physical activities undertaken. However, physical activities can be subdivided into separate types and intensities and the ultimate physical load is the sum of all these activities. This makes it difficult to designate one particular activity as the cause of LBP.
本研究旨在系统评估现有关于体力活动（即职业负荷和非职业体力活动）与下背痛（LBP）之间关联的证据。采用系统方法检索了 1999 年至 2009 年的文献。综合检索了 Medline、Embase 和 CINAHL 后，选择纳入的研究。评估了每项研究的方法学质量。如果研究达到可用最高质量评分的 60%的截止标准，则被认为是“高质量”的研究。共检索到 36 项队列或病例对照研究。高工作量以及负荷的积累或举升的频率是 LBP 的中度至高度危险因素。对于腰椎的弯曲、旋转和别扭位置，发现了强烈的关联。对于休闲时间体力活动、运动和体育锻炼，结果不一致。缺乏关于与 LBP 相关的日常习惯性体力活动（如家务活动和通勤）的研究。总之，LBP 的发生与所进行的体力活动的性质和强度有关。然而，体力活动可以细分为单独的类型和强度，最终的体力负荷是所有这些活动的总和。这使得很难将特定的一种活动指定为 LBP 的原因。
