National Research Centre for the Working Environment, Lersø Parkallé 105, 2100 Copenhagen Ø, Denmark.
BMC Public Health. 2013 Nov 21;13:1088. doi: 10.1186/1471-2458-13-1088.
A high prevalence of low back pain has persisted over the years despite extensive primary prevention initiatives among nurses' aides. Many single-faceted interventions addressing just one aspect of low back pain have been carried out at workplaces, but with low success rate. This may be due to the multi-factorial origin of low back pain. Participatory ergonomics, cognitive behavioral training and physical training have previously shown promising effects on prevention and rehabilitation of low back pain. Therefore, the main aim of this study is to examine whether a multi-faceted workplace intervention consisting of participatory ergonomics, physical training and cognitive behavioral training can prevent low back pain and its consequences among nurses' aides. External resources for the participating workplace and a strong commitment from the management and the organization support the intervention.
METHODS/DESIGN: To overcome implementation barriers within usual randomized controlled trial designed workplace interventions, this study uses a stepped-wedge cluster-randomized controlled trial design with 4 groups. The intervention is delivered to the groups at random along four successive time periods three months apart. The intervention lasts three months and integrates participatory ergonomics, physical training and cognitive behavioral training tailored to the target group. Local physiotherapists and occupational therapists conduct the intervention after having received standardized training. Primary outcomes are low back pain and its consequences measured monthly by text messages up to three months after initiation of the intervention.
Intervention effectiveness trials for preventing low back pain and its consequences in workplaces with physically demanding work are few, primarily single-faceted, with strict adherence to a traditional randomized controlled trial design that may hamper implementation and compliance, and have mostly been unsuccessful. By using a stepped wedge design, and obtain high management commitment and support we intend to improve implementation and aim to establish the effectiveness of a multi-faceted intervention to prevent low back pain. This study will potentially provide knowledge of prevention of low back pain and its consequences among nurses' aides. Results are expected to be published in 2015-2016.
The study is registered as ISRCTN78113519.
尽管护士助理多年来一直接受广泛的初级预防措施，但腰痛的高发率仍持续存在。许多针对腰痛单一方面的干预措施已经在工作场所实施，但成功率较低。这可能是由于腰痛的多因素起源。参与式人体工程学、认知行为训练和体育锻炼以前在预防和康复腰痛方面显示出有希望的效果。因此，本研究的主要目的是检验一种由参与式人体工程学、体育锻炼和认知行为训练组成的多方面工作场所干预措施是否可以预防护士助理的腰痛及其后果。参与工作场所的外部资源和管理层及组织的大力支持为干预措施提供了保障。
方法/设计：为了克服常规随机对照试验设计的工作场所干预措施中的实施障碍，本研究采用了四组递进式楔形集群随机对照试验设计。该干预措施在四个连续的三个月时间间隔内随机分发给各组。干预措施持续三个月，整合了针对目标群体的参与式人体工程学、体育锻炼和认知行为训练。当地的物理治疗师和职业治疗师在接受标准化培训后进行干预。主要结局指标是腰痛及其后果，通过每月的短信调查在干预开始后三个月内进行测量。
针对体力要求高的工作场所预防腰痛及其后果的干预效果试验较少，主要是单一因素的，严格遵循传统的随机对照试验设计可能会阻碍实施和依从性，并且大多没有成功。通过使用递进式楔形设计，并获得高层管理的承诺和支持，我们旨在提高实施效果，并旨在确定一种多方面干预措施预防腰痛的有效性。本研究将为护士助理的腰痛预防提供知识。预计结果将于 2015-2016 年公布。
该研究已在 ISRCTN 注册，编号为 ISRCTN78113519。
