Rasmussen Charlotte Diana Nørregaard, Holtermann Andreas, Bay Hans, Søgaard Karen, Birk Jørgensen Marie
National Research Centre for the Working Environment, Copenhagen Ø, Denmark Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense M, Denmark.
Pain. 2015 Sep;156(9):1786-1794. doi: 10.1097/j.pain.0000000000000234.
This study established the effectiveness of a workplace multifaceted intervention consisting of participatory ergonomics, physical training, and cognitive-behavioural training (CBT) for low back pain (LBP). Between November 2012 and May 2014, we conducted a pragmatic stepped wedge cluster randomised controlled trial with 594 workers from eldercare workplaces (nursing homes and home care) randomised to 4 successive time periods, 3 months apart. The intervention lasted 12 weeks and consisted of 19 sessions in total (physical training [12 sessions], CBT [2 sessions], and participatory ergonomics [5 sessions]). Low back pain was the outcome and was measured as days, intensity (worst pain on a 0-10 numeric rank scale), and bothersomeness (days) by monthly text messages. Linear mixed models were used to estimate the intervention effect. Analyses were performed according to intention to treat, including all eligible randomised participants, and were adjusted for baseline values of the outcome. The linear mixed models yielded significant effects on LBP days of -0.8 (95% confidence interval [CI], -1.19 to -0.38), LBP intensity of -0.4 (95% CI, -0.60 to -0.26), and bothersomeness days of -0.5 (95% CI, -0.85 to -0.13) after the intervention compared with the control group. This study shows that a multifaceted intervention consisting of participatory ergonomics, physical training, and CBT can reduce LBP among workers in eldercare. Thus, multifaceted interventions may be relevant for improving LBP in a working population.
本研究证实了一种由参与式工效学、体育锻炼和认知行为训练（CBT）组成的工作场所多方面干预措施对腰痛（LBP）的有效性。在2012年11月至2014年5月期间，我们进行了一项实用的阶梯式楔形整群随机对照试验，将来自老年护理工作场所（养老院和家庭护理）的594名工人随机分为4个连续时间段，间隔3个月。干预持续12周，共包括19节课程（体育锻炼[12节]、CBT[2节]和参与式工效学[5节]）。腰痛是研究结果，通过每月短信测量天数、强度（0至10数字等级量表上的最严重疼痛）和困扰程度（天数）。使用线性混合模型估计干预效果。根据意向性分析进行分析，包括所有符合条件的随机参与者，并对结果的基线值进行调整。与对照组相比，干预后线性混合模型对腰痛天数产生了显著影响，为-0.8（95%置信区间[CI]，-1.19至-0.38），腰痛强度为-0.4（95%CI，-0.60至-0.26），困扰天数为-0.5（95%CI，-0.85至-0.13）。本研究表明，由参与式工效学、体育锻炼和CBT组成的多方面干预措施可以减少老年护理工作者的腰痛。因此，多方面干预措施可能与改善工作人群的腰痛有关。
