Ribeiro Daniel Cury, Milosavljevic Stephan, Abbott J Haxby
Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy-University of Otago, Dunedin, Otago, New Zealand.
School of Physical Therapy, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
BMJ Open. 2017 Jan 10;7(1):e015568. doi: 10.1136/bmjopen-2016-015568.
Low back pain (LBP) is the most common, costly and disabling musculoskeletal disorder worldwide, and is prevalent in healthcare workers. Posture is a modifiable risk factor for LBP shown to reduce the prevalence of LBP. Our feasibility research suggests that postural feedback might help healthcare workers avoid hazardous postures. The Effectiveness of Lumbopelvic Feedback (ELF) trial will investigate the extent to which postural monitor and feedback (PMF) can reduce exposure to hazardous posture associated with LBP.
This is a participant-blinded, randomised controlled trial with blocked cluster random allocation. Participants will include volunteer healthcare workers recruited from aged care institutions and hospitals. A postural monitoring and feedback device will monitor and record lumbopelvic forward bending posture, and provide audio feedback whenever the user sustains a lumbopelvic forward bending posture that exceeds predefined thresholds. The primary outcome measure will be postural behaviour (exceeding thresholds). Secondary outcome measures will be incidence of LBP, participant-reported disability and adherence. Following baseline assessment, we will randomly assign participants to 1 of 2 intervention arms: a feedback group and a no-feedback control group. We will compare between-group differences of changes in postural behaviour by using a repeated measures mixed-effect model analysis of covariance (ANCOVA) at 6 weeks. Postural behaviour baseline scores, work-related psychosocial factors and disability scores will be input as covariates into the statistical models. We will use logistic mixed model analysis and Cox's proportional hazards for assessing the effect of a PMF on LBP incidence between groups.
Posture is a modifiable risk factor for low back disorders. Findings from the ELF trial will inform the design of future clinical trials assessing the effectiveness of wearable technology on minimising hazardous posture during daily living activities in patients with low back disorders.
ACTRN12616000449437.
下背痛（LBP）是全球最常见、代价高昂且使人致残的肌肉骨骼疾病，在医护人员中也很普遍。姿势是下背痛的一个可改变的风险因素，已表明它能降低下背痛的患病率。我们的可行性研究表明，姿势反馈可能有助于医护人员避免危险姿势。腰骨盆反馈有效性（ELF）试验将研究姿势监测和反馈（PMF）在多大程度上可以减少与下背痛相关的危险姿势暴露。
这是一项参与者设盲、随机对照试验，采用整群随机分组。参与者将包括从老年护理机构和医院招募的志愿者医护人员。一种姿势监测和反馈设备将监测并记录腰骨盆前屈姿势，每当使用者保持超过预定义阈值的腰骨盆前屈姿势时，就会提供音频反馈。主要结局指标将是姿势行为（超过阈值）。次要结局指标将是下背痛的发生率、参与者报告的残疾情况和依从性。在基线评估之后，我们将把参与者随机分配到两个干预组之一：反馈组和无反馈对照组。我们将在6周时使用重复测量混合效应协方差分析（ANCOVA）比较姿势行为变化的组间差异。姿势行为基线分数、与工作相关的社会心理因素和残疾分数将作为协变量输入统计模型。我们将使用逻辑混合模型分析和Cox比例风险模型来评估PMF对组间下背痛发生率的影响。
姿势是下背部疾病的一个可改变的风险因素。ELF试验的结果将为未来临床试验的设计提供信息，这些试验旨在评估可穿戴技术在减少下背部疾病患者日常生活活动中危险姿势方面的有效性。
ACTRN12616000449437。
