van der Weide W E, Verbeek J H, van Tulder M W
Coronel Institute for Occupational and Environmental Health, University of Amsterdam, The Netherlands.
Scand J Work Environ Health. 1997 Jun;23(3):165-78. doi: 10.5271/sjweh.195.
Practical management guidelines for occupational health physicians are needed for the individual support of employees with low-back pain. In this study the level of evidence regarding the efficacy of intervention with vocational outcome parameters was assessed. In a systematic literature search, 40 randomized clinical trials on different types of intervention were retrieved. Their internal validity and statistical power criteria were assessed. The randomization procedure, blinding of patients, and sample size were problematic in most studies. For patients with acute low-back pain limited or moderate evidence was found for the efficacy of no bed rest, a short period of bed rest, and spinal manipulation. For chronic patients limited evidence was found for the efficacy of antidepressants. For the other types of intervention, studies with sufficient statistical power were lacking. Such studies are needed before more-detailed evidence-based guidelines can be formulated for occupational health care.
职业健康医生需要实用的管理指南，以便为患有腰痛的员工提供个人支持。在本研究中，评估了关于职业结局参数干预效果的证据水平。通过系统的文献检索，检索到40项关于不同类型干预的随机临床试验。评估了它们的内部效度和统计效能标准。在大多数研究中，随机化程序、患者盲法和样本量都存在问题。对于急性腰痛患者，发现不卧床休息、短期卧床休息和脊柱推拿的疗效证据有限或中等。对于慢性患者，发现抗抑郁药疗效的证据有限。对于其他类型的干预，缺乏具有足够统计效能的研究。在为职业健康护理制定更详细的循证指南之前，需要进行此类研究。
