van Poppel M N, Koes B W, Smid T, Bouter L M
Institute for Research in Extramural Medicine, Vrije Universiteit, Amsterdam, The Netherlands.
Occup Environ Med. 1997 Dec;54(12):841-7. doi: 10.1136/oem.54.12.841.
To assess the effectiveness of lumbar supports, education, and exercise in the prevention of back pain in industry.
A computerised search for controlled clinical trials was conducted. A criteria list was used to assess the methodological quality of the studies. The available evidence for the effectiveness of the interventions was graded with a rating system for the level of evidence. Effect sizes of individual studies were combined if the studies were sufficiently similar.
11 studies were identified for the review. The methodological quality of all studies was low, with a maximum score of three out of seven for internal validity. There was no evidence for the effectiveness of lumbar supports due to contradictory outcomes of the studies. Five of the six studies on education reported no effect. Thus there is limited evidence that education does not help to prevent back pain. All three studies on exercise reported a positive result, indicating limited evidence for the effectiveness of exercise. The combined effect size for exercise was 0.53, which is a medium sized effect.
Although widely used, there is little evaluative research on the preventive measures studied here. The review showed that there is limited evidence that exercise has some effect in the prevention of back pain and that education is not effective. No conclusive evidence was found for or against the effectiveness of lumbar supports. Research of higher methodological quality is needed before firm conclusions on the effectiveness of lumbar supports, education, and exercise in the prevention of back pain in industry can be drawn.
评估腰部支撑物、教育及运动在预防工业环境中背痛方面的有效性。
进行了一项关于对照临床试验的计算机检索。使用一份标准清单来评估研究的方法学质量。采用证据水平评级系统对干预措施有效性的现有证据进行分级。如果各项研究足够相似，则合并个别研究的效应量。
共识别出11项研究用于综述。所有研究的方法学质量都较低，内部效度在七分制中最高得分为三分。由于研究结果相互矛盾，没有证据表明腰部支撑物有效。六项关于教育的研究中有五项报告无效果。因此，仅有有限的证据表明教育无助于预防背痛。三项关于运动的研究均报告了积极结果，表明运动有效性的证据有限。运动的合并效应量为0.53，属于中等效应。
尽管此处所研究的预防措施被广泛使用，但相关评估研究较少。综述表明，仅有有限的证据表明运动在预防背痛方面有一定作用，而教育无效。对于腰部支撑物的有效性，未找到支持或反对的确凿证据。在能够就腰部支撑物、教育及运动在预防工业环境中背痛的有效性得出确凿结论之前，需要开展方法学质量更高的研究。
