van Poppel M N, Koes B W, van der Ploeg T, Smid T, Bouter L M
Institute for Research in Extramural Medicine, Vrije Universiteit, Amsterdam, The Netherlands.
JAMA. 1998 Jun 10;279(22):1789-94. doi: 10.1001/jama.279.22.1789.
Low back pain is a frequent and costly health problem. Prevention of low back pain is important both for the individual patient and from an economic perspective.
To assess the efficacy of lumbar supports and education in the prevention of low back pain in industry.
A randomized controlled trial with a factorial design.
The cargo department of an airline company in the Netherlands.
A total of 312 workers were randomized, of whom 282 were available for the 6-month follow-up.
Subjects were randomly assigned to 4 groups: (1) education (lifting instructions) and lumbar support, (2) education, (3) lumbar support, and (4) no intervention. Education consisted of 3 group sessions on lifting techniques with a total duration of 5 hours. Lumbar supports were recommended to be used during working hours for 6 months.
Low back pain incidence and sick leave because of back pain during the 6-month intervention period.
Compliance with wearing the lumbar support at least half the time was 43%. In the 282 subjects for whom data were available, no statistically significant differences in back pain incidence (48 [36%] of 134 with lumbar support vs 51 [34%] of 148 without, P=.81) or in sick leave because of low back pain (mean, 0.4 days per month with lumbar support vs 0.4 days without, P=.52) were found among the intervention groups. In a subgroup of subjects with low back pain at baseline, lumbar supports reduced the number of days with low back pain per month (median, 1.2 vs 6.5 days per month; P=.03).
Overall, lumbar supports or education did not lead to a reduction in low back pain incidence or sick leave. The results of the subgroup analysis need to be confirmed by future research. Based on our results, the use of education or lumbar supports cannot be recommended in the prevention of low back pain in industry.
腰痛是一个常见且代价高昂的健康问题。预防腰痛对个体患者以及从经济角度来看都很重要。
评估腰部支撑物和教育在预防工业领域腰痛方面的效果。
一项采用析因设计的随机对照试验。
荷兰一家航空公司的货运部门。
总共312名工人被随机分组，其中282名可进行6个月的随访。
受试者被随机分为4组：（1）教育（搬运指导）和腰部支撑物，（2）教育，（3）腰部支撑物，（4）不干预。教育包括3次关于搬运技术的小组课程，总时长为5小时。建议在6个月的工作时间内使用腰部支撑物。
6个月干预期内的腰痛发病率和因背痛导致的病假情况。
至少一半时间佩戴腰部支撑物的依从率为43%。在有数据的282名受试者中，各干预组在腰痛发病率（佩戴腰部支撑物的134人中48人[36%]，未佩戴的148人中51人[34%]，P = 0.81）或因腰痛导致的病假方面（佩戴腰部支撑物者平均每月0.4天，未佩戴者平均每月0.4天，P = 0.52）均未发现统计学上的显著差异。在基线时有腰痛的受试者亚组中，腰部支撑物减少了每月腰痛的天数（中位数，每月1.2天对6.5天；P = 0.03）。
总体而言，腰部支撑物或教育并未导致腰痛发病率或病假减少。亚组分析的结果需要未来研究加以证实。基于我们的结果，不建议在工业领域预防腰痛时使用教育或腰部支撑物。
