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At least 19 recordsLinked to original sources
PubMed1999

The influence of previous low back trouble, general health, and working conditions on future sick-listing because of low back trouble. A 15-year follow-up study of risk indicators for self-reported sick-listing caused by low back trouble.

STUDY DESIGN: A 15-year follow-up study. OBJECTIVE: To find risk indicators for self-reported sick-listing because of low back trouble and to evaluate which variables were the most important indicators of work incapacity resulting from low back trouble during the follow-up period of 15 years. SUMMARY OF BACKGROUND DATA: The initial data were obtained from a health survey conducted in a general population from the Municipality of Glostrup, Denmark. The follow-up data included information from the Central Person Register, the Early Retirement Pension Register, and a postal questionnaire regarding self-reported sick-listing because of low back trouble. METHODS: An epidemiologic study, in which logistic regression analyses were used for evaluation of the data. The model used consisted of the variable in question, age, gender, and previous experience of low back trouble, along with interactions. RESULTS: It was found that 22 of 37 variables were risk indicators for later self-reported sick-listing because of low back trouble during the preceding year or the 7 years before the date of follow-up evaluation. In analyzing the most significant variables simultaneously, it was found that information from the initial investigation about sick-listing in general during the previous 10 years, sciatic pain, use of analgesics for low back trouble, previous sick-listing because of low back trouble, and occupation were the most important risk indicators for self-reported work incapacity resulting from low back trouble during the follow-up period of 15 years. CONCLUSION: Findings showed that the strongest prognostic indicators of later sick-listing because of low back trouble involve information from the person about previous sick-listing behavior in general and previous experience of low back trouble episodes, especially if these had been accompanied by sciatic pain, use of analgesics, or previous low back trouble sick-listing.

Adult↗
PubMedDate not supplied

Back supports and back injuries: a second visit with the Home Depot cohort study data on low-back injuries.

The back support has been controversial as a means of reducing injuries to the lower back. Diverse issues bear on the interpretation of data obtained in a major epidemiologic investigation of the utility of back supports in the retail-trade home improvement industry. These concerns are focused on alternate explanations for the changes in injury rates observed over the six-year study period, on individual and group factors other than the use of the back support that might have contributed to reducing the risk of injury, and on related methodologic issues. Each issue is addressed with specific reference to how it might affect the analyses and the conclusion that the supports showed a protective effect.

Adult↗
PubMed1995

Outcome of treatment of chronic low back pain in inpatients. Effect of individual physiotherapy including intensive dynamic training in inpatients with chronic low back trouble, evaluated by means of low back pain rating scale.

UNLABELLED: The purpose of the present study is to evaluate the efficacy of the treatment regime for chronic low back pain patients of the impatient clinic of Ringe Rehabilitation Hospital, Denmark, by means of a modified version of Claus Manniche's Low Back Pain Rating Scale. Ninety-three patients were included, of whom 63 (67%) participated in the one year follow-up interview. RESULTS: improvements in subjective as well as objective measures when discharge scores are compared to admission scores. The one year follow-up scores are on the same level as the admission scores. More patients are at work, but still more patients receive pension for health reasons at the one year follow-up. CONCLUSION: The improvements achieved during admission do not last. We suggest that the patients should be more carefully selected for intensive treatment during admission, and that the treatment perhaps should continue beyond the inpatient period. Perhaps the regime should include psychological treatment and vocational rehabilitation, all to be offered at the same institution.

Adult↗
PubMed1996

Low back pain and its relationship to back strength and physical activity in children.

OBJECTIVE: The objective of the study was to determine the occurrence of low back pain and its relationship to back strength and physical activity in children. METHODS AND MATERIALS: The study included 53 boys and 43 girls aged 10 to 19 years from a group of 116 children who had undergone isometric strength testing 4 years previously. No intervention was performed. Each child was asked five questions concerning low back pain. A questionnaire to quantify participation in athletic activities and manual labor was used as the basis for calculation of each child's activity level. Isometric back flexor and extensor strength were measured with the same method used 4 years previously. Statistical analyses were performed with appropriate correction for confounding factors. RESULTS: The frequency of low back pain and the relationship between low back pain and age, between low back pain and back strength, and between low back pain and physical activity were determined. There was a history of low back pain in 51%, and the frequency of low back pain in the past year was 35%. Eight percent of the children had been limited by low back pain, and 7% had seen a doctor for the pain. The first incident of low back pain occurred at a mean age of 12.3 years. The frequencies of a history of low back pain and of low back pain in the past year increased significantly with age (p = 0.02 and 0.01 respectively). Increased physical activity was significantly associated with a history of low back pain (p = 0.03), and increased back flexor strength was significantly associated with a history of low back pain and of low back pain in the past year (p = 0.03 and 0.008, respectively). The rate of low back flexor or strength over 4 years had a significantly positive association with the occurrence of low back pain in the past year (p = 0.008). CONCLUSIONS AND RELEVANCE: Low back pain is common in children, and, in contrast to adults, low back pain in these children was more common with increased physical activity and stronger back flexors. We believe the main causes of low back pain in children are musculotendinous strains and ligamentous sprains.

Adolescent↗
PubMed2000

A prospective study of back belts for prevention of back pain and injury.

CONTEXT: Despite scientific uncertainties about effectiveness, wearing back belts in the hopes of preventing costly and disabling low back injury in employees is becoming common in the workplace. OBJECTIVE: To evaluate the effectiveness of using back belts in reducing back injury claims and low back pain. DESIGN AND SETTING: Prospective cohort study. From April 1996 through April 1998, we identified material-handling employees in 160 new retail merchandise stores (89 required back belt use; 71 had voluntary back belt use) in 30 states (from New Hampshire to Michigan in the north and from Florida to Texas in the south); data collection ended December 1998, median follow-up was 6(1/2) months. PARTICIPANTS: A referred sample of 13,873 material handling employees provided 9377 baseline interviews and 6311 (67%) follow-up interviews; 206 (1.4%) refused baseline interview. MAIN OUTCOME MEASURES: Incidence rate of material-handling back injury workers' compensation claims and 6-month incidence rate of self-reported low back pain. RESULTS: Neither frequent back belt use nor a belt-requirement store policy was significantly associated with back injury claim rates or self-reported back pain. Rate ratios comparing back injury claims of those who reported wearing back belts usually every day and once or twice a week vs those who reported wearing belts never or once or twice a month were 1.22 (95% confidence interval [CI], 0.87-1.70) and 0.95 (95% CI, 0.56-1.59), respectively. The respective odds ratios for low back pain incidence were 0.97 (95% CI, 0.83-1.13) and 0.92 (95% CI, 0.73-1.16). CONCLUSIONS: In the largest prospective cohort study of back belt use, adjusted for multiple individual risk factors, neither frequent back belt use nor a store policy that required belt use was associated with reduced incidence of back injury claims or low back pain. JAMA. 2000;284:2727-2732.

Adult↗
PubMed1997

Risk indicators of low back pain among workers in Japan. Association of familial and physical factors with low back pain.

STUDY DESIGN: A questionnaire was given to 3,042 Japanese workers at a factory in 1992. It surveyed age, gender, weight, height, job classification, and work environment, as well as the perceived causes, onset age, and characteristics of low back pain. Family history of low back pain among first-degree relatives and perception of physical condition also were assessed. OBJECTIVES: To investigate the risk indicators of low back pain in Japanese workers with various kinds of job classifications in a manufacturing company. SUMMARY OF BACKGROUND DATA: Risk indicators of low back pain in Japanese patients have not been fully investigated in previous studies. METHODS: Prevalence rates and characteristics of low back pain were examined among 3,042 factory workers (2,517 men and 525 woman) with jobs with varying physical demands. In the analysis of risk indicators of low back pain, the odds ratios and 95% confidence intervals were computed. In addition, a multiple logistic analysis was performed to evaluate risk indicators of low back pain. RESULTS: Point and lifetime prevalence of low back pain were correlated with the physical demands of the job. The perceived cause found to be most associated with low back pain were lifting in workers with jobs requiring moderate to heavy work and sports activity in sedentary workers. Family history of low back pain in parents, siblings, and children was a risk indicator of low back pain. The average age of the first attack of low back pain in workers with a family history of it in their parents was significantly younger than that in workers with no family history in a multiple logistic analysis in male workers, the physical work demands, age, and family history of low back pain in their parents were risk indicators; however, obesity was not a risk indicator. Physical and mental conditions of workers also were associated with low back pain. CONCLUSIONS: The physical job demands show a clear association with the point and lifetime prevalence of low back pain, and improvements in work conditions may decrease low back symptoms among workers. It is likely that a family history of low back pain and physical and mental conditions of workers also should be considered in the management of low back pain.

Adult↗
PubMed1999

[Back problems during military service--significance for later back problems. A 12-year follow-up study].

One thousand and fifty-eight conscripts participating in an investigation of back problems among conscripts in 1979-80 were re-examined 12 years later with an identical questionnaire concerning back problems. The questionnaire was answered by seven hundred and eighty-four persons (74%). The lifetime prevalence for low-back trouble was 73%, the one-year prevalence 53% and the point prevalence 26%. At the time of follow-up the incidence of low-back trouble depended on ever having had back pains and on having an X-ray made because of back problems. The probability for sick leave from work caused by lowback trouble was increased when back troubles had been reported at the time of the initial investigation. A significant amount of the conscripts that had been rejected due to back problems (60%) had been unfit for work because of low-back trouble in the follow-up period, and 95% of them had had low-back trouble in the year before follow-up, compared to 51% of the other conscripts. Previous back trouble increases the risk of getting back trouble once again. The risk of sick leave from work caused by low-back trouble increases with the incidence of back trouble up to the investigation in 1979-80. Rejection from service due to back problems increases the risk of later low-back trouble and sick leave from work caused by low-back troubles.

Adult↗
PubMed2000

Multidisciplinary biopsychosocial rehabilitation for subacute low back pain among working age adults.

BACKGROUND: Multidisciplinary biopsychosocial rehabilitation programs are widely applied for chronic low back pain patients. The biopsychosocial approach for low back pain could also be considered to prevent chronicity by carrying out the rehabilitation if the acute pain is prolonged. Nevertheless multidisciplinary treatment programmes are often laborious and long processes and require good collaboration between the patient, the rehabilitation team and the work place. By workplace visits and close relationship with occupational health care one might expect results in terms of patients working ability. OBJECTIVES: The objective of this systematic review was to determine the effectiveness of multidisciplinary rehabilitation for subacute low back pain among working age adults. SEARCH STRATEGY: The reviewed studies for this structured Cochrane review were identified from electronic bibliographic databases, the Science Citation Index, reference checking and consulting experts in the rehabilitation field. The original search was planned and performed for more broad area of musculoskeletal disorders. Trials on subacute low back pain were separated afterwards. SELECTION CRITERIA: From all references found in our original search we selected randomized controlled trials (RCTs) and non-randomized controlled clinical trials (CCTs). Trials had to assess the effectiveness of multidisciplinary rehabilitation for working age patients suffering from subacute low back pain (more than 4 weeks but less than 3 months). The rehabilitation program was required to be multidisciplinary, i.e.; it had to consist of a physician's consultation plus either a psychological, social or vocational intervention, or a combination of these. DATA COLLECTION AND ANALYSIS: Four blinded reviewers selected the randomized controlled trials and controlled trials that met the specified inclusion criteria. Two experts in the field of rehabilitation evaluated the clinical relevance and applicability of the findings of the selected studies to actual clinical use. Two other blinded reviewers extracted the data and assessed the main results and the methodological quality of the studies using standardized forms. Finally, a qualitative analysis was performed to evaluate the level of scientific evidence for the effectiveness of multidisciplinary rehabilitation. MAIN RESULTS: After screening 1808 abstracts, and the references of 65 reviews, we found only 2 relevant studies that satisfied our criteria on subacute low back pain. They were both considered to be methodologically low quality randomized controlled trials. The clinical relevance of included studies was sufficient. The level of scientific evidence for the effectiveness of multidisciplinary rehabilitation was moderate on subacute low back pain showing that multidisciplinary rehabilitation which includes workplace visit or more comprehensive occupational health care intervention helps patients to return to work faster, makes sick leaves less and alleviates subjective disability. REVIEWER'S CONCLUSIONS: We conclude that there is moderate evidence of positive effectiveness of multidisciplinary rehabilitation for subacute low back pain and workplace visit increases the effectiveness. But because this evidence is based on the trials that had some methodological shortcomings and several expensive multidisciplinary rehabilitation programmes are commonly used for common subacute low back problems, there is an obvious need for high quality trials in this field.

Acute Disease↗
PubMed2003

Back strength cannot be predicted accurately from anthropometric measures in subjects with and without chronic low back pain.

OBJECTIVES: (1) To develop a multiple regression equation using anthropometric measurements to predict back strength and (2) to estimate the effect of practice on the back strength results and back strength predictions. DESIGN: Comparative study with repeated measures performed on three days. BACKGROUND: The assessment of back muscle relative endurance (% maximal strength) requires the measurement of maximal back strength which is problematic with low back pain patients. METHODS: The back strength (L5/S1 static extension moment), age and 26 anthropometric parameters were obtained from 83 male volunteers [42 healthy subjects and 41 chronic low back pain patients] aged between 20 and 60 years. A subsample of 20 healthy subjects and 20 patients were assessed through three days of testing to evaluate the variations of back strength with practice. RESULTS: The final regression model (n=42 healthy subjects) explained 39% of the variance in back strength. Back strength increased with practice (Day1<Day2 & 3) for both healthy and patients groups. However, the error of prediction of back strength derived from the regression model showed a significant improvement with practice for the patients only. CONCLUSIONS: Back strength cannot be predicted from simple anthropometric measures without important errors. The decrease of the error of prediction obtained for the patient group is indicative of a decreasing influence of psychological factors that are independent of motor learning because the effect of motor learning would have occurred on both groups if present. RELEVANCE: The prediction of back strength would be useful to determine (1) the relative force level of a given exercise or (2) the preinjury back strength. Unfortunately, anthropometric measurements are not enough good predictors of back strength.

Adult↗
PubMed2001

Back muscle fatigability is associated with knee extensor inhibition in subjects with low back pain.

STUDY DESIGN: Cross-sectional study of 25 male golfers with chronic low back pain and 16 healthy controls of similar age. OBJECTIVES: To assess the association between functional capacity of the back extensors and the quadriceps muscles. SUMMARY OF BACKGROUND DATA: Chronic low back pain has been shown to lead to changes in muscle activation patterns of the abdominals and the gluteus maximus. The effect of chronic low back pain on lower limb function has not been investigated. METHODS: Back extensor endurance was assessed by a Biering-Sørensen test; surface EMG was measured bilaterally on the erector spinae at T12 and L4--L5. Muscle inhibition in the quadriceps was assessed by applying an electrical twitch to the maximally contracted muscle. The associations between holding time, decrease in EMG median frequency (i.e., the slope of the regression line on median frequency vs. time), and muscle inhibition were compared for study participants with chronic low back pain and controls. RESULTS: Mean back extensor holding times were 88 +/- 30 seconds for study participants with chronic low back pain and 92 +/- 17 seconds for controls. Both groups showed bilaterally similar decreases in EMG median frequency at L4--L5 and T12; however, the slopes were significantly steeper at L4--L5 than T12. Study participants with chronic low back pain with poor back endurance had significantly higher muscle inhibition compared with study participants with chronic low back pain with good back endurance, whereas such an association was not evident in healthy controls. CONCLUSIONS: In golfers with chronic low back pain reduced back endurance was associated with significant inhibition of the knee extensors, indicating that this muscle group cannot be activated to a full extent. These findings suggest a possible association between back extensor fatigability and knee extensor dysfunction in male golfers with chronic low back pain.

Adult↗
PubMed2003

[Chronic back pain: more than pain in the back. Findings of a regional survey among insurees of a workers pension insurance fund].

BACKGROUND: Surveys with a main focus on back pain tend to isolate the complaint from possibly concomitant pains, other symptoms and disorders. Severe chronic back pain is assumed here to imply more than pain in the back. PARTICIPANTS AND METHODS: We report results from a two stage survey conducted in 1998 - 2000. The initial postal questionnaire addressed all 10,000 actively employed blue collar workers from a regional pension fund (Landesversicherungsanstalt Schleswig-Holstein) aged 40 - 54 and residing in or around Luebeck/Germany (68 % males). Subjects reporting severe and disabling back pain were invited to a socio-medical examination. The response and participation rates were 58 % and 65 % respectively. Non-response and non-participation seem to result in minor though opposite, effects. RESULTS: The prevalence of current back pain (back pain of any severity within the past 7 days) is high (68 %; including 16 % with severe, disabling back pain) despite the preponderance of males and a probable healthy worker effect. 82 % of subjects participating in the second round reported recurrent or persisting back pain on the day of examination, in the majority with a chronic fluctuating and overall deteriorating course pattern. 18 % reported no current back pain and hence gave prospective (and additionally retrospective) evidence of an episodic-intermittent course of the disorder. The former group showed significantly more pains, bodily complaints, dysfunctional cognitions, emotional distress and concomitant disorders. 35 % of them indicated back pain as their dominant health problem; 49 % identified back pain and another disorder as dominant, and 16 % reported other prominent health problems. More than 70 % of "other" disorders originated from the musculoskeletal system often involving the extremities. SUMMARY AND CONCLUSION: Back pain is very common among blue collar workers. Severe disabling back pain is usually associated with numerous other pains, bodily complaints, disorders, and indicators of psychological distress ("amplified back pain"). However, even amplified back pain is not always the sole or dominant health problem. Assessing the degree of "amplification" seems helpful in splitting a previously homogeneous group of severely affected back pain sufferers-with possible prognostic and therapeutic consequences.

Adult↗
PubMed1998

The Saskatchewan health and back pain survey. The prevalence of low back pain and related disability in Saskatchewan adults.

STUDY DESIGN: Population-based, cross-sectional, mailed survey. OBJECTIVES: To determine the lifetime, 6-month period, and point prevalence of low back pain and its related disability among Saskatchewan adults and to investigate the presence and strength of selective response bias. SUMMARY OF BACKGROUND DATA: There have been many reports of the prevalence of low back pain in different populations, and the estimates vary widely depending on case definition. However, most studies fail to differentiate between trivial and disabling back pain, which raises the issue of the usefulness of these estimates. No studies have yet documented the prevalence of graded low back pain severity and its related disability in a North American, general, population-based survey. METHODS: The Saskatchewan Health and Back Pain Survey was mailed to a probability sample of 2184 Saskatchewan adults between 20 and 69 years of age. Fifty-five percent of the eligible population responded to the survey. Respondents were compared with nonrespondents, and the presence of selective response bias by back pain status was investigated by wave analysis. The point and lifetime prevalence of low back pain was determined by simple questions, and the 6-month period prevalence of low back pain was determined by the Chronic Pain Questionnaire. All estimates were age standardized to the Saskatchewan population. RESULTS: The authors estimate that at the time of the survey 28.4% (95% confidence interval, 25.6-31.1) of the Saskatchewan adult population were experiencing low back pain, and 84.1% (95% confidence interval, 81.9-86.3) had experienced it during their lifetime. Overall, 48.9% (95% confidence interval, 45.9-52.0) of the population had experienced low intensity/low-disability low back pain in the previous 6 months, 12.3% (95% confidence interval, 10.3-14.4) had experienced high-intensity/low-disability low back pain, and an additional 10.7% (95% confidence interval, 8.8-12.5) had experienced high-disability low back pain in the previous 6 months. There was little variation in the estimates over age groups, but women experienced more high-disability back pain than men. There was no evidence of selective response bias by low back pain status in the survey. CONCLUSION: Low-intensity/low-disability low back pain is a common problem in the general population. Approximately 11% of the adult population studied had been disabled by low back pain in the previous 6 months.

Adult↗
PubMed1998

Functional changes in back muscle activity correlate with pain intensity and prediction of low back pain during pregnancy.

OBJECTIVE: To assess low back pain (LBP) intensity and subjective disability during pregnancy and compare the pain scores with lumbar motion patterns. DESIGN: A prospective study of pregnant back pain sufferers and healthy controls. SETTING: Kuopio University Hospital, Kuopio, Finland. PARTICIPANTS: Study group consisted of 32 pregnant women with LBP; control group consisted of 21 healthy pregnant women. MAIN OUTCOME MEASURES: Back pain intensity was assessed by visual analog scale (VAS), and subjective disability index was measured by Oswestry Low Back Disability Questionnaire, at 20 and 36 weeks of pregnancy. Back muscle activities were recorded by surface electromyography, and movement sensors were used to detect lumbar motion. RESULTS: In the study group current pain scores (VAS) at first and last trimester correlated strongly (r = .82, p < .00). Pain scores correlated with body weight at the first trimester (r = .54, p = .003) and at the last trimester (r = .67, p < .00). Significant correlation was noted between current pain intensity and back muscle activity level during forward body flexion at first trimester (r = .704, p < .00). Back muscle activity during bending measured at first trimester significantly correlated with pain intensity at last trimester (r = .703, p < .00). Back muscle activity during the first trimester of pregnancy had a negative correlation with current (r = -.57, p = .002) and later subjective disability index (r = -.42, p = .02). It correlated inversely (r = -.54, p = .003) with pain score at last trimester of pregnancy, ie, the lower the back muscle activity at the beginning of pregnancy, the more pain and disability throughout pregnancy. In the control group, three women developed LBP and disability feelings during pregnancy. They had increased muscle activity during flexion at delivery, ie, disturbed flexion relaxation. CONCLUSIONS: Prepregnancy LBP predicts renewed pain during pregnancy, and dysfunction of back muscles has been established in LBP. In this study, disturbance in the relaxation of the back muscles was linearly related to current, and also to later, pain scores. In addition, back muscle activity level was inversely related to the disability index. For the first time, it has been shown prospectively that the function pattern of back extensors seems to predict, and is related to, future back pain. Simple function testing is promising and might be valuable in identifying mothers with a high risk of pregnancy-related back pain and in directing preventive intervention to high risk women by making them aware of self-treatment methods.

Activities of Daily Living↗
PubMed2000

Back schools for non-specific low back pain.

BACKGROUND: Since the introduction of the Swedish back school in 1980, the content of back schools has changed and appears to vary widely today. Back schools are frequently used in the treatment of low back pain patients. OBJECTIVES: The objective of this systematic review was to assess the effects of back schools for patients with non-specific low back pain. SEARCH STRATEGY: We searched the Medline and Embase databases up to December 1997 and the Cochrane Controlled Trials Register up to December 1998 if reported in English, Dutch, French or German. We also screened references given in relevant reviews and identified randomised trials. SELECTION CRITERIA: Only randomised trials that reported on any type of back school for non-specific low back pain were included. DATA COLLECTION AND ANALYSIS: Two reviewers blinded with respect to authors, institution and journal independently extracted the data and assessed trial quality. Our preset "high quality" level was 6 or more out of 11 internal validity criteria with positive scores. As data were statistically and clinically too heterogeneous, a qualitative review (best evidence synthesis) was performed. The evidence was classified into 4 levels (strong, moderate, limited or no evidence) taking into account the methodological quality of the studies. MAIN RESULTS: Fifteen RCTs were included in our systematic review. Overall, the methodological quality was low. Only 3 trials were considered high quality. It was not possible to make relevant subgroup analyses for radiation versus no radiation or to have a relevant subgroup of studies reporting on acute low back pain only. The results indicate that there is moderate evidence that back schools have better short-term effects than other treatments for chronic low back pain, and that there is moderate evidence that back schools in an occupational setting are more effective compared to 'placebo' or waiting list controls. REVIEWER'S CONCLUSIONS: Back schools may be effective for patients with recurrent and chronic low back pain in occupational settings, but little is known about the cost-effectiveness of back schools.

Exercise↗
PubMedDate not supplied

Effect of preexisting back pain on the incidence and severity of back pain in intercollegiate rowers.

BACKGROUND: Back pain is a common problem among rowers. PURPOSE: To determine whether preexisting back pain is a significant risk factor for back pain in intercollegiate rowers and how it relates to the ability of athletes to participate in college rowing. STUDY DESIGN: Survey. METHODS: Surveys from 1829 former intercollegiate rowing athletes were analyzed. The surveys included questions concerning back pain before the subjects' college career, back pain during intercollegiate rowing, missed practices, the duration of time lost from college rowing because of back pain, and career-ending back pain. Back pain was defined as pain lasting longer than 1 week. RESULTS: More subjects with preexisting back pain developed back pain during their college rowing career than subjects without preexisting back pain (57.1% versus 36.6%). Of those with preexisting pain, 55% missed practice because of back pain and 8% ended their college rowing careers; for those without preexisting pain, the percentages were 62% and 17%, respectively. For subjects with pain before their college rowing career, 78.8% missed less than 1 week and 5.9% missed more than 1 month. For subjects with no preexisting pain, 61.9% missed less than 1 week and 18.1% missed more than 1 month. CONCLUSIONS: While rowers with preexisting back pain are more likely to have back pain in college, they are less likely to miss extended periods of practice time or end their college rowing careers because of back pain.

Back Pain↗
PubMed1996

Back school in a first episode of compensated acute low back pain: a clinical trial to assess efficacy and prevent relapse.

OBJECTIVE: To assess the efficacy of a back school program for patients with a first episode of acute work-related low back pain requiring compensation. DESIGN: A randomized single-blind controlled trial. SETTING: A private physiatrics outpatient clinic. PATIENTS: The mean duration of low back pain was 15 days. INTERVENTION: Eligible patients were randomized to a standard treatment program that included daily physiotherapy (n = 86) or the same program with the addition of back school (n = 82). The back school program consisted of three 90-minute sessions given by a single trained instructor at 0, 1, and 8 weeks. MAIN OUTCOME MEASURES: The primary outcomes were the time off work for the presenting episode of back pain and the number and duration of recurrences in the year following the study onset. Secondary outcomes included the level of pain, spinal mobility, active straight-leg raising, and functional disability assessed by the Oswestry and Roland-Morris scales. RESULTS: Those randomized to the back school group gained significantly more knowledge, based on the multiple choice examination (p = .0001) and performed the exercise program significantly better (p = .0001) than the standard care group. There were no differences between the two treatment groups for either of the primary outcomes. The median time to return to work from randomization was 33 days for both the back school and the standard care groups (p = .48). The number of compensated recurrences of low back pain over 1 year was similar (back school = 14, standard care = 10, p = .16), as was the median duration of these episodes (back school = 25 days, standard care = 70 days, p = .21). There were no significant differences favoring the back school group for any of the secondary outcomes at the posttreatment, 6-month, or 12-month assessments. CONCLUSION: A back school intervention in addition to standard care resulted in no reduction in the time to return to work or the number or duration of recurrences of low back pain requiring compensation over a period of one year.

Absenteeism↗
PubMed1999

Active back school: prophylactic management for low back pain. A randomized, controlled, 1-year follow-up study.

STUDY DESIGN: A randomized, controlled, single-center trial with a stratified group design. OBJECTIVE: To investigate the secondary prophylactic effect of the Active Back School program on minimizing recurrences of low back pain episodes. SUMMARY OF BACKGROUND DATA: The results of back school interventions are controversial. Previous work often used short intervention periods and low doses of practical training. However, studies with the highest methodologic scores have shown the best results, especially when conducted in occupational settings and coupled with a comprehensive rehabilitation program. METHODS: By block randomization, 19 men and 24 women were allocated to Active Back School, with 18 men and 20 women as control subjects. The Slumps test and number of low back pain episodes during the previous 36 months were used as stratification factors. There were no significant differences between the groups with regard to demographic factors and initially observed variables. Active Back School consisted of 20 lessons over a 13-week period. Each lesson was divided into a 20-minute theoretical part and a 40-minute exercise part. All participants were examined on enrollment, then 5 and 12 months after initiation of the program. Outcome measures were recurrence of low back pain episodes and number of days of sick leave. RESULTS: The recurrence of new low back pain episodes was significantly lower (P < 0.05) and the time from inclusion to the first new episode significantly longer (P < 0.01) in the Active Back School group than in the control group. In the Active Back School group, seven participants took sick leave because of low back pain episodes during the first 12 months of follow-up compared with 11 among the control subjects. The number of sick leave days was significantly lower (P < 0.05) in the Active Back School group than in the control group. CONCLUSION: Active Back School reduced the recurrence and severity of new low back pain episodes according to results of follow-up examinations performed 5 and 12 months after enrollment.

Adult↗