Documents Martimo, Kari-Pekka 3 results

"Back pain is very common among adults. There is evidence that individuals who physically move or lift objects (manual material handling) on a regular basis increase the strain on their backs and the risk of developing back pain. In many occupations, it is difficult to avoid this. Training on proper lifting techniques and the use of mechanical aides (assistive devices) are considered important techniques to prevent back pain.

We included nine randomised controlled trials (20,101 employees) and nine cohort studies (1280 employees) that examined the effects of training and the use of assistive devices on preventing low-back pain and reducing back-related disability. We found no studies that examined the effects of training or the use of assistive devices as part of a treatment plan for back pain.

We found moderate quality evidence that reports of back pain, back-related disability or absence from work were similar between groups who received training on proper lifting techniques and assistive devices compared to a control group that received either no training, minor advice only, professional education, exercise training or back belts. Reports of back pain were also similar between those who received intensive training and those who received shorter instruction. These findings were consistent when measured in the short-term or long-term and when examined in randomised trials or cohort studies.

These results are similar to other reviews that examined a range of possible prevention measures. Some of the other reviews found that workers who received training were satisfied and demonstrated increased knowledge on the subject, but this did not appear to consistently translate into behaviour change.

In conclusion, training workers in proper material handling techniques or providing them with assistive devices are not effective interventions by themselves in preventing back pain. Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate."

"BACKGROUND: Training and assistive devices are considered major interventions to prevent back pain among workers exposed to manual material handling (MMH). OBJECTIVES: To determine the effectiveness of MMH advice and training and the provision of assistive devices in preventing and treating back pain. SEARCH STRATEGY: We searched MEDLINE to November 2005, EMBASE to August 2005, and CENTRAL, the Back Group's Trials Register, CINAHL, Nioshtic, CISdoc, Science Citation Index, and PsychLIT to September 2005. SELECTION CRITERIA: We included randomized controlled trials (RCT) and cohort studies with a concurrent control group, aimed at changing human behaviour in MMH and measuring back pain, back pain-related disability or sickness absence. DATA COLLECTION AND ANALYSIS: Two authors independently extracted the data and assessed the methodological quality using the criteria recommended by the Back Review Group for RCTs and MINORS for the cohort studies. One author of an original study supplied additional data for the review. The results and conclusions are based on the primary analysis of RCTs. We conducted a secondary analysis with cohort studies. We compared and contrasted the conclusions from the primary and secondary analyses. MAIN RESULTS: We included six RCTs (17,720 employees) and five cohort studies (772 employees). All studies focused on prevention of back pain. Two RCTs and all cohort studies met the majority of the quality criteria and were labeled high quality. We summarized the strength of the evidence with a qualitative analysis since the lack of data precluded a statistical analysis. There is moderate evidence that MMH advice and training are no more effective at preventing back pain or back pain-related disability than no intervention (four studies) or minor advice (one study). There is limited evidence that MMH advice and training are no more effective than physical exercise or back belt use in preventing back pain (three studies), and that MMH advice plus assistive devices are not more effective than MMH advice alone (one study) or no intervention (one study) in preventing back pain or related disability. The results of the cohort studies were similar to the randomised studies. AUTHORS' CONCLUSIONS: There is limited to moderate evidence that MMH advice and training with or without assistive devices do not prevent back pain, back pain-related disability or reduce sick leave when compared to no intervention or alternative interventions. There is no evidence available for the effectiveness of MMH advice and training or MMH assistive devices for treating back pain."

"Training and provision of assistive devices are considered major interventions to prevent and treat low back pain (LBP) among workers exposed to manual material handling (MMH). To establish the effectiveness of training and provision of assistive devices in preventing and treating LBP an update of a Cochrane literature review was performed to November 2010. Randomised controlled trials (RCTs) and cohort studies with a concurrent control group (CCTs) were included. Nine RCTs (20.101 employees) and nine CCTs (1280 employees) were included for prevention: six more than in the previous version. No study on treatment was found. None of the included RCTs and CCTs provided evidence that training and provision of assistive devices prevented LBP when compared to no intervention or another intervention."