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Esa-pekka Takala - One of the best experts on this subject based on the ideXlab platform.
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manual material handling advice and Assistive Devices for preventing and treating back pain in workers a cochrane systematic review
Occupational and Environmental Medicine, 2012Co-Authors: Jos Verbeek, Kari-pekka Martimo, Esa-pekka Takala, Jaro Karppinen, P. Paul F. M. Kuijer, Eira ViikarijunturaAbstract:In many occupations, it is difficult to avoid imposing heavy loads on the back (eg, lifting and moving patients in healthcare). Therefore, it is not surprising that emphasis has been given to optimising lifting techniques and ways to manually handle patients and objects to prevent back pain and injuries. More skilled workers are supposed to cope better with adverse ergonomic conditions, resulting in less strain on the back, less back pain and consequently, less back pain-related disability. This has led to a strong belief that it is useful to advise employees or organise training for them on correct manual material handling (MMH) techniques and to provide them with Assistive Devices. Therefore, we wanted to determine the effectiveness of MMH advice and training and the provision of Assistive Devices in preventing and treating back pain. We have updated the previous version of the systematic review with a new search, new studies and improved methods.1 2 We searched CENTRAL ( The Cochrane Library 2011, issue 1), MEDLINE, EMBASE, CINAHL, Nioshtic, CISdoc, Science Citation Index and PsychLIT to February 2011. We included randomised controlled trials (RCT) and, because we thought it would be difficult to find RCTs, cohort studies with a …
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manual material handling advice and Assistive Devices for preventing and treating back pain in workers
Cochrane Database of Systematic Reviews, 2011Co-Authors: Jos Verbeek, Eira Viikarijuntura, Kari-pekka Martimo, Jaro Karppinen, P. Paul F. M. Kuijer, Esa-pekka TakalaAbstract: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
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manual material handling advice and Assistive Devices for preventing and treating back pain in workers
Cochrane Database of Systematic Reviews, 2011Co-Authors: Jos Verbeek, Eira Viikarijuntura, Kari-pekka Martimo, Jaro Karppinen, P. Paul F. M. Kuijer, Esa-pekka TakalaAbstract:Background Training and the provision of Assistive Devices are considered major interventions to prevent back pain and its related disability 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 methods We searched CENTRAL (The Cochrane Library 2011, issue 1), MEDLINE, EMBASE, CINAHL, Nioshtic, CISdoc, Science Citation Index, and PsychLIT to February 2011. Selection criteria We included randomised controlled trials (RCT) and cohort studies with a concurrent control group that were aimed at changing human behaviour in MMH and measured back pain, back pain-related disability or sickness absence. Data collection and analysis Two authors independently extracted the data and assessed the risk of bias using the criteria recommended by the Cochrane Back Review Group for RCTs and MINORS for the cohort studies. We based the results and conclusions on the analysis of RCTs only. We compared these with the results from cohort studies. Main results We included nine RCTs (20,101 employees) and nine cohort studies (1280 employees) on the prevention of back pain in this updated review. Studies compared training to no intervention (4), professional education (2), a video (3), use of a back belt (3) or exercise (2). Other studies compared training plus lifting aids to no intervention (3) and to training only (1). The intensity of training ranged from a single educational session to very extensive personal biofeedback. Six RCTs had a high risk of bias. None of the included studies showed evidence of a preventive effect of training on back pain. There was moderate quality evidence from seven RCTs (19,317 employees) that those who received training reported levels of back pain similar to those who received no intervention, with an odds ratio of 1.17 (95% confidence intervals (CI) 0.68 to 2.02) or minor advice (video), with a relative risk of 0.93 (95% CI 0.69 to 1.25). Confidence intervals around the effect estimates were still wide due to the adjustment for the design effect of clustered studies. The results of the cohort studies were similar to those of the randomised studies. Authors' conclusions There is moderate quality evidence that MMH advice and training with or without Assistive Devices does not prevent back pain or back pain-related disability when compared to no intervention or alternative interventions. There is no evidence available from RCTs for the effectiveness of MMH advice and training or MMH Assistive Devices for treating back pain. More high quality studies could further reduce the remaining uncertainty.
Jos Verbeek - One of the best experts on this subject based on the ideXlab platform.
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manual material handling advice and Assistive Devices for preventing and treating back pain in workers a cochrane systematic review
Occupational and Environmental Medicine, 2012Co-Authors: Jos Verbeek, Kari-pekka Martimo, Esa-pekka Takala, Jaro Karppinen, P. Paul F. M. Kuijer, Eira ViikarijunturaAbstract:In many occupations, it is difficult to avoid imposing heavy loads on the back (eg, lifting and moving patients in healthcare). Therefore, it is not surprising that emphasis has been given to optimising lifting techniques and ways to manually handle patients and objects to prevent back pain and injuries. More skilled workers are supposed to cope better with adverse ergonomic conditions, resulting in less strain on the back, less back pain and consequently, less back pain-related disability. This has led to a strong belief that it is useful to advise employees or organise training for them on correct manual material handling (MMH) techniques and to provide them with Assistive Devices. Therefore, we wanted to determine the effectiveness of MMH advice and training and the provision of Assistive Devices in preventing and treating back pain. We have updated the previous version of the systematic review with a new search, new studies and improved methods.1 2 We searched CENTRAL ( The Cochrane Library 2011, issue 1), MEDLINE, EMBASE, CINAHL, Nioshtic, CISdoc, Science Citation Index and PsychLIT to February 2011. We included randomised controlled trials (RCT) and, because we thought it would be difficult to find RCTs, cohort studies with a …
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manual material handling advice and Assistive Devices for preventing and treating back pain in workers
Cochrane Database of Systematic Reviews, 2011Co-Authors: Jos Verbeek, Eira Viikarijuntura, Kari-pekka Martimo, Jaro Karppinen, P. Paul F. M. Kuijer, Esa-pekka TakalaAbstract: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
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manual material handling advice and Assistive Devices for preventing and treating back pain in workers
Cochrane Database of Systematic Reviews, 2011Co-Authors: Jos Verbeek, Eira Viikarijuntura, Kari-pekka Martimo, Jaro Karppinen, P. Paul F. M. Kuijer, Esa-pekka TakalaAbstract:Background Training and the provision of Assistive Devices are considered major interventions to prevent back pain and its related disability 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 methods We searched CENTRAL (The Cochrane Library 2011, issue 1), MEDLINE, EMBASE, CINAHL, Nioshtic, CISdoc, Science Citation Index, and PsychLIT to February 2011. Selection criteria We included randomised controlled trials (RCT) and cohort studies with a concurrent control group that were aimed at changing human behaviour in MMH and measured back pain, back pain-related disability or sickness absence. Data collection and analysis Two authors independently extracted the data and assessed the risk of bias using the criteria recommended by the Cochrane Back Review Group for RCTs and MINORS for the cohort studies. We based the results and conclusions on the analysis of RCTs only. We compared these with the results from cohort studies. Main results We included nine RCTs (20,101 employees) and nine cohort studies (1280 employees) on the prevention of back pain in this updated review. Studies compared training to no intervention (4), professional education (2), a video (3), use of a back belt (3) or exercise (2). Other studies compared training plus lifting aids to no intervention (3) and to training only (1). The intensity of training ranged from a single educational session to very extensive personal biofeedback. Six RCTs had a high risk of bias. None of the included studies showed evidence of a preventive effect of training on back pain. There was moderate quality evidence from seven RCTs (19,317 employees) that those who received training reported levels of back pain similar to those who received no intervention, with an odds ratio of 1.17 (95% confidence intervals (CI) 0.68 to 2.02) or minor advice (video), with a relative risk of 0.93 (95% CI 0.69 to 1.25). Confidence intervals around the effect estimates were still wide due to the adjustment for the design effect of clustered studies. The results of the cohort studies were similar to those of the randomised studies. Authors' conclusions There is moderate quality evidence that MMH advice and training with or without Assistive Devices does not prevent back pain or back pain-related disability when compared to no intervention or alternative interventions. There is no evidence available from RCTs for the effectiveness of MMH advice and training or MMH Assistive Devices for treating back pain. More high quality studies could further reduce the remaining uncertainty.
Eira Viikarijuntura - One of the best experts on this subject based on the ideXlab platform.
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manual material handling advice and Assistive Devices for preventing and treating back pain in workers a cochrane systematic review
Occupational and Environmental Medicine, 2012Co-Authors: Jos Verbeek, Kari-pekka Martimo, Esa-pekka Takala, Jaro Karppinen, P. Paul F. M. Kuijer, Eira ViikarijunturaAbstract:In many occupations, it is difficult to avoid imposing heavy loads on the back (eg, lifting and moving patients in healthcare). Therefore, it is not surprising that emphasis has been given to optimising lifting techniques and ways to manually handle patients and objects to prevent back pain and injuries. More skilled workers are supposed to cope better with adverse ergonomic conditions, resulting in less strain on the back, less back pain and consequently, less back pain-related disability. This has led to a strong belief that it is useful to advise employees or organise training for them on correct manual material handling (MMH) techniques and to provide them with Assistive Devices. Therefore, we wanted to determine the effectiveness of MMH advice and training and the provision of Assistive Devices in preventing and treating back pain. We have updated the previous version of the systematic review with a new search, new studies and improved methods.1 2 We searched CENTRAL ( The Cochrane Library 2011, issue 1), MEDLINE, EMBASE, CINAHL, Nioshtic, CISdoc, Science Citation Index and PsychLIT to February 2011. We included randomised controlled trials (RCT) and, because we thought it would be difficult to find RCTs, cohort studies with a …
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manual material handling advice and Assistive Devices for preventing and treating back pain in workers
Cochrane Database of Systematic Reviews, 2011Co-Authors: Jos Verbeek, Eira Viikarijuntura, Kari-pekka Martimo, Jaro Karppinen, P. Paul F. M. Kuijer, Esa-pekka TakalaAbstract: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
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manual material handling advice and Assistive Devices for preventing and treating back pain in workers
Cochrane Database of Systematic Reviews, 2011Co-Authors: Jos Verbeek, Eira Viikarijuntura, Kari-pekka Martimo, Jaro Karppinen, P. Paul F. M. Kuijer, Esa-pekka TakalaAbstract:Background Training and the provision of Assistive Devices are considered major interventions to prevent back pain and its related disability 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 methods We searched CENTRAL (The Cochrane Library 2011, issue 1), MEDLINE, EMBASE, CINAHL, Nioshtic, CISdoc, Science Citation Index, and PsychLIT to February 2011. Selection criteria We included randomised controlled trials (RCT) and cohort studies with a concurrent control group that were aimed at changing human behaviour in MMH and measured back pain, back pain-related disability or sickness absence. Data collection and analysis Two authors independently extracted the data and assessed the risk of bias using the criteria recommended by the Cochrane Back Review Group for RCTs and MINORS for the cohort studies. We based the results and conclusions on the analysis of RCTs only. We compared these with the results from cohort studies. Main results We included nine RCTs (20,101 employees) and nine cohort studies (1280 employees) on the prevention of back pain in this updated review. Studies compared training to no intervention (4), professional education (2), a video (3), use of a back belt (3) or exercise (2). Other studies compared training plus lifting aids to no intervention (3) and to training only (1). The intensity of training ranged from a single educational session to very extensive personal biofeedback. Six RCTs had a high risk of bias. None of the included studies showed evidence of a preventive effect of training on back pain. There was moderate quality evidence from seven RCTs (19,317 employees) that those who received training reported levels of back pain similar to those who received no intervention, with an odds ratio of 1.17 (95% confidence intervals (CI) 0.68 to 2.02) or minor advice (video), with a relative risk of 0.93 (95% CI 0.69 to 1.25). Confidence intervals around the effect estimates were still wide due to the adjustment for the design effect of clustered studies. The results of the cohort studies were similar to those of the randomised studies. Authors' conclusions There is moderate quality evidence that MMH advice and training with or without Assistive Devices does not prevent back pain or back pain-related disability when compared to no intervention or alternative interventions. There is no evidence available from RCTs for the effectiveness of MMH advice and training or MMH Assistive Devices for treating back pain. More high quality studies could further reduce the remaining uncertainty.
Jaro Karppinen - One of the best experts on this subject based on the ideXlab platform.
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manual material handling advice and Assistive Devices for preventing and treating back pain in workers a cochrane systematic review
Occupational and Environmental Medicine, 2012Co-Authors: Jos Verbeek, Kari-pekka Martimo, Esa-pekka Takala, Jaro Karppinen, P. Paul F. M. Kuijer, Eira ViikarijunturaAbstract:In many occupations, it is difficult to avoid imposing heavy loads on the back (eg, lifting and moving patients in healthcare). Therefore, it is not surprising that emphasis has been given to optimising lifting techniques and ways to manually handle patients and objects to prevent back pain and injuries. More skilled workers are supposed to cope better with adverse ergonomic conditions, resulting in less strain on the back, less back pain and consequently, less back pain-related disability. This has led to a strong belief that it is useful to advise employees or organise training for them on correct manual material handling (MMH) techniques and to provide them with Assistive Devices. Therefore, we wanted to determine the effectiveness of MMH advice and training and the provision of Assistive Devices in preventing and treating back pain. We have updated the previous version of the systematic review with a new search, new studies and improved methods.1 2 We searched CENTRAL ( The Cochrane Library 2011, issue 1), MEDLINE, EMBASE, CINAHL, Nioshtic, CISdoc, Science Citation Index and PsychLIT to February 2011. We included randomised controlled trials (RCT) and, because we thought it would be difficult to find RCTs, cohort studies with a …
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manual material handling advice and Assistive Devices for preventing and treating back pain in workers
Cochrane Database of Systematic Reviews, 2011Co-Authors: Jos Verbeek, Eira Viikarijuntura, Kari-pekka Martimo, Jaro Karppinen, P. Paul F. M. Kuijer, Esa-pekka TakalaAbstract: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
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manual material handling advice and Assistive Devices for preventing and treating back pain in workers
Cochrane Database of Systematic Reviews, 2011Co-Authors: Jos Verbeek, Eira Viikarijuntura, Kari-pekka Martimo, Jaro Karppinen, P. Paul F. M. Kuijer, Esa-pekka TakalaAbstract:Background Training and the provision of Assistive Devices are considered major interventions to prevent back pain and its related disability 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 methods We searched CENTRAL (The Cochrane Library 2011, issue 1), MEDLINE, EMBASE, CINAHL, Nioshtic, CISdoc, Science Citation Index, and PsychLIT to February 2011. Selection criteria We included randomised controlled trials (RCT) and cohort studies with a concurrent control group that were aimed at changing human behaviour in MMH and measured back pain, back pain-related disability or sickness absence. Data collection and analysis Two authors independently extracted the data and assessed the risk of bias using the criteria recommended by the Cochrane Back Review Group for RCTs and MINORS for the cohort studies. We based the results and conclusions on the analysis of RCTs only. We compared these with the results from cohort studies. Main results We included nine RCTs (20,101 employees) and nine cohort studies (1280 employees) on the prevention of back pain in this updated review. Studies compared training to no intervention (4), professional education (2), a video (3), use of a back belt (3) or exercise (2). Other studies compared training plus lifting aids to no intervention (3) and to training only (1). The intensity of training ranged from a single educational session to very extensive personal biofeedback. Six RCTs had a high risk of bias. None of the included studies showed evidence of a preventive effect of training on back pain. There was moderate quality evidence from seven RCTs (19,317 employees) that those who received training reported levels of back pain similar to those who received no intervention, with an odds ratio of 1.17 (95% confidence intervals (CI) 0.68 to 2.02) or minor advice (video), with a relative risk of 0.93 (95% CI 0.69 to 1.25). Confidence intervals around the effect estimates were still wide due to the adjustment for the design effect of clustered studies. The results of the cohort studies were similar to those of the randomised studies. Authors' conclusions There is moderate quality evidence that MMH advice and training with or without Assistive Devices does not prevent back pain or back pain-related disability when compared to no intervention or alternative interventions. There is no evidence available from RCTs for the effectiveness of MMH advice and training or MMH Assistive Devices for treating back pain. More high quality studies could further reduce the remaining uncertainty.
P. Paul F. M. Kuijer - One of the best experts on this subject based on the ideXlab platform.
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manual material handling advice and Assistive Devices for preventing and treating back pain in workers a cochrane systematic review
Occupational and Environmental Medicine, 2012Co-Authors: Jos Verbeek, Kari-pekka Martimo, Esa-pekka Takala, Jaro Karppinen, P. Paul F. M. Kuijer, Eira ViikarijunturaAbstract:In many occupations, it is difficult to avoid imposing heavy loads on the back (eg, lifting and moving patients in healthcare). Therefore, it is not surprising that emphasis has been given to optimising lifting techniques and ways to manually handle patients and objects to prevent back pain and injuries. More skilled workers are supposed to cope better with adverse ergonomic conditions, resulting in less strain on the back, less back pain and consequently, less back pain-related disability. This has led to a strong belief that it is useful to advise employees or organise training for them on correct manual material handling (MMH) techniques and to provide them with Assistive Devices. Therefore, we wanted to determine the effectiveness of MMH advice and training and the provision of Assistive Devices in preventing and treating back pain. We have updated the previous version of the systematic review with a new search, new studies and improved methods.1 2 We searched CENTRAL ( The Cochrane Library 2011, issue 1), MEDLINE, EMBASE, CINAHL, Nioshtic, CISdoc, Science Citation Index and PsychLIT to February 2011. We included randomised controlled trials (RCT) and, because we thought it would be difficult to find RCTs, cohort studies with a …
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manual material handling advice and Assistive Devices for preventing and treating back pain in workers
Cochrane Database of Systematic Reviews, 2011Co-Authors: Jos Verbeek, Eira Viikarijuntura, Kari-pekka Martimo, Jaro Karppinen, P. Paul F. M. Kuijer, Esa-pekka TakalaAbstract: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
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manual material handling advice and Assistive Devices for preventing and treating back pain in workers
Cochrane Database of Systematic Reviews, 2011Co-Authors: Jos Verbeek, Eira Viikarijuntura, Kari-pekka Martimo, Jaro Karppinen, P. Paul F. M. Kuijer, Esa-pekka TakalaAbstract:Background Training and the provision of Assistive Devices are considered major interventions to prevent back pain and its related disability 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 methods We searched CENTRAL (The Cochrane Library 2011, issue 1), MEDLINE, EMBASE, CINAHL, Nioshtic, CISdoc, Science Citation Index, and PsychLIT to February 2011. Selection criteria We included randomised controlled trials (RCT) and cohort studies with a concurrent control group that were aimed at changing human behaviour in MMH and measured back pain, back pain-related disability or sickness absence. Data collection and analysis Two authors independently extracted the data and assessed the risk of bias using the criteria recommended by the Cochrane Back Review Group for RCTs and MINORS for the cohort studies. We based the results and conclusions on the analysis of RCTs only. We compared these with the results from cohort studies. Main results We included nine RCTs (20,101 employees) and nine cohort studies (1280 employees) on the prevention of back pain in this updated review. Studies compared training to no intervention (4), professional education (2), a video (3), use of a back belt (3) or exercise (2). Other studies compared training plus lifting aids to no intervention (3) and to training only (1). The intensity of training ranged from a single educational session to very extensive personal biofeedback. Six RCTs had a high risk of bias. None of the included studies showed evidence of a preventive effect of training on back pain. There was moderate quality evidence from seven RCTs (19,317 employees) that those who received training reported levels of back pain similar to those who received no intervention, with an odds ratio of 1.17 (95% confidence intervals (CI) 0.68 to 2.02) or minor advice (video), with a relative risk of 0.93 (95% CI 0.69 to 1.25). Confidence intervals around the effect estimates were still wide due to the adjustment for the design effect of clustered studies. The results of the cohort studies were similar to those of the randomised studies. Authors' conclusions There is moderate quality evidence that MMH advice and training with or without Assistive Devices does not prevent back pain or back pain-related disability when compared to no intervention or alternative interventions. There is no evidence available from RCTs for the effectiveness of MMH advice and training or MMH Assistive Devices for treating back pain. More high quality studies could further reduce the remaining uncertainty.
