Abstract
Limited evidence exists about non-specific low back pain (NSLBP) interventions among tactical personnel (police officers, firefighters, or army forces). The aim was to identify and systematically review the findings of randomized control trials (RCTs) investigating conservative interventions for the treatment NSLBP in tactical personnel. A search of seven databases for randomized controlled trials RCTs were conducted. Two independent reviewers extracted data and assessed the risk of bias (PEDro scale). Five RCTs (n = 387 military subjects; median PEDro score = 7/10) were included. The trials were highly heterogeneous, differing in pain and disability outcome measures, duration of NSLBP symptoms (acute, nonacute, nonchronic, and chronic), types of intervention (exercise, manual therapy, and physical therapy), types of control groups, and intervention durations (4–12 weeks). Two studies reported that strengthening exercise interventions were not effective for reducing pain or disability in military personnel with chronic or nonacute NSLBP. Manual therapy treatment was more effective than usual activities in current pain and pain typical symptoms in soldiers with acute NSLBP after four weeks. A multidimensional intervention reduced disability in military personnel with non-chronic NSLBP after four weeks. Strong evidence does not exist for the efficacy of any conservative interventions in the reduction of pain and disability in tactical populations with NSLBP.
Highlights
The primary job of tactical personnel is to serve and protect their community and country
The workforce impacts of load carriage injuries can be notable with research having identified a significantly greater proportion of absenteeism in police officers, for example, who regularly wore body armor (26%) compared to those who did not (17%) [16] and loads worn by U.S soldiers deployed to Afghanistan predictive of the development of low back pain (LBP) during deployment [17]
The primary aim of this systematic review was to investigate the conservative interventions for the treatment of non-specific low back pain (NSLBP) in tactical populations
Summary
The primary job of tactical personnel (i.e., military, law enforcement, or fire and rescue/first responders’) is to serve and protect their community and country. Given the nature of threat to themselves, and to the need to perform these tasks and duties effectively, tactical personnel wear and carry various items of equipment These items can include, but are not limited to, weapons, communications equipment, body armor, self-contained breathing apparatus, food, and nutrition [1,3,4]. The weight of this equipment often equates to approximately 10 kg of load for general duties police [4], increasing to over 40 kg if these police are specialists [5], around 20 kg for firefighters [3], and over 45 kg for military personnel [6]. Specify study characteristics (e.g., PICOS, length of follow-up) and report characteristics (e.g., years considered, language, publication status) used as criteria for eligibility, giving rationale.
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