Abstract
This systematic review assessed aspects of physical load during work and leisure time as risk factors for back pain. Several reviews on this topic are available, but this one is based on a strict systematic approach to identify and summarize the evidence, comparable with that applied in the clinical literature on the efficacy of intervention for back pain. A computerized bibliographical search was made of several data bases for studies with a cohort or case-referent design. Cross-sectional studies were excluded. A rating system was used to assess the strength of the evidence, based on the methodological quality of 28 cohort and 3 case-referent studies and the consistency of the findings. Strong evidence exists for manual materials handling, bending and twisting, and whole-body vibration as risk factors for back pain. The evidence was moderate for patient handling and heavy physical work, and no evidence was found for standing or walking, sitting, sports, and total leisure-time physical activity.
Highlights
IntroductionPhysical load during work and leisure time as risk factors for back pain
Hoogendoorn WE, van Poppel M N M, Bongers PM, Koes BW, Bouter LM
According to the literature reviewed in this paper, there is moderate evidence that patient handling and heavy physical work are risk factors for back pain, and strong evidence that manual materials handling, bending and twisting, and whole-body vibration at work are risk factors for back pain
Summary
Physical load during work and leisure time as risk factors for back pain. This systematicreview assessedaspectsof physical load duringwork and leisuretime asrisk factors for back pain. A rating system was used to assess the strength of the evidence,based on the methodologicalquality of 28 cohort and 3 case-referentstudies and the consistency of the findings.Strongevidenceexistsfor manual materials handling,bending and twisting,and whole-body vibrationas risk factors for back pain. Key terms bending, lifting, low-back pain, methodological quality, observational studies, overview, rating system, sports,twisting, whole-body vibration. In a recent study of a general population in The Netherlands, the annual prevalence of low-back pain was found to be 46% for men and 52% for women. In 1991, the total cost of back pain to society in The Netherlands was estimated to be 1.7% of the gross national product [6]
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