Back Injury Prevention Research Articles

The use of an online learning module to improve knowledge for prevention of back pain and injury in industrial workers.

Back pain is a significant public health problem that accounts for a high percentage of morbidity and disability worldwide. Low back pain is a frequent cause of missed workdays and job-specific disability and is associated with poor outcomes for employees and employers. An online learning module that focused on normal anatomy of the spine, common pathophysiologic diagnosis or findings that may contribute to back pain, and techniques for back pain reduction was created for employees at risk due to the nature of their labor-intensive jobs. This module also contained case studies and graphics that demonstrated ways to reduce risks or hazards by incorporating job-specific changes in the work environment. A mixed method statistical analysis of knowledge change was completed after participation in the online module. This demonstrated that participants had a marked increase in knowledge in all areas examined. In addition, participants perceived the module as beneficial for grasping anatomical concepts, understanding injury prevention and management strategies, valuing the shared information, leveraging visual aids, and applying practical examples per qualitative questions answered. Participants gained knowledge that can be used on the job to decrease risk of sustaining back pain or injury. The intervention approach enhances the understanding of back pain among industrial workers and holds profound implications for public health on a broader scale. Monitoring population health and preventing back pain and injury while at work is essential for safety and is also a core competency in public health.

Swimming Anatomy and Lower Back Injuries in Competitive Swimmers: A Narrative Review.

Competitive swimmers are at high risk of overuse musculoskeletal injuries due to their high training volumes. Spine injuries are the second most common musculoskeletal injury in swimmers and are often a result of the combination of improper technique, high loads on the spine in strokes that require hyperextension, and repetitive overuse leading to fatigue of the supporting trunk muscles. The purpose of this review is to summarize the current evidence regarding swimming biomechanics, stroke techniques, and common injuries in the lumbar spine to promote a discussion on the prevention and rehabilitation of lower back injuries in competitive swimmers. From a PUBMED/MEDLINE search, 16 articles were identified for inclusion using the search terms "swimming," "low back" or "lumbar," and "injury" or "injuries." Narrative review. Levels 4 and 5. The trunk muscles are integral to swimming stroke biomechanics. In freestyle and backstroke, the body roll generated by the paraspinal and abdominal muscles is integral to efficient stroke mechanics by allowing synergistic movements of the upper and lower extremities. In butterfly and breaststroke, the undulating wave like motion of the dolphin kick requires dynamic engagement of the core to generate repetitive flexion and extension of the spine and is a common mechanism for hyperextension injuries. The most common lower back injuries in swimming were determined to be lumbar strain, spondylolysis and spondylolisthesis, facet joint pain, and disc disease. Most overuse swimming injuries can be treated conservatively with physical therapy and training adjustments. Managing swimmers with low back pain requires a basic knowledge of swimming technique and a focus on prevention-based care. Since most swimming injuries are secondary to overuse, it is important for providers to understand the mechanisms underlying the swimming injury, including an understanding of the biomechanics involved in swimming and the role of spine involvement in the 4 strokes that assist in stabilization and force generation in the water. Knowledge of the biomechanics involved in swimming and the significant demands placed on the spinal musculoskeletal system will aid the clinician in the diagnosis and management of injuries and assist in the development of a proper rehabilitation program aimed at correction of any abnormal swimming mechanics, treatment of pain, and future injury prevention. B. Recommendation based on limited quality or inconsistent patient-oriented evidence.

Initiation and accumulation of loading induced changes to native collagen content and microstructural damage in the cartilaginous endplate

BACKGROUND CONTEXTInjury to the cartilaginous endplate (CEP) is linked to clinically relevant low back disorders, including intervertebral disc degeneration and pain reporting. Despite this link to clinical disorders, the CEP injury pathways and the modulating effect of mechanical loading parameters on the pace of damage accumulation remains poorly understood. PURPOSEThis study examined the effect of cyclic loading on the initiation and accumulation of changes to native collagen content (type I, type II) and microstructural damage in the central region of cadaveric porcine CEPs. STUDY DESIGNIn vitro longitudinal study. METHODSOne hundred fourteen porcine cervical spinal units were included (N=6 per group). The study contained a control group (no cyclic loading) and 18 experimental groups that differed by loading duration (1,000, 3,000, 5,000 cycles), joint posture (flexed, neutral), and cyclic peak compression variation (10%, 20%, 40%). Multicolor immunofluorescence staining was used to quantify loading induced changes to type I (ie, subchondral bone) and type II (ie, endplate) native collagen content (fluorescence area, fluorescence intensity) and microstructural damage (pore area [transverse plane], void area along the CEP-bone border [sagittal plane]). RESULTSSignificant main effects of loading duration and posture were observed for fluorescence area and fluorescence intensity of type I and II collagen. In the transverse plane, type II fluorescence area significantly decreased following 1,000 cycles (-12%), but a significant change in fluorescence intensity was not observed until 3,000 cycles (-17%). Type II fluorescence area (-14%) and intensity (-10%) were both significantly less in flexed postures compared to neutral. Similar trends were observed for type I collagen in the sagittal plane sections. Generally, significant changes to fluorescence area were accompanied by the development of microstructural voids along the endplate-subchondral bone border. CONCLUSIONSThese findings demonstrate that microstructural damage beneath the endplate surface occurs before significant changes to the density of native type I and II collagen fibers. Although flexed postures were associated with greater and accelerated changes to native collagen content, the injury initiation mechanism appears similar to neutral. CLINICAL SIGNIFICANCENeutral joint postures can delay the initiation and pace of microdamage accumulation in the CEP during low-to-moderate demand lifting tasks. Furthermore, the management of peak compression exposures appeared relevant only when a neutral posture was maintained. Therefore, clinical low back injury prevention and load management efforts should consider low back posture in parallel with applied joint forces.

Flexible Wearable Nanomaterial-Based Sensing Device for Back Pain and Injury Prevention

Poor trunk posture during daily activity is known to increase the risk of low back pain and decrease quality of life. Monitoring trunk posture is a promising, proactive way to help prevent low back pain. A flexible, wearable, posture-monitoring sensor has been developed and tested in this letter. The device, referred to as “spine tape,” consists of flexible carbon nanotube composite strain sensing elements, which are screen-printed onto athletic tapes, along with a customized microcontroller-based data collection system. The spine tape possesses highly customizable dimensions and can be readily applied onto the human body, while maintaining a discreet and comfortable user experience. A series of sensing tests, including mechanical loading tests and human subject tests, was performed to characterize the performance of the spine tape. In addition, human motion analysis was used to validate the prototype and identify future improvements.

GAMBARAN UPAYA PENCEGAHAN LOW BACK PAIN PADA PERAWAT DI RSUD SELASIH PANGKALAN KERINCI

Low back pain is an uncomfortable condition on the lower back that comes with limitation of activity and pain when moving or mobilizing. One of the occupations with a high risk of suffering low back pain is nurse. This is related to ergonomic activities of nurse in hospitals. This study aims to describe the efforts of low back pain prevention in nurses. This study uses descriptive quantitative design and was conducted in Selasih Hospital, Pangkalan Kerinci. The sample of the study involves 53 respondents of nurses and uses stratified random sampling technique. Analysis in this study uses univariate analysis. The instrument in the study is a questionnaire based on back injury prevention by Kansas State University Research and Extension. The result shows that in the application of safe patient handling, assistive devices utilization, and stretching exercises, majority of the respondents often apply with percentages in consecutive are 58,5%, 67,9%, and 66,0%. The result also shows in the application of correct standing posture, correct sitting posture, and correct sleeping posture, majority of the respondents often apply with percentages in consecutive are 56,6%, 67,9%, and 54,7%. It could be concluded that efforts to prevent low back pain in nurses are often applied.

Study of the influence of adaptation-changing exercises for the back muscles of fencers in the training process

The article describes the generally accepted direction of physical training of fencers and its importance in the training process. During the study of scientific and methodical literature, it was found that in the training of fencers, little attention is paid to the prevention of back injuries and diseases, which is the main problem of the musculoskeletal system for this sport. An experiment was conducted to introduce adaptation-strengthening exercises into the training process of fencers at the stage of preliminary basic training (children aged 12-13). Two groups of fencing athletes took part in our experiment at the stage of preliminary basic training, which corresponds to the age stage of advanced training. The experiment took place on the basis of the "Harmony" Fencing Center. The control group consisted of 11 athletes aged 12–13 years. There were 12 fencers of the same age in the experimental group. The study took place from September 2021 to May 2022. At the beginning of the study (September 2021), the control and experimental groups were tested according to the standards of general and special physical training provided for in the program for fencing sports schools. Both groups (experimental and control) trained 5 times a week: 4 times specialized training and 1 time general physical training. With the help of testing, it is shown that such an innovation does not affect the general and special preparedness of fencing athletes during the annual training cycle. This shows that adaptive strengthening exercises for the back can be actively used in the training process of young fencers, without harming the basic physical qualities necessary for this sport. In the training process of fencers of training groups, insufficient attention is paid to strengthening and relaxing the muscles of the muscular corset, which is a necessary prevention of injuries and diseases of the back, which is the biggest problem area of the musculoskeletal system of fencers.

Functional versus conventional strength and conditioning programs for back injury prevention in emergency responders.

Back pain and back-related injuries are common complaints among emergency responders. The purpose of this study was to compare the effectiveness of two strength and conditioning programs in improving back muscle characteristics and disabilities in emergency responders (firefighters/paramedics). Participants (n = 24) were randomized into two groups to complete 16 weeks of supervised exercise intervention: 1) Functional training used unilateral movements that mimicked the asymmetrical nature of emergency operations, 2) Conventional training performed bilaterally loaded exercises. Outcome measures were maximum isometric back extension strength, passive muscle stiffness, lumbar extensor fatigability, and revised Oswestry Low Back Pain Questionnaire. A mixed model Analysis of Variance with repeated measures was performed to compare the difference over time and between groups. While the training effects were similar between groups, both programs improved isometric back extension strength (+21.3% functional, +20.3% conventional, p < 0.001, ηp 2 = 0.625) and lumbar extensor muscle fatigability (+17.4% functional, +9.5% conventional, p = 0.009, ηp 2 = 0.191). Bilateral symmetry in muscle stiffness was improved as indicated by reduction in symmetry index (-7.1% functional, -11.8% conventional, p = 0.027, ηp 2 = 0.151). All self-reported pain and disability scores fell within the category of “minimum functional limitation” throughout the intervention and 6-month follow-up periods. For frontline firefighters and paramedics, both functional and conventional strength training are effective for improving back muscle characteristics.

Optimization-based biomechanical lifting models for manual material handling: A comprehensive review.

Lifting is a main task for manual material handling (MMH), and it is also associated with lower back pain. There are many studies in the literature on predicting lifting strategies, optimizing lifting motions, and reducing lower back injury risks. This survey focuses on optimization-based biomechanical lifting models for MMH. The models can be classified as two-dimensional and three-dimensional models, as well as skeletal and musculoskeletal models. The optimization formulations for lifting simulations with various cost functions and constraints are reviewed. The corresponding equations of motion and sensitivity analysis are briefly summarized. Different optimization algorithms are utilized to solve the lifting optimization problem, such as sequential quadratic programming, genetic algorithm, and particle swarm optimization. Finally, the applications of the optimization-based lifting models to digital human modeling which refers to modeling and simulation of humans in a virtual environment, back injury prevention, and ergonomic safety design are summarized.

Effect of Back Support Belt on Musculoskeletal Discomfort During Simulated Manual Handling of Loads Among Male Agricultural Workers

Introduction: The usage of back support belt for manual handling activities particularly lifting/lowering of loads in occupational setting has been a sore point of conflicting agreement between industrial practitioners and academician on its effectiveness in prevention of back injuries. As such, this pre-test and post-test experimental study was designed to investigate the effectiveness of back support belt in reducing localized musculoskeletal discomfort among male agricultural workers. Methods: A total of 38 subjects were randomly assigned into control and intervention groups (19 subjects in each group). The subjects were required to carry out a series of lifting and lowering of incremental weight load similar to the protocol as described in Progressive Isoinertial Lifting Evaluation (PILE) techniques. After completing each lift, subjects were required to rate the discomfort felt in the back region using the Localized Musculoskeletal Discomfort questionnaire. Results: Results showed that only several pairs showing statistically significant differences with no discernible trend. Within the control group, the median calculated from group data showed an overall increased discomfort rating as the weight load increases except for 19.4kg but an overall decreased discomfort within intervention group. Comparison between control and intervention group for post-test results showed significant difference between 5.9kg and middle back although the trend of LMD ratings across body part investigated may suggest interesting relationship. Conclusion: Despite positive subjective perception amongst the wearer as conveyed by industrial practitioners, the epidemiological data, clinical trials, and various other experimental studies in the past few decades including in this study has not shown sufficient evidence of effectiveness.

Development of a Stretchable Circuit and its Integration Method on Knit Fabrics for Lower Back Injury Prevention

Advancements in wearable technology and smart textiles have also opened new possibilities in the sports and medical fields. One of the examples of a relevant application case can be found in cycling. This paper expands on previous research on stretchable electronics on knit fabrics. It describes the development of stretchable circuits for the lower back position and motion tracking to prevent back pain in recreational (road) cyclists by combining electrical and textile engineering with insights generated in rehabilitation sciences and sports physiotherapy. The research process included developing and testing of the functional circuit integrated into a cycling jersey. Thermoplastic polyurethane films were used for the textile integration process to achieve maximum comfort and after-life disassembly possibility. Reliability tests, e.g. washing (ISO 6330-2012) and tensile tests, were conducted. It is concluded that while mechanical stress during washing cycles remains a serious concern for reliability and durability, the use of water-repellent thermoplastic polyurethane sealing seriously reduces the damage caused by water and detergents.

Sport-related back injury prevention with a wearable device

There has been a high incidence rates (∼41%) of back injury from undertaking weightlifting exercises as a result of improper lifting posture, where the spine should remain straight during a lifting movement which is often not adopted correctly by adolescent or beginner athletes. In this work we report a wearable device prototype consisting of independent sensor nodes using inertial measurement units to provide the user with real-time postural feedback on a companion application. From the data collected from four subjects, for several weight-lifting attempts, a strong correlation was found in the relative pitch angle between the upper cervical sensor and lower-lumbar sensor, which proved that the straightness of the user’s back could be inferred using only two sensor nodes.

Using a Food Bank as a Platform for Educating Communities during the COVID-19 Pandemic

ABSTRACT Purpose To describe a partnership between a public university and a regional foodbank aimed to promote health in food insecure communities, and to support nursing students’ learning experiences in community health. Design A single setting case study. Methods A comprehensive health needs assessment conducted through a windshield survey and key informant interviews was used to identify the community’s priorities. Findings Nursing interventions were tailored to the community’s needs by creating healthy recipes and providing education on food safety, lower back injury prevention, and chronic disease prevention and 15 management. Conclusion During pandemics, nursing program partnerships with food banks could play pivotal roles in community health promotion. Clinical Evidence Food banks can serve as clinical platforms for nursing education and community wellness activities.

Lower Back Injury Prevention and Sensitization of Hip Hinge with Neutral Spine Using Wearable Sensors during Lifting Exercises.

The popularization and industrialization of fitness over the past decade, with the rise of big box gyms and group classes, has reduced the quality of the basic formation and assessment of practitioners, which has increased the risk of injury. For most lifting exercises, a universal recommendation is maintaining a neutral spine position. Otherwise, there is a risk of muscle injury or, even worse, of a herniated disc. Maintaining the spine in a neutral position during lifting exercises is difficult, as it requires good core stability, a good hip hinge and, above all, observation of the posture in order to keep it correct. For this reason, in this work the authors propose the prevention of lumbar injuries with two inertial measurement units. The relative rotation between two sensors was measured for 39 voluntary subjects during the performance of two lifting exercises: the American kettlebell swing and the deadlift. The accuracy of the measurements was evaluated, especially in the presence of metals and for fast movements, by comparing the obtained results with those from an optical motion capture system. Finally, in order to develop a tool for improving sport performance and preventing injury, the authors analyzed the recorded motions, seeking to identify the most relevant parameters for good and safe lifting execution.

Implementation of the OSTRC Back Injury Prevention Program among Professional Basketball, Handball, Soccer, and Volleyball Players

The Oslo Sports Trauma Research Center (OSTRC) back injury prevention program (IPP) is an evidence-based injury prevention exercise designed to prevent back pain and other related injuries. The aim of this study was to assess the implementation of the OSTRC Back IPP among professional basketball, handball, soccer, and volleyball players in the Gulf Cooperation Council (GCC) countries. The survey was developed by the study authors and it consisted of two sections: the socio-demographic and questionnaire assess the implementation of OSTRC Back IPP. A total of 360 athletes responded to the survey (response rate was 93.75%). The mean (±SD) of the total implementation score was 6.6 (±1.8) out of 13. Jumping lunges exercise was the highest implemented exercise, making up 56.1% of the participated players, followed by the side plank and jump turns 53.3% and 53.1%, respectively. In contrast, the lowest implemented exercise was the rotational strength exercise which accounts for 46.4%. There were no statistically significant differences between the GCC countries in the implementation of all exercises except for the side lunges exercise. The rate of implementation of the OSTRC Back IPP among players was low in the GCC countries.

Understanding Causal Pathways for Occupationally Related Low Back Disorders

Extended Abstract Low back pain has been a leading cause of disability worldwide for nearly two decades (Hartvigsen et al 2018). In a study of US health care spending between 1996 through 2013, low back and neck pain was the health care condition with the highest increase in spending (Dieleman et. al. 2016). Continued increases in health care costs due to low back pain are not sustainable. Therefore, we need to develop better low back disorder prevention plans or tools. In order to prevent occupational low back disorders several tools (ie. NIOSH lifting guide, 3DSSPP, Snook Tables, Lumbar Motion Monitor risk model, REBA, LiFFT) have been developed to quantify the biomechanical or physical exposure risk. There are a multitude of risk factors for low back disorders including psychological, psychosocial, and personal factors none of which are included in the available ergonomics tools (Ferguson and Marras, 1997). The goal of this panel is to promote discussion of the biopsychosocial risk factors that lead to low back disorders and disability. Health care providers suggest that patient advocacy should include preventing prolonged work loss (Nguyen and Randolph, 2007) yet one of the most common personal risk factors of low back pain is previous history of low back pain. The prevention tools above do not include any personal risk factors regarding an individual’s low back health status or any other personal risk factor. Should a new low back injury prevention tool include some personal risk factors for previous low back injury or some other personal risk factor? What about a smoking status risk factor or since sitting is the new smoking what about a sitting risk factor? What about psychosocial factors such as supervisor support or co-worker support? What new tools might we need? What stakeholders to do we need or want at the table in order to develop a tool that will actually be effective and who will the users be? The National Institute of Occupational Safety and Health funded several field studies in the 2000s to examine biomechanical exposure as risk factors of low back disorders. Several of the panelists had studies in the group. A consortium was formed to pool data where possible to increase statistical power to measure these more complex relationships. The common surveillance questionnaire measures of low back disorder included varying degrees of low back disorder severity. The surveillance measures in order from least severe to most severe were 1) any low back pain, 2) seeking medical care due to low back pain and 3) self-reported lost time due to low back pain in the past year. The panelists will be asked to address how the role of their specific topic may change as a function of the various surveillance measures. What does a new tool being developed really need to prevent (low back pain, seeking medical care, self-reported lost time, low back disability)? We will have each panel member discuss causality from several different multidimensional perspectives and will have an open debate/discussion. We will also allow time for audience perspectives Panelist Roles Dr. Jay Kapellusch will be discussing the role of psychophysics and the NIOSH lifting equation. Dr. Matthew S. Thiese will be examining the role of psychosocial risk factors. Dr. Kermit Davis will address interventions. Dr. Sean Gallagher will be probing specific physical injury mechanisms. Dr. William S. Marras will be presenting the multidimensional causal pathway for low back disorders.

Work-Related Factors Associated with Low Back Pain Among Nurse Professionals in East and West Wollega Zones, Western Ethiopia, 2017: A Cross-Sectional Study

IntroductionLow back pain (LBP) is yet the persistent public health challenges around the globe. It substantially affects quality of life and poses disability, particularly to the global working population. The profound losses in productivity and compensation premiums due to the condition have also been a challenge to contemporary occupational health. As such, it no doubt demands informed management and due response. The objective of this research was therefore to investigate the prevalence and work-related factors associated with low back pain among nurses in public hospitals in western Ethiopia.MethodsA health facility-based cross-sectional study was conducted from March to April 2017. A sample of 422 nurses was selected using systematic random sampling technique. The standardized Nordic Musculoskeletal survey was interviewer-administered for data collection. The association of different explanatory variables with LBP was explored using a binary logistic regression analysis. The significance of associations was ascertained at a p value of < 0.05 and odds ratios (OR) with 95% confidence intervals (CI).ResultsThe response rate was 99% (N = 418). The mean age was 31.39 (standard deviation ± 7.01) years. The prevalence of LBP in the past 12 months was 63.6% (N = 266) [95% CI (58.9, 68.2)]. About 34.2% (n = 91) of the victims had sought medical care. The prevalence in the last 7 days was 53.4% (n = 142). The majority, 72.2% (n = 192), indicated that their activity was limited. Work experience [AOR 4.332; 95% CI (2.550, 7.360)], shift work [AOR 2.118; 95% CI (1.165, 3.850)], and health and safety training [AOR 2.058; 95% CI (1.127, 3.063)] were significantly associated with low back pain.ConclusionsThe prevalence of low back pain was high, as in many other studies. The finding implies that practices and implementations that focus on the prevention and control of back pain injuries should target proper management of workplace conditions, like shift work and provision of health and safety training.

Waist-assistive exoskeleton powered by a singular actuation mechanism for prevention of back-injury

This paper proposes the design of an electrically-powered waist assistive exoskeleton wire-driven only by one actuator and its control method. The developed exoskeleton is intended to reduce muscle fatigue and further prevent back-injury of industrial workers who undergo repeated, intensive waist motions. Considering requirements specially for industrial purposes, system performances related to cost, weight, operational time, and system endurance & maintainability of the robot have to be specially pursued. Therefore, reduction in the number of actuators without deteriorating the robot’s main function can be an effective approach. Along with this concept, only the single actuator mounted on the back part of the robot is proposed to simultaneously drive both legs by wire through a differential gear mechanism. The applied differential mechanism allows natural motions generally observed in human walking with almost zero mechanical impedance, but the waist motion for lifting-up heavy objects can be assisted by the powered extension of both legs. A current control algorithm embedded in a micro-controller is specially designed to achieve objectives of the robot.In order to evaluate the waist assistance provided by the developed robot, activation signals of electromyography (EMG) on main muscles of working wearers related to waist motions were measured. Further, the usability was evaluated using the responses of a questionnaire survey. Thus, the proposed method for waist assistance by a singular actuator is verified to be conclusively effective.

The Impact of Story-Based Video Back Injury Prevention Training on Employee Motivation, Engagement, Knowledge, and Behavior

The Impact of Story-Based Video Back Injury Prevention Training on Employee Motivation, Engagement, Knowledge, and Behavior

Back School programme for nurses has reduced low back pain levels: A randomised controlled trial.

(i) To examine patient lifting techniques used by nurses, and (ii) to evaluate an effectiveness of the Spine Care for Nurses programme in chronic nonspecific low back pain syndrome reduction and the execution of proper patient lifting techniques. Millions of nurses around the world suffer from occupational-related chronic nonspecific low back pain (chronic nonspecific low back pain syndrome). Generally, low back pain in nurses is a result of increased pressure on the spine and can be associated with improperly conducted patient lifting techniques. A randomised controlled trial was conducted among 137 nurses with chronic nonspecific low back pain syndrome. Participants were randomised into an experimental and control group (experimental group n=67, control group n=70). Nurses in the experimental group attended the Spine Care for Nurses programme for 3months. The programme consisted of didactic education, spine-strengthening exercises and education on safe patient handling techniques. The control group only received a brief written lifestyle guidance. The Zebris WinSpine Triple Lumbar examination was used to analyse nurses' patient lifting techniques (horizontal and vertical lifting). The lumbar pain intensity was measured with a 0-100 visual analogue scale. The pre-intervention average chronic nonspecific low back pain syndrome intensity score on visual analogue scale decreased from 49.3 to the postintervention score of 7.5. The correct execution of vertical lifting techniques in the experimental group increased from 8.91%-97.01% (control group: 8.57% pre-intervention test and postintervention test 11.42%). The horizontal patient lifting technique pre-intervention increased from 10.44%-100% correct execution in the experimental group (control group: pre-intervention test 10.00% and postintervention test 11.42%). The Spine Care for Nurses programme significantly reduced chronic nonspecific low back pain syndrome and increased the number of properly executed horizontal and vertical patient lifting techniques in nurses. We recommend that healthcare organisations should consider the implementation of regular Spine Care for Nurses programmes as successful low back injury prevention programmes.

ANAMT Technical Guideline (DT 05): prevention of occupational low back pain through back belts, lumbar support or braces.

Low back pain is a considerable global public health problem. Use of back belts in occupational settings arises from the expectation of countless biomechanical benefits, which together would contribute to the prevention of this problem. To orient students, physicians and health institutions on the use of back belts, lumbar support or braces for prevention of low back pain or injury among asymptomatic workers. The present guideline was developed based on a systematic literature review; 809 studies were located in database MEDLINE and 571 in EMBASE and Cochrane CENTRAL. Evaluating back-belt use as preventive intervention against low back pain demands quantifying benefits, harms and difficulties to implementation, as well as the methodological quality of primary studies. Despite the weak benefits reflected in the individual, partial and isolated results of a few studies, there is no consistent evidence for the use of back belts, lumbar supports or braces for primary prevention of low back pain or occupational low back injury among workers. According to the available evidence, back-belt use is not associated with reduction of absenteeism.