Long-term effectiveness of an educational and physical intervention for preventing low-back pain
                    recurrence: a randomized controlled trial

Chaléat-Valayer, Emmanuelle; Denis, Angélique; Abelin-Genevois, Kariman; Zelmar, Amélie; Siani-Trebern, Fabienne; Touzet, Sandrine; Bergeret, A.; Colin, Cyrille; Fassier, Jean‐Baptiste

doi:10.5271/sjweh.3597

“…FABs related to physical activity are known to affect exercise adherence [ [63] are usually considered helpful in the management of fear avoidance-related pain. An intervention including education in addition to exercise was slightly more effective in reducing FABs-PA among French hospital workers with LBP than the present study [61].…”

Section: Discussioncontrasting

confidence: 66%

“…FABs-PA results at baseline in the current study were comparable to those detected among French hospital workers with recurrent LBP [61], but lower than among LBP patients seeking medical care for their pain [62]. FABs related to physical activity are known to affect exercise adherence [ [63] are usually considered helpful in the management of fear avoidance-related pain.…”

Section: Discussionsupporting

confidence: 61%

“…The reduction of FABs during the intervention was statistically significant, but we do not know its clinical relevance (three questions related to returning to work were removed from the original FAB Questionnaire). Among hospital workers with recurrent LBP, an intervention combining education and exercise reduced FABs-PA, but did not reduce LBP recurrence episodes in two-year follow up [61]. Understanding the causality and reasons for exercise adherence is complicated, multidimensional, and difficult to study.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Fear-avoidance beliefs are associated with exercise adherence: Secondary analysis of a randomised controlled trial (RCT) among female healthcare workers with recurrent low back pain

Taulaniemi¹,

Kankaanpää

²

,

Rinne³

et al. 2020

Preprint

0

View full text Add to dashboard Cite

Background: Exercise is recommended for the treatment and management of low back pain (LBP) and the prevention of chronicity. Exercise adherence has been only modest in intervention studies among people with musculoskeletal pain. Fear-avoidance beliefs (FABs) are known to affect exercise adherence.The purpose was twofold: to examine which bio-psycho-social factors contributed to exercise adherence during a 6-month neuromuscular exercise intervention among female healthcare workers with recurrent LBP, and to investigate how exercising affects FABs at 6 and 12 months’ follow-up. Methods: Some 219 healthcare workers aged 30–55 years with mild-to-moderate re-current non-specific LBP were originally allocated into: 1) exercise, 2) counselling, 3) combined exercise and counselling, and 4) control groups. In the present secondary analysis, groups 1 and 3 (exercise only and exercise+counselling) were merged to be exercisers and groups 2 and 4 were merged to be non-exercisers. Baseline variables of the exercise compliers (≥24 times over 24 weeks; n=58) were compared to those of the non-compliers (<1 time/week, 0–23 times; n=52). The effects of the exercise programme on FABs were analysed by a generalised linear mixed model according to the intention-to-treat principle (exercisers; n= 110 vs non-exercisers; n=109) at three measurement points (baseline, 6, and 12 months). A per-protocol analysis compared the more exercised to the less exercised and non-exercisers. Results: A low education level (p=0.026), shift work (p=0.023), low aerobic (p=0.048) and musculoskeletal (p=0.043) fitness, and high baseline physical activity-related FABs (p=0.019) were related to low exercise adherence. The exercise programme reduced levels of both physical activity- and work-related FABs, and there was a dose response: FABs reduced more in persons who exercised ≥24 times compared to those who exercised 0-23 times.Conclusion: Healthcare workers who had lower education and fitness levels, worked shifts, and had high physical activity-related FABs had a lower adherence to the 6-month neuromuscular exercise programme. Exercising with good adherence reduced levels of FABs, which have been shown to be linked with prolonged LBP. Motivational strategies should be targeted at persons with low education and fitness levels and high FABs in order to achieve better exercise adherence.

show abstract

“…FABs-PA results at baseline in the current study were comparable to those detected among French hospital workers with recurrent LBP [61], but lower than among LBP patients seeking medical care for their pain [62]. Interventions to reduce FABs very seldom include exercise only , but a Pilates-type exercise has shown to reduce FABs more than stationary cycling in short term among chronic LBP patients [64].…”

Section: Discussionsupporting

confidence: 52%

Fear-avoidance beliefs are associated with exercise adherence: Secondary analysis of a randomised controlled trial (RCT) among female healthcare workers with recurrent low back pain

Taulaniemi¹,

Kankaanpää

²

,

Rinne³

et al. 2020

Preprint

0

View full text Add to dashboard Cite

Background: Exercise is recommended for the treatment and management of low back pain (LBP) and the prevention of chronicity. Exercise adherence has been only modest in intervention studies among people with musculoskeletal pain. Fear-avoidance beliefs (FABs) are known to affect exercise adherence.The purpose was twofold: to examine which bio-psycho-social factors contributed to exercise adherence during a 6-month neuromuscular exercise intervention among female healthcare workers with recurrent LBP, and to investigate how exercising affects FABs at 6 and 12 months’ follow-up. Methods: Some 219 healthcare workers aged 30–55 years with mild-to-moderate re-current non-specific LBP were originally allocated into: 1) exercise, 2) counselling, 3) combined exercise and counselling, and 4) control groups. In the present secondary analysis, groups 1 and 3 (exercise only and exercise+counselling) were merged to be exercisers and groups 2 and 4 were merged to be non-exercisers. Baseline variables of the exercise compliers (≥24 times over 24 weeks; n=58) were compared to those of the non-compliers (<1 time/week, 0–23 times; n=52). The effects of the exercise programme on FABs were analysed by a generalised linear mixed model according to the intention-to-treat principle (exercisers; n= 110 vs non-exercisers; n=109) at three measurement points (baseline, 6, and 12 months). A per-protocol analysis compared the more exercised to the less exercised and non-exercisers. Results: A low education level (p=0.026), shift work (p=0.023), low aerobic (p=0.048) and musculoskeletal (p=0.043) fitness, and high baseline physical activity-related FABs (p=0.019) were related to low exercise adherence. The exercise programme reduced levels of both physical activity- and work-related FABs, and there was a dose response: FABs reduced more in persons who exercised ≥24 times compared to those who exercised 0-23 times.Conclusion: Healthcare workers who had lower education and fitness levels, worked shifts, and had high physical activity-related FABs had a lower adherence to the 6-month neuromuscular exercise programme. Exercising with good adherence reduced levels of FABs, which have been shown to be linked with prolonged LBP. Motivational strategies should be targeted at persons with low education and fitness levels and high FABs in order to achieve better exercise adherence.

show abstract

“…Multifaceted 15 studies reporting on 16 different interventions were identified and grouped within the multifaceted domain [35,49,[62][63][64][65][66][67][68][69][70][71][72][73][74]. 11 interventions from high-quality studies and 2 interventions from medium quality studies presented no benefit of multifaceted workplace-interventions on MSD.…”

Section: Participatory Ergonomicsmentioning

confidence: 99%

A Systematic Review of Workplace Interventions to Rehabilitate Musculoskeletal Disorders Among Employees with Physical Demanding Work

Sundstrup

¹

,

Seeberg

²

,

Bengtsen

³

et al. 2020

View full text Add to dashboard Cite

Purpose This systematic review investigates the effectiveness of workplace interventions to rehabilitate musculoskeletal disorders (MSDs) among employees with physically demanding work. Methods A systematic search was conducted in bibliographic databases including PubMed and Web of Science Core Collection for English articles published from 1998 to 2018. The PICO strategy guided the assessment of study relevance and the bibliographical search for randomized controlled trials (RCTs) and non-RCTs in which (1) participants were adult workers with physically demanding work and MSD (including specific and non-specific MSD and musculoskeletal pain, symptoms, and discomfort), (2) interventions were initiated and/ or carried out at the workplace, (3) a comparison group was included, and (4) a measure of MSD was reported (including musculoskeletal pain, symptoms, prevalence or discomfort). The quality assessment and evidence synthesis adhered to the guidelines developed by the Institute for Work & Health (Toronto, Canada) focusing on developing practical recommendations for stakeholders. Relevant stakeholders were engaged in the review process. Results Level of evidence from 54 high and medium quality studies showed moderate evidence of a positive effect of physical exercise. Within this domain, there was strong evidence of a positive effect of workplace strength training. There was limited evidence for ergonomics and strong evidence for no benefit of participatory ergonomics, multifaceted interventions, and stress management. No intervention domains were associated with "negative effects". Conclusions The evidence synthesis recommends that implementing strength training at the workplace can reduce MSD among workers with physically demanding work. In regard to workplace ergonomics, there was not enough evidence from the scientific literature to guide current practices. Based on the scientific literature, participatory ergonomics and multifaceted workplace interventions seem to have no beneficial effect on reducing MSD among this group of workers. As these interventional domains were very heterogeneous, it should also be recognized that general conclusions about their effectiveness should be done with care. Systematic review registration PROSPERO CRD42018116752(https ://www.crd.york.ac.uk/prosp ero/displ ay_recor d.php?Recor dID=11675 2).

show abstract

Long-term effectiveness of an educational and physical intervention for preventing low-back pain recurrence: a randomized controlled trial

Cited by 28 publications

References 35 publications

Fear-avoidance beliefs are associated with exercise adherence: Secondary analysis of a randomised controlled trial (RCT) among female healthcare workers with recurrent low back pain

Fear-avoidance beliefs are associated with exercise adherence: Secondary analysis of a randomised controlled trial (RCT) among female healthcare workers with recurrent low back pain

Fear-avoidance beliefs are associated with exercise adherence: Secondary analysis of a randomised controlled trial (RCT) among female healthcare workers with recurrent low back pain

A Systematic Review of Workplace Interventions to Rehabilitate Musculoskeletal Disorders Among Employees with Physical Demanding Work

Contact Info

Product

Resources

About