BACKGROUND: Core muscle functional strength training (CMFST) has been reported to reduce injuries to the lower extremity. However, no study has confirmed whether CMFST can reduce the risk of low back pain (LBP). OBJECTIVE: This study identified the effects of CMFST on the incidence of LBP in military recruits. DESIGN, SETTING, PARTICIPANTS AND INTERVENTION: We performed a prospective, open-label, randomized, controlled study in a population of young healthy male naval recruits from a Chinese basic combat training program. Participants were randomly assigned to either the core group or the control group. In additional to normal basic combat training, recruits in the core group underwent a CMFST program for 12 weeks, while recruits in the control group received no extra training. MAIN OUTCOME MEASURES: At the beginning of the study and at the 12th week, the number of participants with LBP was counted, and lumbar muscle endurance was measured. In addition, when participants complained of LBP, they were assessed using the visual analog scale (VAS) and Roland Morris Disability Questionnaire (RMDQ). RESULTS: A total of 588 participants were included in the final analysis (295 in the core group and 293 in the control group). The incidence of LBP in the control group was about twice that of the core group over the 12-week study (20.8% vs 10.8%, odds ratio: 2.161-2.159, P < 0.001). The core group had better lumbar muscle endurance at 12 weeks than the control group ([200.80 ± 92.98] s vs [147.00 ± 84.51] s, P < 0.01). There was no significant difference in VAS score between groups, but the core group had a significantly lower RMDQ score at week 12 than the control group (3.33 ± 0.58 vs 5.47 ± 4.41, P < 0.05). CONCLUSION This study demonstrated that the CMFST effectively reduced the incidence of LBP, improved lumbar muscle endurance, and relieved the dysfunction of LBP during basic military training.
Humans ; Low Back Pain/prevention & control* ; Male ; Military Personnel ; Muscles ; Prospective Studies ; Resistance Training ; Treatment Outcome

Several clinical practice guidelines related to the assessment and management of low back pain (LBP) have been published with varied scopes and methods. This paper summarises the first French occupational guidelines for management of work-related LBP (October 2013). There main originality is to treat all the three stages of primary, secondary and tertiary prevention of work-related LBP. The guidelines were written by a multidisciplinary working group of 24 experts, according to the Clinical Practice Guidelines method proposed by French National Health Authority, and reviewed by a multidisciplinary peer review committee of 50 experts. Recommendations were based on a large systematic review of the literature carried out from 1990 to 2012 and rated as strong (Level A), moderate (B), limited (C) or based on expert consensus (D) according to their level of evidence. It is recommended to deliver reassuring and consistent information concerning LBP prognosis (Level B); to perform a clinical examination looking for medical signs of severity related to LBP (Level A), encourage continuation or resumption of physical activity (Level A), identify any changes in working conditions and evaluate the occupational impact of LBP (Level D). In case of persistent/recurrent LBP, assess prognostic factors likely to influence progression to chronic LBP, prolonged disability and delayed return to work (Level A). In case of prolonged/repeated sick leave, evaluate the pain, functional disability and their impact and main risk factors for prolonged work disability (Level A), promote return to work measures and inter professional coordination (Level D). These good practice guidelines are primarily intended for professionals of occupational health but also for treating physicians and paramedical personnel participating in the management of LBP, workers and employers.
Allied Health Personnel ; Consensus ; Humans ; Low Back Pain* ; Motor Activity ; Occupational Health ; Peer Review ; Prognosis ; Return to Work ; Risk Factors ; Sick Leave ; Tertiary Prevention

INTRODUCTIONThere have been intermittent reports of peroneal neuropathy (PN) occurring after liver transplantation. Although PN may not be viewed as a serious complication by liver transplant (LT) recipients who require the transplant for survival, PN can significantly reduce quality of life. The incidence of PN appears to have increased after the use of gel pads was introduced. These gel pads, which are placed under patients' knees during surgery, are used to reduce lower back strain and prevent contact between the peroneal nerve at the fibular head and the hard surface of the operating table. The aim of the present study was to investigate the association, if any, between the use of gel pads and the incidence of PN.

METHODSThe medical records of 261 adult LT recipients were retrospectively reviewed. The recipients were divided into gel pad (n = 167) and non-gel pad (n = 94) groups. The incidence and possible risk factors of PN were compared between the two groups.

RESULTSThe overall incidence of PN was 8.0% (21/261). The occurrence of PN was significantly higher in the gel pad group than in the non-gel pad group (10.8% vs. 3.2%; p < 0.05). Other possible risk factors were comparable between the two patient groups.

CONCLUSIONAs the use of gel pads may increase the incidence of PN, we recommend against the use of gel pads under the knees of LT recipients.

Adult ; Female ; Gels ; Humans ; Incidence ; Liver Failure ; complications ; surgery ; Liver Transplantation ; adverse effects ; Low Back Pain ; prevention & control ; Male ; Middle Aged ; Peroneal Neuropathies ; etiology ; prevention & control ; Postoperative Complications ; prevention & control ; Protective Devices ; Quality of Life ; Retrospective Studies ; Risk Factors ; Treatment Outcome

BACKGROUND: Stochastic resonance whole-body vibration training (SR-WBV) was tested to reduce work-related musculoskeletal complaints. METHODS: Participants were 54 white-collar employees of a Swiss organization. The controlled crossover design comprised two groups each given 4 weeks of exercise and no training during a second 4-week period. Outcome was daily musculoskeletal well-being, musculoskeletal pain, and surefootedness. In addition, participants performed a behavioral test on body balance prior to when SR-WBV started and after 4 weeks of SR-WBV. RESULTS: Across the 4-week training period, musculoskeletal well-being and surefootedness were significantly increased (p < 0.05), whereas musculoskeletal pain was significantly reduced only in those who reported low back pain during the last 4 weeks prior to the study (p < 0.05). Body balance was significantly increased by SR-WBV (p < 0.05). CONCLUSION: SR-WBV seems to be an efficient option in primary prevention of musculoskeletal complaints and falls at work.
Cross-Over Studies ; Low Back Pain ; Musculoskeletal Pain ; Musculoskeletal System ; Occupational Health ; Primary Prevention ; Vibration* ; Workplace*

OBJECTIVEThis paper discusses the necessary factors keeping normal spine curve and body pressure uniform distribution in sitting posture based on analysis sitting posture of low back pain and long time sitting persons. The purpose is to correct the sitting posture and prevention low back pain by changing the curves of the chair and material.

METHODS16 patients with low back pain were equally divided into research group and control group. The patients in research group accepted the rehabilitation chair, and other patients in control group accepted the chair same to before. JOA score were used as effect measures in both groups.

RESULTSThe differences were statistically significant (P < 0.005) comparison of control group after 6 months.

CONCLUSIONSThe rehabilitation chair is in accord with the body biomechanics, and has significant meaning for preventing low back pain.

Adult ; Equipment Design ; Humans ; Interior Design and Furnishings ; Low Back Pain ; prevention & control ; rehabilitation ; Middle Aged ; Posture ; Rehabilitation ; instrumentation

According to human biomechanics the ideal static equilibrium model of stooped human body was built, based on which a wearable stoop-assist device (WSAD) as an intervention to reduce the load on the erector spinae was developed. Electromyography (EMG) experiments were conducted to evaluate the effectiveness of the WSAD. Results showed that the integrated EMG of the thoracic erector spinae (TES), the lumbar erector spinae (LES), the latissimus dorsi (LD) and the rectus abdominis (RA) were reduced by 43%, 48%, 32% and 14% respectively, when Sagittal trunk bent forward to 90 degrees from the vertical. Therefore, by reducing back erector spinae activity, the WSAD could reduce the incidence of developing LBP for those who adopt the prolonged stooped posture in work.
Humans ; Incidence ; Low Back Pain ; epidemiology ; prevention & control ; Posture ; Protective Devices

BACKGROUNDSeated workplaces have greatly increased in China. Many researchers have found that seated work is a risk factor in the development of low-back pain. Backrest can reduce the load on the lower back by transmitting more of the weight from the upper body to the floor via the backrest so as to prevent low-back pain. To design a suitable chair backrest for seated office work, some backrest parameters must be optimized. In this study, the role of backrest density on lumbar load and comfort were investigated. The goal of the study was to help establish criteria with which backrests that alleviate and prevent low back pain during seated office work can be designed and selected.

METHODSTwenty volunteers (10 men and 10 women) were seated in three backrest conditions (10 kg/m(3), 25 kg/m(3), and 40 kg/m(3)). Pressure data, including contact pressure (CP), peak contact pressure (PCP) and contact area were collected during 15-minute trial. Subjective data were collected after each pressure test.

RESULTSBackrest density had a significant effect on backrest pressure variables. CP and PCP increased with increasing backrest density. Contact area decreased with increased density. In terms of user preference, the backrest with low density was most highly rated.

CONCLUSIONSBackrest density plays an important role in lumbar load and comfort during seated work. During designing and selecting backrests, backrest density should be focused on so as to alleviate and prevent low-back pain during seated office work. Backrest density at 10 kg/m(3) got the lowest CP and PCP and largest contact area. Backrest with low density can reduce lumbar pressure and increase support contact area, which could raise comfort feeling. Backrest density at 10 kg/m(3) is better to maintain a balance between providing effective support and alleviating excess lordosis.

Back Injuries ; prevention & control ; Biomechanical Phenomena ; Female ; Humans ; Interior Design and Furnishings ; Low Back Pain ; prevention & control ; Male ; Regression Analysis

Pushing and pulling (P&P) is a common operating mode of operator's physical works, and plays an important role in evaluation of human behavior health and operation performance. At present, there are many research methods of P&P, and this article is a state-of-art review of the classification of P&P research methods, the various impact factors in P&P program, technical details of internal/external P&P force measurement and evaluation, the limitation of current research methods and the future developments in the ergonomics field.
Biomechanical Phenomena ; Ergonomics ; methods ; Hand Strength ; physiology ; Humans ; Low Back Pain ; prevention & control ; Physical Exertion ; Posture ; physiology ; Task Performance and Analysis ; Weight-Bearing ; physiology

The use of opioids for the treatment of chronic non-cancer pain has become more widespread recently. Available data support the short-term use of opioids in clearly defined nociceptive and neuropathic pain states. Their use in 'pathological' pain states without a clear diagnosis, such as chronic low back pain, is more contentious. A decision to initiate opioid treatment in these conditions requires careful consideration of benefits and risks; the latter include not only commonly considered adverse effects such as constipation, but also opioid-induced hyperalgesia, abuse, addiction and diversion. Ideally, treatment goals should not only be relief of pain, but also improvement of function. Opioid treatment of chronic non-cancer pain requires informed consent by, and preferably a treatment contract with, the patient. Treatment should be initiated by a trial period with defined endpoints using slow-release or transdermal opioids. Ongoing management of the patient requires ideally a multi-disciplinary setting. Treatment should not be regarded as life-long and can be discontinued by tapering the dose.
Analgesics, Opioid ; adverse effects ; therapeutic use ; Humans ; Hyperalgesia ; chemically induced ; Low Back Pain ; drug therapy ; Pain, Intractable ; drug therapy ; Substance-Related Disorders ; prevention & control

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Drugs, Chinese Herbal ; administration & dosage ; therapeutic use ; Female ; Follow-Up Studies ; Humans ; Injections, Epidural ; Intervertebral Disc Displacement ; complications ; drug therapy ; physiopathology ; prevention & control ; Low Back Pain ; complications ; drug therapy ; Lumbar Vertebrae ; injuries ; Male ; Middle Aged ; Pharmaceutical Preparations ; administration & dosage ; Recovery of Function ; Recurrence ; Time Factors ; Treatment Outcome