ABSTRACT
Aim:
The aim of this study was to determine the most effective exercise program for the
management of occupational lower back pain.
Background:
Occupational lower back pain accounts for 25% of workdays lost. The annual
occurrence of occupational related lower back pain among blue collar workers in
South Africa has shown to be between 55,7% and 63,9%.
Methodology:
Primary studies were searched with the use of the Entrez-cross-database search tool.
Methodologies were assessed and critiqued. Data which included exercise detail,
outcome measures of lower back pain intensity, painful episodes, sick leave and
physical measures with statistical p-values was then extracted.
Results:
Nine primary studies, which included 11 exercise groups, complied to the inclusion
and exclusion criteria. These studies proved to be of high methodology quality with
quality scoring 70% on the quality assessment checklist. Exercise regimes, which
included stretching, strengthening, endurance exercises and the combination use of
stretching, strengthening and endurance exercises were identified and grouped
according to the corresponding outcome measures. No meta-analysis could be done as
no similar exercises with similar outcome measures could be found.
Discussion:
The limitations in the nine selected studies methodological quality were the lack of
blinding of the assessors and subjects, and in six of the nine studies the lack of
adequate participation rate among the intervention subjects. The validation process is
acknowledged as a weakness within this study. Stretching, dynamic strengthening and
endurance exercises were not statistically significant. Isometric exercise was
statistically significant for lower back pain relief when the control group (p<0,0001)
was compared to the experimental group. Isometric exercise however had no
significant effect on abdominal strength at 9 months follow up period. Functionalexercises were statistically significant when the exercise group was compared to the
control group with lower back pain intensity relief (p<0,018), painful episodes
(p<0,018), sick leave (p< 0,0044). Functional exercises also had a long-term
statistically significant effect on back muscle strength. A meta analysis could not be
done due to insufficient similar studies.
Conclusion:
Although the methodology quality of the nine primary studies showed to be of high
quality the validation process was a weakness within this study. Functional
strengthening exercises were the most effective type of exercise for the management
of occupational lower back pain among blue-collar workers. Future similar
randomized control trials on exercise as an intervention to occupational lower back
pain are needed to conduct a meta analysis. A meta analysis will be able to provide
more evidence to establish which exercise regime is most effective for the
management of occupational lower back pain.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:wits/oai:wiredspace.wits.ac.za:10539/4935 |
| Date | 06 June 2008 |
| Creators | Van der Merwe, Petronella Dorothea |
| Source Sets | South African National ETD Portal |
| Language | English |
| Detected Language | English |
| Type | Thesis |
| Format | 514869 bytes, application/pdf, application/pdf |
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