Since three of four RCTs on lumbar supports reported no effect , there is no evidence for the effectiveness of lumbar supports .
The four RCTs on exercise consistently reported a positive effect , indicating limited evidence for the effectiveness of exercise .
CONCLUSION There is no evidence for the effectiveness of lumbar supports or education in the primary prevention of low back pain at the workplace .
There is limited evidence for the efficacy of exercise , and the effect that can be obtained is moderate .
OBJECTIVE To up date the evidence on the effectiveness of lumbar supports , education and exercise in the primary prevention of low back pain at the workplace .
A controlled trial of an educational program to prevent low back injuries.
BACKGROUND Low back injuries are common and costly , accounting for 15 to 25 percent of injuries covered by workers ' compensation and 30 to 40 percent of the payments made under that program . The high costs of injury , the lack of effective treatment . and the evidence that there are behavioral risk factors have led to widespread use of employee education programs that teach safe lifting and h and ling . The effectiveness of those programs , however , has received little rigorous evaluation . METHODS We evaluated an educational program design ed to prevent low back injury in a r and omized , controlled trial involving about 4000 postal workers . The program , similar to that in wide use in so-called back schools , was taught by experienced physical therapists . Work units of workers and supervisors were trained in a two-session back school ( three hours of training ) , followed by three to four reinforcement sessions over the succeeding few years . Injured subjects ( from both the intervention and the control groups ) were r and omized a second time to receive either training or no training after their return to work . RESULTS Physical therapists trained 2534 postal workers and 134 supervisors . Over 5.5 years of follow-up , 360 workers reported low back injuries , for a rate of 21.2 injuries per 1000 worker-years of risk . The median time off from work per injury was 14 days ( range , 0 to 1717 ) ; the median cost was $ 204 ( range , zero to $ 190,380 ) . After their return to work , 75 workers were injured again . Our comparison of the intervention and control groups found that the education program did not reduce the rate of low back injury , the median cost per injury , the time off from work per injury , the rate of related musculoskeletal injuries , or the rate of repeated injury after return to work ; only the subjects ' knowledge of safe behavior was increased by the training . CONCLUSIONS A large-scale , r and omized , controlled trial of an educational program to prevent work-associated low back injury found no long-term benefits associated with training
Since three of four RCTs on lumbar supports reported no effect , there is no evidence for the effectiveness of lumbar supports .
The four RCTs on exercise consistently reported a positive effect , indicating limited evidence for the effectiveness of exercise .
CONCLUSION There is no evidence for the effectiveness of lumbar supports or education in the primary prevention of low back pain at the workplace .
There is limited evidence for the efficacy of exercise , and the effect that can be obtained is moderate .
OBJECTIVE To up date the evidence on the effectiveness of lumbar supports , education and exercise in the primary prevention of low back pain at the workplace .