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 prospective study of back belts for prevention of back pain and injury.
CONTEXT Despite scientific uncertainties about effectiveness , wearing back belts in the hopes of preventing costly and disabling low back injury in employees is becoming common in the workplace . OBJECTIVE To evaluate the effectiveness of using back belts in reducing back injury cl aims and low back pain . DESIGN AND SETTING Prospect i ve cohort study . From April 1996 through April 1998 , we identified  material -h and ling employees in 160 new retail merch and ise stores ( 89 required back belt use ; 71 had voluntary back belt use ) in 30 states ( from New Hampshire to Michigan in the north and from Florida to Texas in the south ) ; data collection ended December 1998 , median follow-up was 6(1/2 ) months . PARTICIPANTS A referred sample of 13,873 material h and ling employees provided 9377 baseline interviews and 6311 ( 67 % ) follow-up interviews ; 206 ( 1.4 % ) refused baseline interview . MAIN OUTCOME MEASURES Incidence rate of material -h and ling back injury workers ' compensation cl aims and 6-month incidence rate of self-reported low back pain . RESULTS Neither frequent back belt use nor a belt-requirement store policy was significantly associated with back injury cl aim rates or self-reported back pain . Rate ratios comparing back injury cl aims of those who reported wearing back belts usually every day and once or twice a week vs those who reported wearing belts never or once or twice a month were 1.22 ( 95 % confidence interval [ CI ] , 0.87 - 1.70 ) and 0.95 ( 95 % CI , 0.56 - 1.59 ) , respectively . The respective odds ratios for low back pain incidence were 0.97 ( 95 % CI , 0.83 - 1.13 ) and 0.92 ( 95 % CI , 0.73 - 1.16 ) . CONCLUSIONS In the largest prospect i ve cohort study of back belt use , adjusted for multiple individual risk factors , neither frequent back belt use nor a store policy that required belt use was associated with reduced incidence of back injury cl aims or low back pain . JAMA . 2000;284:2727 - 2732
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 .