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 .
Lumbar supports for prevention and treatment of low back pain: a systematic review within the framework of the Cochrane Back Review Group.
STUDY DESIGN A systematic review of r and omized and nonr and omized controlled trials . SUMMARY OF BACKGROUND DATA Lumbar supports are used in the treatment of low back pain , but also to prevent the onset ( primary prevention ) or recurrences of a low back pain episode ( secondary prevention ) . OBJECTIVES To assess the effects of lumbar sup-ports for prevention and treatment of nonspecific low back pain .  METHODS The Medline , Cinahl , and Current Contents data bases ; the Cochrane Controlled Trials Register up to September 1999 ; and the Embase data base up to September 1998 were all search ed . References of identified trials and systematic review s were review ed and the Science Citation Index used to identify additional trials . Method ologic quality assessment and data extraction were performed by two review ers independently . A quantitative analysis was performed in which the strength of evidence was classified as strong , moderate , limited or conflicting , and no evidence . RESULTS Five r and omized and two nonr and omized preventive trials and six r and omized therapeutic trials were included in the review . Only 4 of the 13 studies were of high quality . There was moderate evidence that lumbar supports are not effective for primary prevention . No evidence was found on the effectiveness of lumbar supports for secondary prevention . The systematic review of therapeutic trials showed that there is limited evidence that lumbar supports are more effective than no treatment , whereas it is still unclear whether lumbar supports are more effective than other interventions for treatment of low back pain . CONCLUSIONS There continues to be a need for high quality r and omized trials on the effectiveness of lumbar supports . One of the most essential issues to tackle in these future trials seems to be the realization of adequate compliance
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 .