A multi-faceted workplace intervention for low back pain in nurses' aides

A pragmatic stepped wedge cluster randomised controlled trial
The present study established the effectiveness of a workplace multi-faceted intervention consisting of participatory ergonomics, physical training and cognitive behavioural training for low back pain. Between November 2012 and May 2014, we conducted a pragmatic stepped-wedge cluster-randomized controlled trial with 594 workers from eldercare workplaces (nursing homes and home care) randomized to four successive time periods, three months apart. The intervention lasted 12 weeks and consisted of 19 sessions in total (physical training (12 sessions), cognitive behavioural training (2 sessions) and participatory ergonomics (5 sessions)). Low back pain was the outcome and was measured as days, intensity (worst pain on a 0-10 numeric rank scale) and bothersomeness (days) by monthly text messages. Linear mixed models were used to estimate the intervention effect. Analyses were performed according to intention to treat, including all eligible randomized participants and were adjusted for baseline values of the outcome. The linear mixed models yielded significant effects on low back pain days of -0.8 (95% confidence interval -1.19 to -0.38), low back pain intensity of -0.4 (95% confidence interval -0.60 to -0.26) and bothersomeness days of -0.5 (95% confidence interval -0.85 to -0.13) after the intervention compared to the control group. This study shows that a multi-faceted intervention consisting of participatory ergonomics, physical training and cognitive behavioural training can reduce low back pain among workers in eldercare. Thus, multi-faceted interventions may be relevant for improving low back pain in a working population.This is an open access article distributed under the terms of the Creative Commons Attribution-Noncommercial No Derivatives 3.0 License, which permits downloading and sharing the work provided it is properly cited. The work cannot be changed in any way or used commercially  

Source: Rasmussen CDN, Holtermann A, Bay H, et al. Pain, 2015.
http://dx.doi.org/10.1097/j.pain.0000000000000234 

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