Individual Participant Data Meta-Analysis of Mechanical Workplace Risk Factors and Low Back Pain

Abstract Background Proven treatments for low back pain, at best, only provide modest overall benefits. Matching people to treatments that are likely to be most effective for them may improve clinical outcomes and makes better use of health care resources. Methods We conducted an individual participant data meta-analysis of randomised controlled trials of three types of therapist delivered interventions for low back pain (active physical, passive physical and psychological treatments). We applied two statistical methods (recursive partitioning and adaptive risk group refinement) to identify potential subgroups who might gain greater benefits from different treatments from our individual participant data meta-analysis. Results We pooled data from 19 randomised controlled trials, totalling 9328 participants. There were 5349 (57%) females with similar ratios of females in control and intervention arms. The average age was 49 years (standard deviation, SD, 14). Participants with greater psychological distress and physical disability gained most benefit in improving on the mental component scale (MCS) of SF-12/36 from passive physical treatment than non-active usual care (treatment effects, 4.3; 95% confidence interval, CI, 3.39 to 5.15). Recursive partitioning method found that participants with worse disability at baseline gained most benefit in improving the disability (Roland Morris Disability Questionnaire) outcome from psychological treatment than non-active usual care (treatment effects, 1.7; 95% CI, 1.1 to 2.31). Adaptive risk group refinement did not find any subgroup that would gain much treatment effect between psychological and non-active usual care. Neither statistical method identified any subgroups who would gain an additional benefit from active physical treatment compared to non-active usual care. Conclusions Our methodological approaches worked well and may have applicability in other clinical areas. Passive physical treatments were most likely to help people who were younger with higher levels of disability and low levels of psychological distress. Psychological treatments were more likely to help those with severe disability. Despite this, the clinical importance of identifying these subgroups is limited. The sizes of sub-groups more likely to benefit and the additional effect sizes observed are small. Our analyses provide no evidence to support the use of sub-grouping for people with low back pain.

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The effect of spinal manipulative therapy on pain relief and function in patients with chronic low back pain: An individual participant data meta-analysis

Physiotherapy ◽

10.1016/j.physio.2021.03.006 ◽

2021 ◽

Author(s):

Annemarie de Zoete ◽

Sidney M. Rubinstein ◽

Michiel R. de Boer ◽

Raymond Ostelo ◽

Martin Underwood ◽

...

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Pain Relief ◽

Meta Analysis ◽

Spinal Manipulative Therapy ◽

Individual Participant Data ◽

Low Back ◽

Manipulative Therapy ◽

Individual Participant ◽

And Function

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Association between sedentary behavior and low back pain; A systematic review and meta-analysis

Health Promotion Perspectives ◽

10.34172/hpp.2021.50 ◽

2021 ◽

Vol 11 (4) ◽

pp. 393-410

Author(s):

Sadegh Baradaran Mahdavi ◽

Roya Riahi ◽

Babak Vahdatpour ◽

Roya Kelishadi

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Low Back Pain ◽

Back Pain ◽

Sedentary Behavior ◽

Sedentary Lifestyle ◽

Meta Analysis ◽

Significant Risk ◽

Sitting Time ◽

Low Back

Background: Sedentariness is a substantial risk for many chronic diseases. We aimed to investigate the correlation of sedentary behavior and its indicators with low back pain (LBP) among adults and children. Methods: Original articles published up to April 28, 2020, using PubMed, Embase, Web of Science and Scopus were evaluated. Odds ratio (OR, 95% CI) was considered the overall effect size for desired associations. Results: We reviewed 49 English articles with analytical observational study design, of which, 27 studies with cross sectional/survey design were retained in the meta-analysis. Among adults, sedentary lifestyle was a considerable risk factor for LBP (OR=1.24, 1.02-1.5); prolonged sitting time (OR=1.42, 1.09-1.85) and driving time (OR=2.03, 1.22-3.36) were the significant risk factors. Sedentary behavior was associated with LBP in office workers (OR=1.23). Moreover, excess weight (OR=1.35, 1.14-1.59) and smoking (OR=1.28, 1.03-1.60) were associated with LBP. Among children, sedentary lifestyle was a remarkable risk factor for LBP (OR=1.41, 1.24- 1.60); prolonged TV watching (OR=1.23, 1.08-1.41) and computer/mobile using and console playing time (OR=1.63, 1.36-1.95) were significant risk factors for LBP. Consumption of coffee, however, has yield conflicting results to be considered as a risk factor. Moreover, the researches on the correlation between sedentariness and high-intensity LBP are scarce and inconclusive. Conclusion: Sedentary behavior, whether in work or leisure time, associates with a moderate increase in the risk of LBP in adults, children and adolescents.

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Risk factors for pelvic girdle pain postpartum and pregnancy related low back pain postpartum; a systematic review and meta-analysis

Musculoskeletal Science and Practice ◽

10.1016/j.msksp.2020.102154 ◽

2020 ◽

Vol 48 ◽

pp. 102154 ◽

Cited By ~ 1

Author(s):

M. Wiezer ◽

M.A.H. Hage-Fransen ◽

A. Otto ◽

M.S. Wieffer-Platvoet ◽

M.H. Slotman ◽

...

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Low Back Pain ◽

Back Pain ◽

Meta Analysis ◽

Pelvic Girdle ◽

Pelvic Girdle Pain ◽

Low Back

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The factors of non-specific chronic low back pain in nurses: A meta-analysis

Journal of Back and Musculoskeletal Rehabilitation ◽

10.3233/bmr-200161 ◽

2021 ◽

pp. 1-11

Author(s):

Weige Sun ◽

Haijiao Zhang ◽

Limei Tang ◽

Ying He ◽

Suzhai Tian

Keyword(s):

Risk Factors ◽

Low Back Pain ◽

Back Pain ◽

Chronic Low Back Pain ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

College Education ◽

Low Back ◽

Night Shifts

BACKGROUND: Numerous studies have investigated factors for non-specific chronic low back pain (NSCLBP) in nurses, and have reached different conclusions. Evidence-based recommendations are required for the prevention and treatment of NSCLBP in nurses. OBJECTIVE: This meta-analysis aimed to systematically review and quantify the factors of NSCLBP in nurses. METHODS: Eleven databases were searched. The odds ratios (OR) with 95% confidence intervals (CIs) were pooled using meta-analysis, and either a fixed-effect or random-effect model was used based on heterogeneity across included studies. RESULTS: Eighteen publications including 11,752 nursing staff were included. Being female (pooled estimate [95% CI], 1.56 [1.24–1.96]; P< 0.001), married (1.89 [1.38–2.60]; P< 0.001), overweight (0.63 [0.43–0.93]; P= 0.02), working at least 10 years (0.65 [0.48–0.89]; P= 0.007), and working night shifts (2.19 [1.16–4.21]; P= 0.02) were positively related to NSCLBP. Junior college education (0.60 [0.47–0.77]; P< 0.001) and job satisfaction (0.58 [0.47–0.73]; P< 0.001) were negatively related. Age (0.80 [0.50–1.27]; P= 0.34) and physical exercise (0.99 [0.39–2.49]; P= 0.98) were not related. CONCLUSIONS: This is the first meta-analysis to quantify the risk factors for NSCLBP in nurses. Being female, married, working night shifts, overweight, working at least 10 years and dissatisfied with work are risk factors. High-quality prospective studies are required to validate the findings of this study.

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