Abstract
Purpose
The objective of this study was to evaluate the effects of an exercise program focusing on muscle stretching and endurance training on the 12-month incidence of low back pain (LBP) in office workers.
Methods
A 12-month prospective cluster-randomized controlled trial was conducted in healthy office workers with lower-than-normal trunk extension flexibility or trunk muscle endurance. Healthy office workers (n = 563) were randomly assigned at the cluster level into either intervention (n = 282) or control (n = 281) groups. Participants in the intervention group received an exercise program that included daily stretching exercise and twice-a-week muscle endurance training. Those in the control group received no intervention. The 12-month incidence of LBP was the primary outcome. Secondary outcome were pain intensity, disability level, and quality of life and health status. Analyses were performed using the Cox proportional hazard models.
Results
Over the 12-month follow-up, 8.8 % of participants in the intervention group and 19.7 % in the control group developed incidence of LBP. Hazard rate ratios showed a protective effect of the exercise program for LBP (HR = 0.37, 95 % CI 0.22–0.64) after adjusting for biopsychosocial factors. There was no significant difference in pain intensity, disability, and quality of life and health status between those who reported incidence of LBP in the intervention and control groups.
Conclusion
An exercise program consisting of muscle stretching and endurance training is an effective intervention to reduce incident LBP for office workers with lower-than-normal trunk extension flexibility or trunk muscle endurance.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Henchoz Y, Kai-Lik So A (2008) Exercise and nonspecific low back pain: a literature review. Jt Bone Spine 75:533–539
Cote P, van der Velde G, Cassidy JD, Carroll LJ, Hogg-Johnson S, Holm LW, Carragee EJ, Haldeman S, Nordin M, Hurwitz EL, Guzman J, Peloso PM (2009) The burden and determinants of neck pain in workers: results of the bone and joint decade 2000–2010 task force on neck pain and its associated disorders. J Manip Physiol Ther 32:S70–S86
Armiger P, Martyn M (2010) Stretching for function flexibility. Lippincott Williams & Wilkins, Philadelphia
Oatis CA (2009) Kinesiology: the mechanics & pathomechanics of human movement, 2nd edn. Lippincott Williams & Wilkins, Philadelphia
Peltonen JE, Taimela S, Erkintalo M, Salminen JJ, Oksanen A, Kujala UM (1998) Back extensor and psoas muscle cross-sectional area, prior physical training, and trunk muscle strength—a longitudinal study in adolescent girls. Eur J Appl Physiol Occup Physiol 77:66–71
Norris C, Matthews M (2008) The role of an integrated back stability program in patients with chronic low back pain. Complement Ther Clin Pract 14:255–263
da Costa BR, Vieira ER (2008) Stretching to reduce work-related musculoskeletal disorders: a systematic review. J Rehabil Med 40:321–328
Visser B, van Dieen JH (2006) Pathophysiology of upper extremity muscle disorders. J Electromyogr Kinesiol 16:1–16
Wilson A (2002) Effective management of musculoskeletal injury. A clinical ergonomics approach to prevention, treatment and rehabilitation. Churchill Livingstone, Edinburgh
Hamberg-van Reenee H, Ariens G, Blatter B, Twisk J, van Mechelen W, Bongers P (2006) Physical capacity in relation to low back, neck, or shoulder pain in a working population. Occup Environ Med 63:371–377
Chok B, Lee R, Latimer J, Tan SB (1999) Endurance training of the trunk extensor muscles in people with subacute low back pain. Phys Ther 79:1032–1042
Phakthongsuk P (2009) Construct validity of the Thai version of the job content questionnaire in a large population of heterogeneous occupations. J Med Assoc Thai 92:564–572
Henchoz Y, de Goumoens P, So AK, Paillex R (2010) Functional multidisciplinary rehabilitation versus outpatient physiotherapy for non specific low back pain: randomized controlled trial. Swiss Med Wkly 140:13133
Latimer J, Maher CG, Refshauge K, Colaco I (1999) The reliability and validity of the Biering-Sorensen test in asymptomatic subjects and subjects reporting current or previous nonspecific low back pain. Spine 24:2085–2089
Richardson CA, Jull G, Hodges P, Hides J (1999) Therapeutic exercise for spine segmental stabilization in low back pain: scientific basis and clinical approach. Churchill Livingstone, London
Doymaz F, Cavlak U (2007) Relationship between thigh skinfold measurement, hand grip strength, and trunk muscle endurance: differences between the sexes. Adv Ther 24:1192–1201
Pensri P, Baxtex G, McDonough S (2005) Reliability and internal consistency of the Thai version of Roland-Morris Disability Questionnaire and Waddell Disability Index for back pain patients. Chula Med J 49:333–349
Jirarattanaphochai K, Jung S, Sumananont C, Saengnipanthkul S (2005) Reliability of the medical outcomes study short-form survey version 2.0 (Thai version) for the evaluation of low back pain patients. J Med Assoc Thai 88:1355–1361
Moore C, Holland J, Shaib F, Ceridan E, Schonard C, Marasa M (2012) Prevention of low back pain in sedentary healthy workers: a pilot study. Am J Med Sci 344:90–95
Hamberg-van Reenen HH, Visser B, van der Beek AJ, Blatter BM, van Dieen JH, van Mechelen W (2009) The effect of a resistance-training program on muscle strength, physical workload, muscle fatigue and musculoskeletal discomfort: an experiment. Appl Ergon 40:396–403
Andersen LL, Christensen KB, Holtermann A, Poulsen OM, Sjogaard G, Pedersen MT, Hensen EA (2010) Effect of physical exercise interventions on musculoskeletal pain in all body regions among office workers: a 1-year randomized controlled trial. Man Ther 15:100–104
Shirado O, Ito T, Kikumoto T, Takeda N, Minami A, Strax TE (2005) A novel back school using a multidisciplinary team approach featuring quantitative functional evaluation and therapeutic exercises for patients with chronic low back pain: the Japanese experience in the general setting. Spine 30:1219–1225
Escolar-Reina P, Medina-Mirapeix F, Gascon-Canovas JJ, Montilla-Herrador J, Jimeno-Serrano FJ, de Oliveira Sousa SL, del Bano-Aledo ME, Lomass-Vega R (2010) How do care-provider and home exercise program characteristics affect patient adherence in chronic neck and back pain: a qualitative study. BMC Health Serv Res 10:60
Ryan CG, Gray HG, Newton M, Granat MH (2010) Pain biology education and exercise classes compared to pain biology education alone for individuals with chronic low back pain: a pilot randomised controlled trial. Man Ther 15:382–387
Koes BW, van Tulder M, Lin CW, Macedo LG, McAuley J, Maher C (2010) An updated overview of clinical guidelines for the management of non-specific low back pain in primary care. Eur Spine J 19:2075–2094
Acknowledgments
This work was funded by the Social Security Office of Thailand (Grant No. 002/2553) and Chulalongkorn University Centenary Academic Development Project (#12).
Conflict of interest
None.
Author information
Authors and Affiliations
Corresponding author
Electronic supplementary material
Below is the link to the electronic supplementary material.
Rights and permissions
About this article
Cite this article
Sihawong, R., Janwantanakul, P. & Jiamjarasrangsi, W. A prospective, cluster-randomized controlled trial of exercise program to prevent low back pain in office workers. Eur Spine J 23, 786–793 (2014). https://doi.org/10.1007/s00586-014-3212-3
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00586-014-3212-3