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| Neuromuscular exercise and counseling decrease absenteeism due to low back pain in young conscripts: a randomized, population-based primary prevention study [with consumer summary] |
| Suni JH, Taanila H, Mattila VM, Ohrankammen O, Vuorinen P, Pihlajamaki H, Parkkari J |
| Spine 2013 Mar 1;38(5):375-384 |
| clinical trial |
| 5/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed* |
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STUDY DESIGN: Controlled intervention with group randomization. OBJECTIVE: To investigate the effectiveness of a 6-month neuromuscular exercise (NME) and counseling program for reducing the incidence of low back pain (LBP) and disability in young conscripts with a healthy back at the beginning of their compulsory military service. SUMMARY OF BACKGROUND DATA: Basic military training is physically demanding on the back and requires adequate physical fitness. LBP causes significant morbidity and absence from military service. METHODS: Participants were conscripts of four successive age cohorts (n = 1,409). In the pre-study year, before adoption of the intervention, two successive cohorts of conscripts of four companies (n = 719) were followed prospectively for 6 months to study the baseline incidence of different categories of LBP. In the intervention year, conscripts (n = 690) of two new cohorts of the same companies (intervention group: anti-tank, engineer; control group: signal, mortar) were followed for 6 months. The intervention program aimed to improve conscripts' control of their lumbar neutral zone (NZ), and specifically to avoid full lumbar flexion in all daily tasks. RESULTS: Total number and incidence of off-duty days due to LBP were significantly decreased in the intervention companies compared to controls (adjusted hazard ratio 0.42, 95% confidence interval 0.18 to 0.94, p = 0.035). The number of LBP cases, number of health clinic visits due to LBP, and number of the most severe cases showed a similar decreasing trend, but without statistical significance. CONCLUSIONS: These findings provide evidence that exercise and education to improve control of the lumbar NZ have a prophylactic effect on LPB-related off-duty service days in the military environment when implemented as part of military service among young healthy men.
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