Prevention of Chronic Low Back Pain in Female Nurses – NURSE-RCT

Background  

Low back pain (LBP) is among the leading worldwide causes of years lived with disability and induces a high economic burden. Studies from across the globe have documented higher prevalence of LBP in healthcare personnel compared with other occupations, the annual prevalence ranging from 45% to 77%. Several physical requirements related to work, such as lifting and transferring patients or working in awkward spine postures, are the major contributors to the high incidence of LBP and injury, and the risk of developing chronic LBP. Persistent LBP in healthcare personnel causes considerable functional and work disability, and is a strong risk factor for long-term sickness absence and dropout from profession at early stages of their career. 

Aims  

The NURSE-study aims to prevent the development of chronic LBP in female healthcare workers. We compared the effectiveness of 6-months Pilates type neuromuscular exercise and back care counselling programs or either alone in treating pain intensity, its’ interference, and fear of pain in health-care workers with recurrent non-specific LBP (NSLBP) compared to non-treatment control group. We also assessed cost-effectiveness as days of sickness absence reduced and quality adjusted life years (QALY) gained. Results on effectiveness and cost-effectiveness were available after 12 and 24 months. 

Methods  

The study was a randomized controlled intervention, which began 2011. We compared the effectiveness of 6-months neuromuscular exercise and back care counselling programs or either alone in treating pain, its’ interference and fear of pain in workers with recurrent NSLBP compared to non-treatment control group. We also assess cost-effectiveness as days of sickness absence reduced and quality adjusted life years (QALY) gained. Results on effectiveness and cost-effectiveness were assessed in 12 and 24 months follow-up. 

We selected the biopsychosocial approach as the data gathering model of the study, while the results of former studies support this approach in the prevention of chronic LBP. In addition to results on effectiveness of the interventions, we reported cross-sectional and follow-up findings on pain, functioning and workability with emphasis on searching predictive factors. 

Registration  

NCT01465698  

Co-operation  

• The UKK Institute for Health Promotion Research
• Tampere University Hospital, Finland  
• Finnish Institute of Occupational Health (FIOH)  
• University of Zürich  

Contact  

Pauliina Husu, Senior Researcher, pauliina.husu(a)ukkinstituutti.fi 

Publications  

Suni JH, Rinne M, Kankaanpää M, Taulaniemi A, Lusa S, Lindholm H, Parkkari J. Neuromuscular exercise and back counseling for female nursing personnel with recurrent non-specific low back pain: study protocol of a randomised controlled trial (NURSE-RCT). BMJ Open Sport Exerc Med 2016;2:e000098.  

Taulaniemi RPA, Kankaanpää MJ, Tokola KJ, Kankaanpää M, Suni JH. Reliability of musculoskeletal fitness tests and movement control impairment test battery in female health-care personnel with recurrent low back pain.J Nov Physiother 2016,6:1. (Assessed 7.6.2018)  

Kolu P, Tokola K, Kankaanpaa M, Suni J. Evaluation of the effects of physical activity, cardiorespiratory condition, and neuromuscular fitness on direct health-care costs and sickness-related absence among nursing personnel with recurrent nonspecific low back pain. Spine (Phila Pa 1976) 2017;42:854−62.  

For all publications of this research, see the Finnish description. To find the list of publications “Julkaisuja”, scroll the page down. To open the publication links, click “Lue lisaa” and “Lue julkaisu”.