Neuromuscular Exercise and Counseling Decrease Absenteeism Due to Low Back Pain in Young Conscripts

Background 

Basic military training is physically demanding on the back and requires adequate physical fitness and trunk control. Low back pain causes significant morbidity and absence from military service.

Aim 

To investigate the effectiveness of neuromuscular exercise and counselling program for reducing the incidence of low back pain and disability in young conscripts with a healthy back at the beginning of their compulsory military service.

Methods 

Controlled intervention with group randomization. Started 2007.

Participants were conscripts of 4 successive age cohorts (n = 1409). In the pre-study year 2006, before adoption of the intervention, 2 successive cohorts of conscripts of 4 companies (n = 719) were followed prospectively for 6 months to study the baseline incidence of low back complaints.

The 6-month intervention program aimed to improve conscripts’ control of their lumbar neutral zone and specifically to avoid full lumbar flexion in all daily tasks (2007–2008).

Results 

Total number and incidence of off-duty days due to low back pain were significantly decreased in the intervention companies compared with controls (adjusted hazard ratio = 0.42, 95% confidence interval = 0.18–0.94, P = 0.035).

The number of low back pain cases, number of health clinic visits due to low back pain, and number of the most severe cases showed a similar decreasing trend but without statistical significance.

These findings provide evidence that exercise and education to improve control of the lumbar neutral zone have a prophylactic effect on low back pain related off-duty service days in the military environment when implemented as part of military service among young healthy men.

Contact 

Jari Parkkari 
D.Med.Sc. 
jari.parkkari(a)ukkinstituutti.fi 

Publications 

Taanila H, Suni JH, Kannus P, Pihlajamäki H, Ruohola J-P, Viskari J, Parkkari J. Risk factors of actue and overuse musculoskeletal injuries among young conscripts: a population-based cohort study. BMC Musculoskeletal disorders 2015;16:104.

Taanila H, Parkkari J, Suni J. Musculoskeletal disorders in male Finnish conscripts: risk factors and effectiveness of neuromuscular exercise in the prevention of acute injuries ind low back pain. Saarbrücken: LAP Lambert, 2013.

Suni JH, Taanila H, Mattila VM, Ohrankämmen O, Vuorinen P, Pihlajamäki H, Parkkari J, Neuromuscular Exercise and Counseling Decrease Absenteeism Due to Low Back Pain in Young Conscripts. A Randomized, Population-Based Primary Prevention Study. Spine 2013; XX: 1—10 DOI: 10.1097/BRS.0b013e318270a12d

Taanila H. Musculoskeletal disorders in male Finnish conscripts: importance of physical fitness as a risk factor, and effectiveness of neuromuscular exercise and counseling in the prevention of acute injuries, and low back pain and disability. Tampere: Tampereen yliopisto. Acta Universitatis Tamperensis 1812, 2013. Academic dissertation.

Taanila H, Suni J, Pihlajamäki H, Mattila VM, Ohrankämmen O, Vuorinen P, Parkkari J. Musculoskeletal disorders in physically active conscripts: a one-year follow-up study in the Finnish Defence Forces. BMC Musculoskeletal disorders 2009;10:89.