BMJ  2008;336:429-431 (23 February), doi:10.1136/bmj.39463.418380.BE (published 31 January 2008)

Research

Effect of training and lifting equipment for preventing back pain in lifting and handling: systematic review

Kari-Pekka Martimo, medical specialist1, Jos Verbeek, team leader2, Jaro Karppinen, medical specialist3, Andrea D Furlan, associate scientist4, Esa-Pekka Takala, medical specialist1, P Paul F M Kuijer, senior researcher5, Merja Jauhiainen, information specialist6, Eira Viikari-Juntura, research professor1

1 Musculoskeletal Disorders Group, Centre of Expertise for Health and Work Ability, Finnish Institute of Occupational Health, Helsinki, Finland, 2 Knowledge Transfer in Occupational Health and Safety Group, Centre of Expertise for Good Practices and Competence, Finnish Institute of Occupational Health, Kuopio, Finland, 3 Musculoskeletal Disorders Group, Centre of Expertise for Health and Work Ability, Finnish Institute of Occupational Health, Oulu, Finland, 4 Institute for Work and Health, Toronto, Canada, 5 Coronel Institute of Occupational Health, Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands, 6 Knowledge Transfer in Occupational Health and Safety Group, Centre of Expertise for Good Practices and Competence, Finnish Institute of Occupational Health, Helsinki, Finland

Correspondence to: K P Martimo kari-pekka.martimo{at}ttl.fi

Objectives To determine whether advice and training on working techniques and lifting equipment prevent back pain in jobs that involve heavy lifting.

Data sources Medline, Embase, CENTRAL, Cochrane Back Group’s specialised register, CINAHL, Nioshtic, CISdoc, Science Citation Index, and PsychLIT were searched up to September-November 2005.

Review methods The primary search focused on randomised controlled trials and the secondary search on cohort studies with a concurrent control group. Interventions aimed to modify techniques for lifting and handling heavy objects or patients and including measurements for back pain, consequent disability, or sick leave as the main outcome were considered for the review. Two authors independently assessed eligibility of the studies and methodological quality of those included. For data synthesis, we summarised the results of studies comparing similar interventions. We used odds ratios and effect sizes to combine the results in a meta-analysis. Finally, we compared the conclusions of the primary and secondary analyses.

Results Six randomised trials and five cohort studies met the inclusion criteria. Two randomised trials and all cohort studies were labelled as high quality. Eight studies looked at lifting and moving patients, and three studies were conducted among baggage handlers or postal workers. Those in control groups received no intervention or minimal training, physical exercise, or use of back belts. None of the comparisons in randomised trials (17 720 participants) yielded significant differences. In the secondary analysis, none of the cohort studies (772 participants) had significant results, which supports the results of the randomised trials.

Conclusions There is no evidence to support use of advice or training in working techniques with or without lifting equipment for preventing back pain or consequent disability. The findings challenge current widespread practice of advising workers on correct lifting technique.


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Rapid Responses:

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There is more to lifting than preventing back pain
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bmj.com, 12 Feb 2008 [Full text]
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