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A SYSTEMATIC REVIEW OF EXERCISES, USED IN A WORKPLACE SETTING, FOR THE MANAGEMENT OF OCCUPATIONAL LOWER BACK PAIN

Petronella D van der Merwe

A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in partial fulfilment of the requirements for the degree of Master of Science in Physiotherapy. Johannesburg, 2007

DECLARATION
I Petronella D van der Merwe declare that this research report is my own work. It is being submitted for the degree of Masters of Physiotherapy in the University of Witwatersrand, Johannesburg. It has not been submitted before for any degree or examination at this or any other University.

………………………… ……………………..Day of…………………, 2007

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DEDICATION

Thank you for all your love and support. My Husband, Levouy, and adoring boys, Jared and Liam You are my inspiration “ All things are possible in God who strengthens me…”

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ABSTRACT
Aim: The aim of this study was to determine the most effective exercise program for the management of occupational lower back pain. Background: Occupational lower back pain accounts for 25% of workdays lost. The annual occurrence of occupational related lower back pain among blue collar workers in South Africa has shown to be between 55,7% and 63,9%. Methodology: Primary studies were searched with the use of the Entrez-cross-database search tool. Methodologies were assessed and critiqued. Data which included exercise detail, outcome measures of lower back pain intensity, painful episodes, sick leave and physical measures with statistical p-values was then extracted. Results: Nine primary studies, which included 11 exercise groups, complied to the inclusion and exclusion criteria. These studies proved to be of high methodology quality with quality scoring 70% on the quality assessment checklist. Exercise regimes, which included stretching, strengthening, endurance exercises and the combination use of stretching, strengthening and endurance exercises were identified and grouped according to the corresponding outcome measures. No meta-analysis could be done as no similar exercises with similar outcome measures could be found. Discussion: The limitations in the nine selected studies methodological quality were the lack of blinding of the assessors and subjects, and in six of the nine studies the lack of adequate participation rate among the intervention subjects. The validation process is acknowledged as a weakness within this study. Stretching, dynamic strengthening and endurance exercises were not statistically significant. Isometric exercise was statistically significant for lower back pain relief when the control group (p

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