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Walsh N.E. and Schwartz R.K.
Departments of Rehabilitation, Medicine and Occupational
Therapy
The University of Texas Health Science Center, San Antonio,
TX
Summary: This study involved 90 grocery warehouse workers
randomly selected from more than 800 employees. Anyone currently
being treated for back pain or injury was excluded from the study.
Questionnaires were completed related to personal and demographic
data and all participants were tested for abdominal strength.
Subjects were then randomly assigned to one of three groups
for the six-month period of the study: a control group with no
intervention, an experimental group receiving only a one-hour
training session on back pain prevention and proper body mechanics,
and an experimental group that received the one-hour training
plus a lumbosacral orthosis to wear during working hours.
The back support used was elastic mesh to bind abdominal musculature
against the suprapubic area and had a custom molded thermoplastic
lumbar insert. The six-month follow-up included abdominal strength
testing, a pain/back injury questionnaire, work injury incidence
from health records, productivity and job time lost, and use
of health care services.
Conclusion: "This study supports the concept of using
education and prophylactic bracing to prevent back injury and
reduce time lost from work. It appears that the use of intermittent
prophylactic bracing has no adverse effect on abdominal strength
and may contribute to decreased lost time from work injuries."
Note: A follow-up from the authors in a subsequent Letters
to the Editor column explained that the days lost from work due
to back injury decreased considerably more than days lost due
to other injuries. A reevaluation of the data, say the authors,
provides the conclusions that there does appear to be a specific
benefit to the orthosis wearer in the prevention of injury and
also that training has a major effect of reducing back injuries
but only a minor effect in reducing non-back injuries. (A second
study using a biomechanically ineffective "sham" orthosis
was proposed by the authors but was not approved by government
funding sources.)
Published in American Journal of Physical Medicine and
Rehabilitation, 1990, pp. 245-250 (Review by Chase Ergonomics
based on a published paper and discussion with Dr. Walsh, June
1996.)
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