Dose-response relationship between work-related cumulative postural exposure and low back pain: A systematic review

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Daniel Cury Ribeiro1,2,*, Daniela Aldabe3, J. Haxby Abbott4, Gisela Sole1 and Stephan Milosavljevic1

1University of Otago, Centre for Physiotherapy Research, School of Physiotherapy, PO Box 56, Dunedin 9054, New Zealand

2Otago Institute of Sport and Adventure, Otago Polytechnic, Private Bag 1910, Dunedin 9054, New Zealand

3University of Otago, School of Physical Education, Dunedin 9054, New Zealand

4University of Otago, Dunedin School of Medicine, Dunedin 9054, New Zealand ?* Author to whom correspondence should be addressed. Tel: 0064-03-479-3666; fax: 0064-03-479-3676; e-mail: daniel.cury.ribeiro{at}gmail.com Received August 22, 2011. Accepted January 13, 2012. Objectives: To assess the evidence for a dose–response relationship between ROM, duration, and frequency of trunk flexion, and risk of occupational LBP.

Methods: An electronic systematic search was conducted using Medline, Cumulative Index to Nursing and Allied Health Literature, EMBASE, and Scopus databases focusing on cohort and case–control studies. Studies were included if they focused on non-specific LBP and postural exposure, considering ROM, duration, or frequency of trunk flexion as independent variables. No language restriction was imposed. Included studies were assessed for risk of bias using the Newcastle-Ottawa Scale for observational studies and a summary of evidence is presented. Results: Eight studies were included and all were methodologically rated as high quality. The included studies yielded a total of 7023 subjects who were considered for risk analysis. Different outcome measures for postural exposure were adopted making meta-analysis difficult to perform. Conclusions: We could not find a clear dose–response relationship for work posture exposures and LBP. Limited evidence was found for ROM and duration of sustained flexed posture as risk factor for LBP. We found no evidence for frequency of trunk flexion as a risk factor for LBP. © The Author 2012. Published by Oxford University Press on behalf of the British Occupational Hygiene SocietyThis ArticleAnn Occup Hyg (2012) 56 (6): 684-696. doi: 10.1093/annhyg/mes003 First published online: February 22, 2012 Current Issue
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Posted in: between, cumulative, Doseresponse, exposure, postural, relationship, review, systematic, workrelated