Interventions to prevent back pain and back injury in nurses: a systematic review.

Abstract

Objective: To assess the effectiveness of interventions that aim to prevent back pain and back injury in nurses. Methods: A systematic literature review was undertaken. The methods of a leading back review group were followed. Ten relevant databases were searched, theses were examined and reference lists checked. Two reviewers applied selection criteria, assessed methodological quality and extracted data from trials. A qualitative synthesis of evidence was undertaken and sensitivity analyses performed. Results: Sixteen trials including eight randomised controlled trials and eight non-randomised controlled trials met eligibility criteria. Overall, study quality was poor, with only one trial classified as high quality. The review identified moderate level evidence from multiple trials that manual handling training in isolation is not effective and multidimensional interventions are effective in preventing back pain and injury in nurses. Single trials provided moderate evidence that stress management programs do not prevent back pain and limited evidence that lumbar supports are effective in preventing back injury in nurses. There is conflicting evidence regarding the efficacy of exercise interventions and the provision of manual handling equipment and training. Conclusion: There is no strong evidence regarding the efficacy of interventions aiming to prevent back pain and injury in nurses. Data from multiple trials suggests that multidimensional strategies are effective and manual handling training in isolation is ineffective however only moderate level evidence is available. For all other interventions (exercise, lumbar supports, stress management and manual handling equipment and training) there is conflicting evidence or data from only single trials available. This review highlights the need for high quality randomised controlled studies to examine the effectiveness of interventions to prevent back pain and injury in nursing populations. Implications for future research are discussed.