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Original research
Effectiveness of a lumbopelvic monitor and feedback device to change postural behaviour: the ELF cluster randomised controlled trial
  1. Daniel Cury Ribeiro1,
  2. Stephan Milosavljevic2,
  3. Jane Terry1,
  4. J H Abbott3
  1. 1 School of Physiotherapy, University of Otago, Dunedin, New Zealand
  2. 2 School of Physiotherapy, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
  3. 3 Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
  1. Correspondence to Daniel Cury Ribeiro, School of Physiotherapy, University of Otago, Dunedin 9016, New Zealand; daniel.ribeiro{at}


Objectives The aim of this clustered, randomised controlled trial was to assess the effectiveness of a lumbopelvic postural feedback device for changing postural behaviour in a group of healthcare workers. We hypothesised that workers exposed to auditory postural feedback would reduce the number of times forward bending posture is adopted at work.

Methods This was a participant and assessor blinded, randomised, sham-controlled trial with blocked cluster random allocation. We recruited healthcare workers from aged care institutions. Healthcare sites were randomly allocated to the feedback or sham group (SG). A postural monitoring and feedback device was used to monitor and record lumbopelvic forward bending posture, and provided audio feedback whenever the user sustained lumbopelvic forward bending posture that exceeded predefined thresholds. The primary outcome measure was postural behaviour (exceeding thresholds). We used a robust variant of repeated measures mixed-effect model for assessing within-group and between-group differences in postural behaviour.

Results We recruited 19 sites, and 130 healthcare workers participated. There were no within-group changes on the number of times postural threshold was exceeded at 1-week follow-up (feedback group: −0.7, 95% CI −2.61 to 0.72; SG −0.3, −1.65 to 0.98), and no differences (0.05, 95% CI −1.83 to 1.94) between SG and feedback group.

Conclusions Findings from this trial indicate that audio feedback provided by a postural monitor device did not reduce the number of times healthcare workers exceeded the postural threshold.

Trial registration number ACTRN12616000449437.

  • ergonomics
  • occupational health practice
  • back disorders
  • musculoskeletal
  • intervention studies

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  • Contributors DCR conceived the project, was responsible for the design of the trial, is the guarantor and led efforts for securing funding, with the contributions and guidance from SM and JHA. SM and JHA contributed to design of the trial. JHA developed the research programme line of enquiry. JT helped with data collection and analysis. All authors analysed the data, revised and approved the manuscript. All authors revised manuscript for important content and approved the final version.

  • Funding This work was supported by Health Research Council New Zealand (15/527) and Lottery Health Research (AP353007). The trial sponsor is the University of Otago. The trial started in April 2016, and is funded until 2018. Part of this work was conducted during the Sir Charles Hercus Health Research Fellowship (18/111) awarded to DCR.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval The study protocol was approved by the University of Otago Ethics Committee (H15/094). Aged care institutions provided consent for the research team to invite healthcare workers to take part in the study. Individual consent was then be obtained to enrol participants in the trial.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon reasonable request through the PI ( The protocol is available at: