Evidence map›Paper›PMID 30173369›Full record

Trial reportInternational archives of occupational and environmental health2019

Mechanisms for reducing low back pain: a mediation analysis of a multifaceted intervention in workers in elderly care.

Matthew L Stevens, Eleanor Boyle, Jan Hartvigsen, Gemma Mansell, Karen Søgaard, Marie B Jørgensen, Andreas Holtermann, Charlotte D N Rasmussen

Abstract readRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in International archives of occupational and environmental health, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Trial
  3. Trial
  4. Article
  5. The Impact of Quality of Work Organization on Distress and Absenteeism among Healthcare Workers.International journal of environmental research and public health · 2022
    Article
  6. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Matthew L StevensMusculoskeletal Health Sydney, School of Public Health, The University of Sydney, PO Box M179, Missenden Rd, Sydney, NSW, 2050, Australia. matthew.stevens@sydney.edu.au.ORCID http://orcid.org/0000-0002-2621-4811
Eleanor BoyleDepartment of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.
Jan HartvigsenDepartment of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.
Gemma MansellResearch Institute for Primary Care and Health Sciences, Keele University, Staffordshire, UK.
Karen SøgaardDepartment of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.
Marie B JørgensenThe National Research Centre for the Working Environment, Copenhagen, Denmark.
Andreas HoltermannDepartment of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.
Charlotte D N RasmussenThe National Research Centre for the Working Environment, Copenhagen, Denmark.

Funding

National Prevention Fund 11-2-1a-113The Danish Working Environment Research Fund 201100813
6 · The paper itself

Abstract

purposeA multifaceted workplace intervention consisting of participatory ergonomics, physical training, and cognitive-behavioural training (CBT) has shown effectiveness for reducing low back pain (LBP). However, the mechanisms of action underlying these intervention components are not well understood.

methodsThis was a mediation analysis of a cluster-randomised controlled trial of a multifaceted intervention in 420 workers in elderly care. Mediation analysis was carried out via structural equation modelling. Potential mediators investigated were: fear-avoidance beliefs, perceived muscle strength, use of assistive devices at work and perceived physical exertion at work. LBP outcomes assessed were: days with LBP, LBP intensity and days with bothersome LBP.

resultsThere were no significant indirect effects of the intervention on LBP outcomes. There were significant effects of the intervention on both fear-avoidance measures [β = - 0.63, 95% CI (1.23, 0.03); β = - 1.03, 95% CI (- 1.70, - 0.34)] and the use of assistive devices [β = - 0.55, 95% CI (- 1.04, - 0.05)], but not on perceived muscle strength [β = - 0.18, 95% CI (- 0.50, 0.13)] or physical exertion [β = - 0.05, 95% CI (- 0.40, 0.31)]. The only potential mediator with a significant effect on LBP outcomes was physical exertion, which had a significant effect on LBP intensity [β = 0.14, 95% CI (0.04, 0.23)].

conclusionsA multifaceted intervention consisting of participatory ergonomics, physical training, and CBT was able to decrease fear-avoidance beliefs and increase use of assistive devices in the workplace. However, these changes did not explain the effect of any of the intervention components on days with LBP, LBP intensity and days with bothersome LBP.

Indexed as

ExerciseAdolescentAdultAgedCluster AnalysisCognitive Behavioral TherapyErgonomicsFemaleHome Health AidesHumansLow Back PainMaleMiddle AgedNursing AssistantsNursing HomesOccupational DiseasesCognitive behavioural trainingMusculoskeletal disordersNurses’ aidesParticipatory ergonomicsPhysical trainingWorkplace interventions

Identifiers

PMID30173369

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.