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A longitudinal observational study of back pain incidence, risk factors and occupational physical activity in Swedish marine trainees

Monnier, Andreas ; Larsson, Helena ; Nero, Hakan LU ; Djupsjöbacka, Mats and Äng, Björn O. (2019) In BMJ Open 9(5).
Abstract

Objectives To evaluate the occurrence of low back pain (LBP) and LBP that limits work ability, to identify their potential early risks and to quantify occupational physical activity in Swedish Armed Forces (SwAF) marines during their basic 4 month marine training course. Design Prospective observational cohort study with weekly follow-ups. Participants Fifty-three SwAF marines entering the training course. Outcomes Incident of LBP and its related effect on work-ability and associated early risks. Occupational physical activity, as monitored using accelerometers and self-reports. Results During the training course, 68% of the marines experienced at least one episode of LBP. This yielded a LBP and LBP limiting work ability incidence rate... (More)

Objectives To evaluate the occurrence of low back pain (LBP) and LBP that limits work ability, to identify their potential early risks and to quantify occupational physical activity in Swedish Armed Forces (SwAF) marines during their basic 4 month marine training course. Design Prospective observational cohort study with weekly follow-ups. Participants Fifty-three SwAF marines entering the training course. Outcomes Incident of LBP and its related effect on work-ability and associated early risks. Occupational physical activity, as monitored using accelerometers and self-reports. Results During the training course, 68% of the marines experienced at least one episode of LBP. This yielded a LBP and LBP limiting work ability incidence rate of 13.5 (95% CI 10.4 to 17.8) and 6.3 (95% CI 4.2 to 10.0) episodes per 1000 person-days, respectively. Previous back pain and shorter body height (≤1.80 m) emerged as independent risks for LBP (HR 2.5, 95% CI 1.4 to 4.3; HR 2.0, 95% CI 1.2 to 3.3, respectively), as well as for LBP that limited work ability (HR 3.6, 95% CI 1.4 to 8.9; HR 4.5, 95% CI 2.0 to 10.0, respectively). Furthermore, managing fewer than four pull-ups emerged as a risk for LBP (HR 1.9, 95% CI 1.2 to 3.0), while physical training of fewer than three sessions per week emerged as a risk for LBP that limited work ability (HR 3.0, 95% CI 1.2 to 7.4). More than 80% of the work time measured was spent performing low levels of ambulation, however, combat equipment (≥17.5 kg) was carried for more than half of the work time. Conclusions Incidents of LBP are common in SwAF marines' early careers. The link between LBP and previous pain as well as low levels of exercise highlights the need for preventive actions early on in a marine's career. The role of body height on LBP needs further investigation, including its relationship with body-worn equipment, before it can effectively contribute to LBP prevention.

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author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Back pain, Epidemiology, Preventive medicine
in
BMJ Open
volume
9
issue
5
article number
025150
publisher
BMJ Publishing Group
external identifiers
  • scopus:85065908315
  • pmid:31092646
ISSN
2044-6055
DOI
10.1136/bmjopen-2018-025150
language
English
LU publication?
yes
id
9e974574-1fb8-4c53-9339-cdb168c68ff3
date added to LUP
2019-06-12 14:43:01
date last changed
2024-05-28 14:49:13
@article{9e974574-1fb8-4c53-9339-cdb168c68ff3,
  abstract     = {{<p>Objectives To evaluate the occurrence of low back pain (LBP) and LBP that limits work ability, to identify their potential early risks and to quantify occupational physical activity in Swedish Armed Forces (SwAF) marines during their basic 4 month marine training course. Design Prospective observational cohort study with weekly follow-ups. Participants Fifty-three SwAF marines entering the training course. Outcomes Incident of LBP and its related effect on work-ability and associated early risks. Occupational physical activity, as monitored using accelerometers and self-reports. Results During the training course, 68% of the marines experienced at least one episode of LBP. This yielded a LBP and LBP limiting work ability incidence rate of 13.5 (95% CI 10.4 to 17.8) and 6.3 (95% CI 4.2 to 10.0) episodes per 1000 person-days, respectively. Previous back pain and shorter body height (≤1.80 m) emerged as independent risks for LBP (HR 2.5, 95% CI 1.4 to 4.3; HR 2.0, 95% CI 1.2 to 3.3, respectively), as well as for LBP that limited work ability (HR 3.6, 95% CI 1.4 to 8.9; HR 4.5, 95% CI 2.0 to 10.0, respectively). Furthermore, managing fewer than four pull-ups emerged as a risk for LBP (HR 1.9, 95% CI 1.2 to 3.0), while physical training of fewer than three sessions per week emerged as a risk for LBP that limited work ability (HR 3.0, 95% CI 1.2 to 7.4). More than 80% of the work time measured was spent performing low levels of ambulation, however, combat equipment (≥17.5 kg) was carried for more than half of the work time. Conclusions Incidents of LBP are common in SwAF marines' early careers. The link between LBP and previous pain as well as low levels of exercise highlights the need for preventive actions early on in a marine's career. The role of body height on LBP needs further investigation, including its relationship with body-worn equipment, before it can effectively contribute to LBP prevention.</p>}},
  author       = {{Monnier, Andreas and Larsson, Helena and Nero, Hakan and Djupsjöbacka, Mats and Äng, Björn O.}},
  issn         = {{2044-6055}},
  keywords     = {{Back pain; Epidemiology; Preventive medicine}},
  language     = {{eng}},
  number       = {{5}},
  publisher    = {{BMJ Publishing Group}},
  series       = {{BMJ Open}},
  title        = {{A longitudinal observational study of back pain incidence, risk factors and occupational physical activity in Swedish marine trainees}},
  url          = {{http://dx.doi.org/10.1136/bmjopen-2018-025150}},
  doi          = {{10.1136/bmjopen-2018-025150}},
  volume       = {{9}},
  year         = {{2019}},
}