Physical Exercise Is Confirmed to Reduce Low Back Pain Symptoms in Office Workers: A Systematic Review of the Evidence to Improve Best Practices in the Workplace
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Literature Research
2.3. Inclusion and Exclusion Criteria
2.4. Study Quality Assessment
2.5. Data Extraction and Synthesis
3. Results
3.1. Pain and Disability
3.2. Flexibility, ROM, and Muscular Strength
3.3. Quality of Life
4. Discussion
4.1. Effects of Physical Exercise on Pain and Disability
4.2. Effects of Physical Exercise on Flexibility, ROM, and Muscular Strength
4.3. Effects of Physical Exercise on Quality of Life
4.4. Limitations
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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PICOS | Details |
---|---|
Participants | Office workers with LBP symptoms |
Interventions | Supervised or non-supervised exercise protocol, performed at home or in the workplace |
Comparative factors | Exercise intervention for LBP management |
Outcomes | Primary outcomes: LBP symptoms Secondary outcomes: flexibility and ROM of the trunk, muscular strength of the trunk, QoL |
Study designs | Pilot study, RCT, no-RCT, exploratory study, Randomized pilot trial |
Citation | Randomization Procedure | Similarity of Study Groups | Inclusion or Exclusion Criteria | Dropouts | Blinding | Compliance | Intention-to-Treat Analysis | Timing of Outcomes Assessment | Follow-up | Results |
---|---|---|---|---|---|---|---|---|---|---|
Phattharasupharerk S. et al. (2018) [15] | + | − | + | + | + | − | + | + | − | 6/9 |
Shariat A. et al. (2018) [16] | + | + | + | + | + | - | − | − | − | 5/9 |
Suni J.H. et al. (2017) [17] | + | + | + | + | + | + | − | − | + | 7/9 |
Shariat A. et al. (2017) [18] | + | + | − | − | − | − | − | − | − | 2/9 |
Habibi E. et al. (2015) [19] | − | + | − | − | − | − | − | + | − | 2/9 |
Kim T.H. et al. (2015) [20] | + | + | + | + | + | + | − | − | + | 7/9 |
Mehrparvar A. H. et al. (2014) [21] | + | − | + | + | − | − | − | − | − | 3/9 |
del Pozo-Cruz B. et al. (2013) [22] | + | + | + | + | + | + | − | − | − | 6/9 |
del Pozo-Cruz B. et al. (2012) [23] | + | + | + | + | + | + | + | − | − | 7/9 |
Pensri P. et al. (2012) [24] | − | − | + | + | − | + | − | + | + | 5/9 |
Macedo A.C. et al. (2011) [25] | − | − | − | + | − | + | − | − | − | 2/9 |
Study | Subjects | Grouping | Training Modality, Program and Intensity | Duration and Frequency |
---|---|---|---|---|
Phattharasupharerk S. et al. (2018) [15] | N: 72 Age: 20–40 years old Chronic LBP | EG (36) EdG (36) | EG: Qigong protocol Based on static and dynamic posture, meditation/imagination, and breathing exercise. Week 1: 25 min of static qigong, 5 min of dynamic qigong, 2 min of acupressure at acupoint GV20, 10 min of Wu Chi meditation. Week 2: 28 min of static qigong, 4 min of acupressure at acupoint K11, 15 min of Wu Chi meditation. Week 3: 28 min of static qigong, 5 min of dynamic qigong, 4 min of acupressure at acupoint LI4, 15 min of Wu Chi meditation Week 4: 28 min of static qigong, 5 min of dynamic qigong, 4 min of acupressure at acupoint PC6, 15 min of Wu Chi meditation. Week 5: 28 min of static qigong, 5 min of dynamic qigong, 4 min of acupressure at acupoint ST36, 15 min of Wu Chi meditation. Week 6: 4 min of static qigong, 10 min of dynamic qigong, 4 min of acupressure at acupoint HT7, 15 min of Wu Chi meditation. EdG: Education protocol General advice on managing LBP in order to reduce it, and the recommendation to stay active. | 6 weeks 60 min 1 d/w At home every day Adh: n.r. |
Shariat A. et al. (2018) [16] | N: 142 (47 M; 95 F) Age: 20–50 years old Subacute LBP | WBG (43) EgG (37) WB+EgG (34) CG (28) | WBG: stretching protocol Office-based stretching exercises adopted from McKenzie’s exercises, William’s exercises, and ACSM guidelines. The exercises were performed constant, controlled, and slow. Tension was progressively increased to the end of the joint’s ROM until the mild discomfort point is touched. 10 repetitions (or last for a period of 10–15 sec) and 3 sets (with a rest of 60–90 sec. Ergonomic protocol Total workplace occupational safety and health and ergonomic intervention (chair height and working desk, sitting posture, distance and level between the eyes and the monitor). | 6 months 3 d/w 10–15 min Adh: n.r. |
Suni J.H. et al. (2017) [17] | N: 143 Age 30–50 years old Subacute LBP | EG (75) CG (68) | Warm-up: 10 min of aerobic exercise. Main part: 10 functional flexibility exercises, 4 strength, and 5 core exercises. Cool-down: 10 min of stretching. | EG: 10 weeks 2 d/w 60 min Adh: 67% |
Shariat A. et al. (2017) [18] | N: 40 Age: mean 28 years old | WBG (20) CG (20) | 13 office-based stretching exercises. Each exercise was designed to have slow, controlled, and constant movements. Tension was progressively increased to the end of the joint’s ROM until the mild discomfort point is touched. The entire set of exercise was performed for 3 times with a rest of 60–90 sec between sets. Week 1–2: learn and practice. Week 3–5: 10 sec for each exercise. Week 6–8: 20 sec for each exercise. Week 9–11: 30 sec for each exercise. | 11 weeks 10–15 min 3 d/w Adh: n.r. |
Habibi E. et al. (2015) [19] | N: 75 (52 M; 23 F) Age: mean 41.2 years old | EgG (25) EG (25) WBG (25) | Ergonomic protocol Different courses based on educational needs. The objectives were understanding office ergonomics principles, self-evaluation of workplace conditions, and arranging and organizing personal workspace. EG: water protocol Water exercise to strengthen the muscles around the spine. SG: web-based exercise Exercises during work time. They were designed for short periods of time, and for many of them, there was no need to get up and stand. At regular intervals the app reminded the user to exercise. | EgG and WBG 2.5 months EG 2.5 months 2–3 d/w 20 min Adh: n.r. |
Kim T.H. et al. (2014) [20] | N: 53, F Age: 20–40 years old Chronic LBP | HG (27) TG (26) | HG: Exercise protocol + TENS Warm-up Main part: isometric contraction of core muscles, including internal/external oblique, rectus abdominis, and erector spinae muscles. Cool-down: slow and controlled movement, controlling their breathing. TG: TENS treatment 20 min of TENS and 15 min of hot-pack treatment. | 8 weeks 30 min exercise (only HG) 20 min TENS 15 min hot pack 5 d/w Adh: 85.5% |
Mehrparvar A. H. et al. (2014) [21] | N: 164 (81 M; 83 F) Age: mean 38 years old | EgG (83) WBG (81) | Ergonomic protocol Change in desk placement, seat height, position of keyboard, mouse and monitor, following OSHA VDT workstation checklist. SG: Exercise protocol One training session to learn exercise. Stretching of neck, shoulder, writ, back, and low back. | 1 months 15 min 2 times/day, every day Adh: n.r. |
del Pozo-Cruz B. et al. (2013) [22] del Pozo-Cruz B. et al. (2012) [23] | N: 90 (12 M; 78 F) Age: mean 46 years old Subacute LBP | WBG (46)CG (44) | Postural stability muscles (abdominal, lumbar, hip and thigh muscles) exercise to strength, flexibility, mobility, and stretching. Mobility exercises: large movements of the joints associated with the postural stability muscles. Flexibility exercises: static work methodology. Strengthening exercises: shortening and stretching motion that progressively changed in speed (1:1, 1:2, 1:3, 2:1, 3:1) combined with slight isometric contractions of the muscles involved in the exercises. Stretching exercises: moderate stretching of the muscles involved in the session. | 9 months 11 min 5 d/w Adh: 92% |
Pensri P. et al. (2012) [24] | N: 30 (6 M; 24 F) Age: 18–60 years old Chronic LBP | HG (30) | Brief education regarding LBP and home-based exercise protocol. Home-based exercises were categorized in core stability, stretching, and mobility. Each exercise was performed for 5–15 sec and repeat 5 times per set. Sometimes they received treatment including hot packs, lumbar packs, lumbar traction, and/or electrotherapy. | 8 weeks 3 t/d Adh: 33 day of 40 |
Macedo A.C. et al. (2011) [25] | N: 40 Age: 40.8 years old | EG (29) CG (21) | Stretching exercises for the body parts most affected by pain complaints. Playful and recreational activities. Massage with physiotherapy ball and exercises with Pilates balls. Relaxation exercises/stretches on an individual basis, in pairs and in groups performed with background music. | 8 months 15 min 3 d/w Adh: 48% |
Study | Group Comparison | Results |
---|---|---|
Phattharasupharerk S. et al. (2018) [15] | EG versus EdG | Pain and disability VAS (sc): ↑EG *; ↓EdG; ** RMDQ (sc): ↑EG *; ↓EdG; ** Quality of life ST-5 (sc): ↑EG; ↓EdG; ** Flexibility, ROM and muscular strength Lumbar flexion (°): ↑EG *; ↓EdG; ** Lumbar extension (°): #; ↑EG *; =EdG; ** Lumbar rotation R (°): ↑EG; ↓EdG; ** Lumbar rotation L (°): #; ↑EG *; =EdG; ** Lumbar bending R (°): ↑EG *; =EdG; ** Lumbar bending R (°): ↑EG *; =EdG; ** Core stability index (mmHg * sec): ↑EG *; ↓EdG; ** |
Shariat A. et al. (2018) [16] | WBG versus EgG | Pain and disability LB CMDQ (sc): ↑EG *; ↑EgG * |
WBG versus WB+EgG | Pain and disability LB CMDQ (sc): ↑EG *; ↑E+EgG * | |
WBG versus CG | Pain and disability LB CMDQ (sc): ↑EG *; =CG; ** | |
EgG versus WB+EgG | Pain and disability LB CMDQ (sc): ↑EgG *; ↑E+EgG * | |
EgG versus CG | Pain and disability LB CMDQ (sc): ↑EgG *; =CG | |
WB+EgG versus CG | Pain and disability LB CMDQ (sc): ↑E+EgG *; =CG; ** | |
Suni J.H. et al. (2017) [17] | EG versus CG | Pain and disability LB VAS (sc): ↑EG; ↑CG LBP frequency (sc): ↑EG; ↑CG LB strain after work (sc): ↑EG; ↑CG Quality of life SF-36-PF: ↑EG; ↑CG; ** SF-36-RP: ↑EG *; ↑CG SF-36-BP: ↑EG; ↑CG; ** SF-36-GH: ↑EG *; ↑CG SF-36-VT: ↑EG *; ↑CG SF-36-SF: n.r. SF-36-RE: ↑EG; ↓CG SF-36-MH: n.r. Flexibility, ROM and muscular strength Trunk-side bending (cm): ↑EG *; ↑CG; ** Static wall squat test (sec): ↑EG *; ↑CG; ** |
Shariat A. et al. (2017) [18] | WBG versus CG | Pain and disability LB CMDQ (sc): ↑WBG *; =CG; ** Flexibility, ROM and muscular strength Hip R (°): ↑WBG; ↓CG; ** Hip L (°): ↑WBG; =CG; ** Knee R (°): ↑WBG; =CG; ** Knee L (°): ↑WBG; =CG; ** |
Habibi E. et al. (2015) [19] | EG versus EgG | Pain and disability LBP incidence (%): ↑EG *; ↑EgG * |
EG versus WBG | Pain and disability LBP incidence (%): ↑EG *; =WBG | |
EgG versus WBG | Pain and disability LBP incidence (%): ↑EgG *; =WBG | |
Kim T.H. et al. (2015) [20] | HG versus TG | Pain and disability VAS at rest (mm): ↑HG *; ↑TG; ** VAS during movement (mm): ↑HG *; ↑TG; ** PPT quadratus lumborum (Kg/cm2): ↑HG *; ↑TG; ** PPT sacroiliac joint (Kg/cm2): ↑HG *; ↑TG; ** Flexibility, ROM and muscular strength Active ROM trunk flexion (°):↑HG *; ↑TG; **Active ROM trunk extension (°):↑HG *; ↑TG; ** Propioception at 20° flexion (°):↑HG *; ↑TG; ** Propioception at 10° extension (°):↑HG *; ↑TG; ** |
Mehrparvar A.H. et al. (2014) [21] | WGB versus EgG | Pain and disability Pain frequency: ↑WBG *; ↑EgG *; ** |
Del Pozo–Cruz B. et al. (2013) [22] | WBG versus CG | Pain and disability VAS (%): ** ODI (%): ** SBST (%): ** Quality of life EQ-5D-3L (%): ** Mobility: ** Self-care: ** Daily task: Pain/discomfort: ** Anxiety/depression: ** |
Del Pozo-Cruz B. et al. (2012) [23] | WBG versus CG | Pain and disability SBST, total (sc): ↑WBG *; =CG; ** Item1 - Bothersomeness: ↑WBG; ↓CG Item2 - Referred leg pain: ↑WBG; ↓CG Item3 - Co-morbid pain: ↑WBG; ↑CG Item4 - Fear avoidance: ↑WBG; ↑CG; ** Item5 - Functional disability: ↑WBG; ↓CG; ** Item6 - Functional disability: ↑WBG; ↑CG; ** Item7 - Catastrophizing: ↑WBG; ↑CG Item8 - Anxiety: ↑WBG; ↓CG Item9 - Depression: ↑WBG; ↑CG Low risk of chronicity (%): ↑WBG; ↓CG ** Medium risk of chronicity (%): ↑WBG; ↓CG High risk of chronicity (%): ↑WBG; ↓CG |
Pensri P. et al. (2012) [24] | HG | Pain and disability VAS (sc): ↑ * Backache Index (sc): ↑ |
Macedo AC et al. (2011) [25] | EG versus CG | Pain and disability VAS – L lumbar zone (mm): ↑EG *; ↓CG; ** VAS – R lumbar zone (mm): ↑EG *; ↓CG; ** |
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Gobbo, S.; Bullo, V.; Bergamo, M.; Duregon, F.; Vendramin, B.; Battista, F.; Roma, E.; Bocalini, D.S.; Rica, R.L.; Alberton, C.L.; et al. Physical Exercise Is Confirmed to Reduce Low Back Pain Symptoms in Office Workers: A Systematic Review of the Evidence to Improve Best Practices in the Workplace. J. Funct. Morphol. Kinesiol. 2019, 4, 43. https://doi.org/10.3390/jfmk4030043
Gobbo S, Bullo V, Bergamo M, Duregon F, Vendramin B, Battista F, Roma E, Bocalini DS, Rica RL, Alberton CL, et al. Physical Exercise Is Confirmed to Reduce Low Back Pain Symptoms in Office Workers: A Systematic Review of the Evidence to Improve Best Practices in the Workplace. Journal of Functional Morphology and Kinesiology. 2019; 4(3):43. https://doi.org/10.3390/jfmk4030043
Chicago/Turabian StyleGobbo, Stefano, Valentina Bullo, Manuele Bergamo, Federica Duregon, Barbara Vendramin, Francesca Battista, Enrico Roma, Danilo Sales Bocalini, Roberta Luksevicius Rica, Cristine Lima Alberton, and et al. 2019. "Physical Exercise Is Confirmed to Reduce Low Back Pain Symptoms in Office Workers: A Systematic Review of the Evidence to Improve Best Practices in the Workplace" Journal of Functional Morphology and Kinesiology 4, no. 3: 43. https://doi.org/10.3390/jfmk4030043