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Can Passive Prone Extensions of the Back Prevent Back Problems?: A Randomized, Controlled Intervention Trial of 314 Military Conscripts

Larsen, Kristian PT, MPH*; Weidick, Flemming MD†; Leboeuf-Yde, Charlotte DC, MPH, PhD*

Randomized Trial

Summary of Background Data. Back schools may be effective in treating back problems, but there is conflicting evidence of the effect on prevention.

Objectives. To investigate if passive prone extensions of the back can prevent back problems.

Study Design. Prospective, randomized controlled intervention trial.

Methods. In total, 314 male conscripts were randomized into two groups. After randomization, 65 conscripts dropped out for administrative reasons, leaving 249 conscripts to participate fully in the study. Data were collected through questionnaires at the start of military duty and after 10 months. All conscripts in the intervention group had one 40-minute theoretical lesson on back problems and ergonomics and had to perform passive prone extensions of the back daily during the rest of their military duty. The control group had no intervention. Outcome variables were as follows: 1) number of persons with self-reported back problems during the last 3 weeks; 2) number of persons with self-reported back problems during the last year; and 3) number of persons who reported having consulted the regiment medical physician with back problems during their military service.

Results. In an intention-to-treat analysis, significantly fewer persons in the intervention group versus those in the control group reported back problems during the last year (33%versus 51%), and the number needed to prevent was 6. Significantly fewer persons in the intervention group versus those in the control group consulted the regiment infirmary (9%versus 25%), and the number needed to prevent was 6.

Conclusion. It may be possible to reduce the prevalence rate of back problems and the use of health care services during military service, at a low cost, using passive prone extensions of the back motivated by a back school approach, including the theory of the disc as a pain generator and ergonomic instructions.

From the *Medical Research Unit in Ringkjøbing County, Ringkøbing,

and the †Jutland Dragoon Regiment, Holstebro, Denmark.

Acknowledgment date: February 16, 2001.

First revision date: December 18, 2001. Second revision date: May 8, 2002.

Acceptance date: May 13, 2002.

The manuscript submitted does not contain information about medical device(s)/drug(s).

Foundation funds were received in support of this work. No benefits of any kind have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.

Address correspondence to Kristian Larsen, PT, MPH, Medical Research Unit in Ringkjøbing County, Amtsrådhuset, Torvet 7, DK-6950 Ringkøbing, Denmark; E-mail: fekl@ringamt.dk

© 2002 Lippincott Williams & Wilkins, Inc.