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education on ergonomics, theory, workstation education, and lifting. ... implemented as an in-service or other continuin
CRITICALLY APPRAISED PAPER (CAP) FOCUSED QUESTION For nurses with low back pain and poor body posture, will a spinal training program (Back School), as compared to passive physiotherapy treatment, decrease pain intensity and improve body posture? Jaromi, M., Nemeth, A., Kranicz, J., Laczko, T. & Betlehem, J. (2012). Treatment and ergonomics training of work-related lower back pain and body posture problems for nurses. Journal of Clinical Nursing, 21(11-12), 1776–1784. http://dx.doi.org/10.1111/j.13652702.2012.04089.x CLINICAL BOTTOM LINE: The results of this randomized controlled trial, which included testing the efficacy of a structured intervention program for reducing back pain in nurses, show promise for reducing pain and improving body posture in health care professions. Results of the study indicated that both groups of subjects tested reported and demonstrated significant improvement in back pain intensity reduction and improved body posture, although subjects in the experimental group showed a more significant improvement overall. The experimental group took part in ergonomic training with six sessions of follow-up training. The follow-up training included education on ergonomics, theory, workstation education, and lifting. In addition, subjects in the experimental group engaged in redesigning their workstations and body strengthening that included musculature of the anterior thorax, lower extremity, back, shoulder, and abdomen. Occupational therapy and nursing, in particular, within the physical dysfunction practice can have similar responsibilities in regards to client handling and transferring. As indicated by Jaromi and colleagues (2012), the intervention of ergonomic training and Back School could be implemented as an in-service or other continuing education opportunity within a variety of physical dysfunction facilities in which occupational therapists are employed in efforts to prevent or remediate dysfunction in health care professionals. RESEARCH OBJECTIVE(S) List study objectives. To test the effectiveness, meaning the degree to which Back School aids in the relief of chronic back pain and improves posture in nurses when compared to other methods such as passive physiotherapy. 1

DESIGN TYPE AND LEVEL OF EVIDENCE: Level 1: Randomized controlled trial, including a 6-month and 12-month follow-up Limitations (appropriateness of study design): Was the study design type appropriate for the knowledge level about this topic? Circle yes or no, and if no, explain. YES/NO SAMPLE SELECTION How were subjects selected to participate? Please describe. The subjects were randomly assigned to the control group and the experimental group. The subjects were nurses working in the inpatient clinics of the University of Pecs in Hungary; the exact method of recruitment was not reported. Inclusion Criteria Less than 60 years of age, having experienced more than 3 months of lower back pain with or without referred pain, and had an active diagnosis of chronic low back pain. Exclusion Criteria “Pregnancy, previous spinal surgery, current nerve root entrapment with significant neurological deficit, spinal cord compression, tumors, structural deformities or severe instability, osteoporosis, inflammatory disease of the spine, spinal infection, severe cardiovascular or metabolic disorder, depression or connective tissue disorder” (p. 1778). SAMPLE CHARACTERISTICS N= % Dropouts 11.7% #/ (%) Male

18 (16%)

Ethnicity

NA

Disease/disability diagnosis

#/ (%) Female

93 (84%)

Chronic low back pain and body posture problems

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