Mechanisms of action of lumbar supports: a systematic review

M N van Poppel, M P de Looze, B W Koes, T Smid, L M Bouter

Research output: Contribution to JournalArticleAcademicpeer-review

Abstract

STUDY DESIGN: A systematic review and meta-analysis of studies on the putative mechanisms of action of lumbar supports in lifting activities.

OBJECTIVE: To summarize the evidence bearing on the putative mechanisms of action of lumbar supports.

SUMMARY OF BACKGROUND DATA: A restriction of trunk motion and a reduction in required back muscle forces in lifting are two proposed mechanisms of action of lumbar supports. Available studies on these putative mechanisms of action of lumbar supports have reported contradictory results.

METHODS: A literature search for controlled studies on mechanisms of action of lumbar supports was conducted. The methodologic quality of the studies was assessed. The evidence for the two proposed mechanisms of action of lumbar supports was determined in meta-analyses.

RESULTS: Thirty-three studies were selected for the review. There was evidence that lumbar supports reduce trunk motion for flexion-extension and lateral bending, with overall effect sizes of 0.70 (95% confidence interval [CI] 0.39-1. 01) and 1.13 (95% CI 0.17-2.08), respectively. The overall effect size for rotation was not statistically significant (0.69; 95% CI -0. 40-4.31). There was no evidence that lumbar supports reduce the electromyogram activity of erector spinae muscles (effect size of 0. 09; 95% CI -0.41-0.59) or increase the intra-abdominal pressure (effect size of 0.26; 95% CI -0.07-0.59).

CONCLUSION: There is evidence that lumbar supports reduce trunk motion for flexion-extension and lateral bending. More research is needed on the separate outcome measures for trunk motion before definite conclusions can be drawn about the work conditions in which lumbar supports may be most effective. Studies of trunk motion at the workplace or during specified lifting tasks would be especially useful in this regard.

LanguageEnglish
Pages2103-13
Number of pages11
JournalSpine
Volume25
Issue number16
DOIs
Publication statusPublished - 15 Aug 2000

Fingerprint

Confidence Intervals
Meta-Analysis
Back Muscles
Electromyography
Workplace
Outcome Assessment (Health Care)
Pressure
Muscles
Research

Keywords

  • Back Injuries
  • Braces
  • Female
  • Humans
  • Lifting
  • Low Back Pain
  • Lumbar Vertebrae
  • Lumbosacral Region
  • Male
  • Occupational Diseases
  • Journal Article
  • Meta-Analysis

Cite this

van Poppel, M N ; de Looze, M P ; Koes, B W ; Smid, T ; Bouter, L M. / Mechanisms of action of lumbar supports : a systematic review. In: Spine. 2000 ; Vol. 25, No. 16. pp. 2103-13.
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abstract = "STUDY DESIGN: A systematic review and meta-analysis of studies on the putative mechanisms of action of lumbar supports in lifting activities.OBJECTIVE: To summarize the evidence bearing on the putative mechanisms of action of lumbar supports.SUMMARY OF BACKGROUND DATA: A restriction of trunk motion and a reduction in required back muscle forces in lifting are two proposed mechanisms of action of lumbar supports. Available studies on these putative mechanisms of action of lumbar supports have reported contradictory results.METHODS: A literature search for controlled studies on mechanisms of action of lumbar supports was conducted. The methodologic quality of the studies was assessed. The evidence for the two proposed mechanisms of action of lumbar supports was determined in meta-analyses.RESULTS: Thirty-three studies were selected for the review. There was evidence that lumbar supports reduce trunk motion for flexion-extension and lateral bending, with overall effect sizes of 0.70 (95{\%} confidence interval [CI] 0.39-1. 01) and 1.13 (95{\%} CI 0.17-2.08), respectively. The overall effect size for rotation was not statistically significant (0.69; 95{\%} CI -0. 40-4.31). There was no evidence that lumbar supports reduce the electromyogram activity of erector spinae muscles (effect size of 0. 09; 95{\%} CI -0.41-0.59) or increase the intra-abdominal pressure (effect size of 0.26; 95{\%} CI -0.07-0.59).CONCLUSION: There is evidence that lumbar supports reduce trunk motion for flexion-extension and lateral bending. More research is needed on the separate outcome measures for trunk motion before definite conclusions can be drawn about the work conditions in which lumbar supports may be most effective. Studies of trunk motion at the workplace or during specified lifting tasks would be especially useful in this regard.",
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Mechanisms of action of lumbar supports : a systematic review. / van Poppel, M N; de Looze, M P; Koes, B W; Smid, T; Bouter, L M.

In: Spine, Vol. 25, No. 16, 15.08.2000, p. 2103-13.

Research output: Contribution to JournalArticleAcademicpeer-review

TY - JOUR

T1 - Mechanisms of action of lumbar supports

T2 - Spine

AU - van Poppel, M N

AU - de Looze, M P

AU - Koes, B W

AU - Smid, T

AU - Bouter, L M

PY - 2000/8/15

Y1 - 2000/8/15

N2 - STUDY DESIGN: A systematic review and meta-analysis of studies on the putative mechanisms of action of lumbar supports in lifting activities.OBJECTIVE: To summarize the evidence bearing on the putative mechanisms of action of lumbar supports.SUMMARY OF BACKGROUND DATA: A restriction of trunk motion and a reduction in required back muscle forces in lifting are two proposed mechanisms of action of lumbar supports. Available studies on these putative mechanisms of action of lumbar supports have reported contradictory results.METHODS: A literature search for controlled studies on mechanisms of action of lumbar supports was conducted. The methodologic quality of the studies was assessed. The evidence for the two proposed mechanisms of action of lumbar supports was determined in meta-analyses.RESULTS: Thirty-three studies were selected for the review. There was evidence that lumbar supports reduce trunk motion for flexion-extension and lateral bending, with overall effect sizes of 0.70 (95% confidence interval [CI] 0.39-1. 01) and 1.13 (95% CI 0.17-2.08), respectively. The overall effect size for rotation was not statistically significant (0.69; 95% CI -0. 40-4.31). There was no evidence that lumbar supports reduce the electromyogram activity of erector spinae muscles (effect size of 0. 09; 95% CI -0.41-0.59) or increase the intra-abdominal pressure (effect size of 0.26; 95% CI -0.07-0.59).CONCLUSION: There is evidence that lumbar supports reduce trunk motion for flexion-extension and lateral bending. More research is needed on the separate outcome measures for trunk motion before definite conclusions can be drawn about the work conditions in which lumbar supports may be most effective. Studies of trunk motion at the workplace or during specified lifting tasks would be especially useful in this regard.

AB - STUDY DESIGN: A systematic review and meta-analysis of studies on the putative mechanisms of action of lumbar supports in lifting activities.OBJECTIVE: To summarize the evidence bearing on the putative mechanisms of action of lumbar supports.SUMMARY OF BACKGROUND DATA: A restriction of trunk motion and a reduction in required back muscle forces in lifting are two proposed mechanisms of action of lumbar supports. Available studies on these putative mechanisms of action of lumbar supports have reported contradictory results.METHODS: A literature search for controlled studies on mechanisms of action of lumbar supports was conducted. The methodologic quality of the studies was assessed. The evidence for the two proposed mechanisms of action of lumbar supports was determined in meta-analyses.RESULTS: Thirty-three studies were selected for the review. There was evidence that lumbar supports reduce trunk motion for flexion-extension and lateral bending, with overall effect sizes of 0.70 (95% confidence interval [CI] 0.39-1. 01) and 1.13 (95% CI 0.17-2.08), respectively. The overall effect size for rotation was not statistically significant (0.69; 95% CI -0. 40-4.31). There was no evidence that lumbar supports reduce the electromyogram activity of erector spinae muscles (effect size of 0. 09; 95% CI -0.41-0.59) or increase the intra-abdominal pressure (effect size of 0.26; 95% CI -0.07-0.59).CONCLUSION: There is evidence that lumbar supports reduce trunk motion for flexion-extension and lateral bending. More research is needed on the separate outcome measures for trunk motion before definite conclusions can be drawn about the work conditions in which lumbar supports may be most effective. Studies of trunk motion at the workplace or during specified lifting tasks would be especially useful in this regard.

KW - Back Injuries

KW - Braces

KW - Female

KW - Humans

KW - Lifting

KW - Low Back Pain

KW - Lumbar Vertebrae

KW - Lumbosacral Region

KW - Male

KW - Occupational Diseases

KW - Journal Article

KW - Meta-Analysis

U2 - 10.1097/00007632-200008150-00016

DO - 10.1097/00007632-200008150-00016

M3 - Article

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SP - 2103

EP - 2113

JO - Spine

JF - Spine

SN - 0362-2436

IS - 16

ER -