Mechanisms of action of lumbar supports: a sytematic review

M.N.M. van Poppel-Bruinvels, 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 [Cl] 0.39-1.01) and 1.13 (95% Cl 0.17-2.08), respectively. The overall effect size for rotation was not statistically significant (0.69; 95% Cl -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% Cl -0.41-0.59) or increase the intra-abdominal pressure (effect size of 0.26; 95% Cl -0.07-0.59). Conclusion. There is evidence that lumbar supports reduce trunk motion for flexion-extension and latera 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
    Pages2103-2113
    Number of pages11
    JournalSpine
    Volume25
    Issue number16
    DOIs
    Publication statusPublished - 2000

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

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    van Poppel-Bruinvels, M.N.M. ; de Looze, M.P. ; Koes, B.W. ; Smid, T. ; Bouter, L.M. / Mechanisms of action of lumbar supports: a sytematic review. In: Spine. 2000 ; Vol. 25, No. 16. pp. 2103-2113.
    @article{928314e02e174aec95605703bce41197,
    title = "Mechanisms of action of lumbar supports: a sytematic 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 [Cl] 0.39-1.01) and 1.13 (95{\%} Cl 0.17-2.08), respectively. The overall effect size for rotation was not statistically significant (0.69; 95{\%} Cl -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{\%} Cl -0.41-0.59) or increase the intra-abdominal pressure (effect size of 0.26; 95{\%} Cl -0.07-0.59). Conclusion. There is evidence that lumbar supports reduce trunk motion for flexion-extension and latera 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.",
    author = "{van Poppel-Bruinvels}, M.N.M. and {de Looze}, M.P. and B.W. Koes and T. Smid and L.M. Bouter",
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    language = "English",
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    Mechanisms of action of lumbar supports: a sytematic review. / van Poppel-Bruinvels, M.N.M.; de Looze, M.P.; Koes, B.W.; Smid, T.; Bouter, L.M.

    In: Spine, Vol. 25, No. 16, 2000, p. 2103-2113.

    Research output: Contribution to JournalArticleAcademicpeer-review

    TY - JOUR

    T1 - Mechanisms of action of lumbar supports: a sytematic review

    AU - van Poppel-Bruinvels, M.N.M.

    AU - de Looze, M.P.

    AU - Koes, B.W.

    AU - Smid, T.

    AU - Bouter, L.M.

    PY - 2000

    Y1 - 2000

    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 [Cl] 0.39-1.01) and 1.13 (95% Cl 0.17-2.08), respectively. The overall effect size for rotation was not statistically significant (0.69; 95% Cl -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% Cl -0.41-0.59) or increase the intra-abdominal pressure (effect size of 0.26; 95% Cl -0.07-0.59). Conclusion. There is evidence that lumbar supports reduce trunk motion for flexion-extension and latera 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 [Cl] 0.39-1.01) and 1.13 (95% Cl 0.17-2.08), respectively. The overall effect size for rotation was not statistically significant (0.69; 95% Cl -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% Cl -0.41-0.59) or increase the intra-abdominal pressure (effect size of 0.26; 95% Cl -0.07-0.59). Conclusion. There is evidence that lumbar supports reduce trunk motion for flexion-extension and latera 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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    SP - 2103

    EP - 2113

    JO - Spine

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    JF - Spine

    SN - 0362-2436

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