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J Clin Nurs. 2012 Jun;21(11-12):1776-84. doi: 10.1111/j.1365-2702.2012.04089.x.

Treatment and ergonomics training of work-related lower back pain and body posture problems for nurses.

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Institute of Physiotherapy, Faculty of Health Sciences, University of Pecs, Pecs, Hungary.



The purpose of the study was to measure the effectiveness of a spine training programme (Back School) in nurses who have been living with chronic low back pain. It was hypothesised that active therapy, ergonomics and education called Back School will significantly decrease the pain intensity levels and improve the body posture of the study participants.


A chronic low back pain is a significant work-related health problem among healthcare workers around the world. Proper body posture is essential for decreasing pain in healthcare workers who have history of chronic low back pain. By teaching proper body posture and with the creation of occupational settings that are 'spine-friendly' hospitals and other healthcare settings can significantly lower the suffering of their nursing staff.


Single-blinded randomised controlled trial was utilised with six- and 12-months follow-up.


The study was carried out at the University of Pecs, Faculty of Health Sciences from 2007 to 2008 involving 124 nurses with low back pain. Participants were randomly assigned to the study group (who have received ergonomics training and education called Back School) with an intervention conducted once a week for a six-week period. The control group received passive physiotherapy once a week for a six-week period. Further follow-up measurements were conducted at six and 12 months, respectively. The study variables and outcome measures were pain intensity and body posture (angle of thoracic kyphosis and lumbar lordosis). The pain intensity was investigated with the Visual Analogue Scale. Body posture was recorded and analysed with the Zebris biomechanical motion analysis system.


The statistical analysis of repeated measures indicated a significant decrease in back pain intensity after the therapy in both groups, compared with measurements before the therapy; however, the BS group showed significantly better results during the six-month and one-year follow-up period. The biomechanical analysis of postures after the therapy in the BS group showed significant improvements over the control group; during the follow-up, the difference was still significant, yet slightly reduced.


This study has shown that a significant reduction in the pain intensity and improvement in body posture can be achieved by the usage of the active physical therapy methods (Back School) in nurses who are experiencing chronic lower back pain.


The Back School programme when compared with the passive physical therapies (such as massage, ultrasound treatment, etc.) shows significant improvement in reduction in pain and greatly improves the posture of healthcare workers. The adoption of the Back School programme for the treatment of the healthcare workers with chronic low back problems should be a treatment of choice and standard that should be adopted when designing occupational healthcare policies and procedures.

[Indexed for MEDLINE]

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