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J Clin Nurs. 2018 Mar;27(5-6):e895-e902. doi: 10.1111/jocn.13981. Epub 2018 Jan 23.

Back School programme for nurses has reduced low back pain levels: A randomised controlled trial.

Author information

Faculty of Health Sciences, Institute of Physiotherapy and Sport Science, University of Pécs, Pecs, Hungary.
Veterans Administration Louis Stokes Medical Center, Cleveland, OH, USA.
Faculty of Physical Education and Sport, Institute of Physiotherapy and Theoretical Subjects, Babes-Bolyai University, Cluj-Napoca, Romania.
Faculty of Health Sciences, Doctoral School of Health Sciences, University of Pécs, Pecs, Hungary.
Department of Kinesitherapy and Special Methods in Physiotherapy, The Jerzy Kukuczka Academy of Physical Education in Katowice, Katowice, Poland.



(i) To examine patient lifting techniques used by nurses, and (ii) to evaluate an effectiveness of the Spine Care for Nurses programme in chronic nonspecific low back pain syndrome reduction and the execution of proper patient lifting techniques.


Millions of nurses around the world suffer from occupational-related chronic nonspecific low back pain (chronic nonspecific low back pain syndrome). Generally, low back pain in nurses is a result of increased pressure on the spine and can be associated with improperly conducted patient lifting techniques.


A randomised controlled trial was conducted among 137 nurses with chronic nonspecific low back pain syndrome. Participants were randomised into an experimental and control group (experimental group n = 67, control group n = 70). Nurses in the experimental group attended the Spine Care for Nurses programme for 3 months. The programme consisted of didactic education, spine-strengthening exercises and education on safe patient handling techniques. The control group only received a brief written lifestyle guidance. The Zebris WinSpine Triple Lumbar examination was used to analyse nurses' patient lifting techniques (horizontal and vertical lifting). The lumbar pain intensity was measured with a 0-100 visual analogue scale.


The pre-intervention average chronic nonspecific low back pain syndrome intensity score on visual analogue scale decreased from 49.3 to the postintervention score of 7.5. The correct execution of vertical lifting techniques in the experimental group increased from 8.91%-97.01% (control group: 8.57% pre-intervention test and postintervention test 11.42%). The horizontal patient lifting technique pre-intervention increased from 10.44%-100% correct execution in the experimental group (control group: pre-intervention test 10.00% and postintervention test 11.42%).


The Spine Care for Nurses programme significantly reduced chronic nonspecific low back pain syndrome and increased the number of properly executed horizontal and vertical patient lifting techniques in nurses.


We recommend that healthcare organisations should consider the implementation of regular Spine Care for Nurses programmes as successful low back injury prevention programmes.


Back School; Spine Care for Nurses programme; chronic nonspecific low back pain in nurses; horizontal and vertical patient lifting techniques; proper patient lifting and handling techniques

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