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Systematic Reviews
Published in: Systematic Reviews 1/2021

01-12-2021 | Back Pain | Protocol

Work-related interventions for preventing back pain—protocol for a systematic review and network meta-analysis

Authors: Angelika Eisele-Metzger, Daria S. Schoser, Kathrin Grummich, Guido Schwarzer, Lukas Schwingshackl, Bianca Biallas, Christiane Wilke, Joerg J. Meerpohl, Cordula Braun

Published in: Systematic Reviews | Issue 1/2021

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Abstract

Background

Back pain is a widespread health problem that accounts for substantial disability and high costs. The workplace is considered to critically affect the occurrence and persistence of back pain and therefore offers an important opportunity for preventive interventions. Various work-related intervention strategies including both single- and multicomponent interventions have been developed and evaluated so far. To determine their effectiveness, a method of analysis is needed that particularly meets the challenges of the multidimensionality and diversity of these interventions. This planned systematic review and network meta-analysis aims to compare the effects of different work-related interventions for preventing non-specific back pain in people within a formal employment-related context.

Methods

We will search the following databases: CENTRAL, MEDLINE, Web of Science, CINAHL, PsycINFO, PEDro, SPORTDiscus, and Academic Search Premier from their inception onwards, as well as additional sources. Randomized controlled trials (RCTs) and cluster-RCTs will be considered if they (1) include people within a formal employment-related context, (2) include people without back pain or mixed samples (i.e., people with and without back pain), (3) compare one or more work-related preventive intervention(s) to a control condition, and (4) assess non-specific back pain (incidence or/and pain intensity), ability to work (numbers of participants or/and numbers of days absent from work), intervention-related adverse events or/and self-reported satisfaction with the intervention. Random-effects pairwise meta-analyses and frequentist network meta-analyses will be conducted where appropriate. We will calculate summary effect sizes for each comparison of interventions and rank interventions according to their P scores. If feasible, we will conduct additional component network meta-analyses. We plan to conduct subgroup analyses for job exposure, intervention duration, baseline back pain, different localizations of back pain, and gender. Risk of bias will be assessed using RoB 2 and the certainty of the evidence will be rated using the GRADE approach.

Discussion

This systematic review aims to identify work-related intervention strategies as well as components within work-related interventions that are effective for preventing back pain. We expect the results to provide guidance for selecting the most promising interventions and foster the purposeful use of resources. Additionally, they may inform the development and implementation of work-related interventions as well as the design of future research in this field.

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Appendix
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Literature
1.
Hurwitz EL, Randhawa K, Yu H, Côté P, Haldeman S. The Global Spine Care Initiative: a summary of the global burden of low back and neck pain studies. Eur Spine J. 2018;27(6):796–801.PubMedCrossRef
2.
Vos T, Lim SS, Abbafati C, Abbas KM, Abbasi M, Abbasifard M, et al. Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet. 2020;396(10258):1204–22.CrossRef
3.
Wu A, March L, Zheng X, Huang J, Wang X, Zhao J, et al. Global low back pain prevalence and years lived with disability from 1990 to 2017: estimates from the Global Burden of Disease Study 2017. Ann Transl Med. 2020;8(6):299.PubMedPubMedCentralCrossRef
4.
Hoy D, Brooks P, Blyth F, Buchbinder R. The epidemiology of low back pain. Best Pract Res Clin Rheumatol. 2010;24(6):769–81.PubMedCrossRef
5.
Dagenais S, Caro J, Haldeman S. A systematic review of low back pain cost of illness studies in the United States and internationally. Spine J. 2008;8(1):8–20.PubMedCrossRef
6.
7.
Schaafsma FG, Anema JR, van der Beek AJ. Back pain: prevention and management in the workplace. Best Pract Res Clin Rheumatol. 2015;29(3):483–94.PubMedCrossRef
8.
Al-Otaibi S. Prevention of occupational back pain. J Fam Commun Med. 2015;22(2):73–7.CrossRef
9.
Sowah D, Boyko R, Antle D, Miller L, Zakhary M, Straube S. Occupational interventions for the prevention of back pain: overview of systematic reviews. J Saf Res. 2018;66:39–59.CrossRef
10.
Bell JA, Burnett A. Exercise for the primary, secondary and tertiary prevention of low back pain in the workplace: a systematic review. J Occup Rehabil. 2009;19(1):8–24.PubMedCrossRef
11.
Steffens D, Maher CG, Pereira LSM, Stevens ML, Oliveira VC, Chapple M, et al. Prevention of low back pain: a systematic review and meta-analysis. JAMA Intern Med. 2016;176(2):199–208.PubMedCrossRef
12.
Dawson AP, McLennan SN, Schiller SD, Jull GA, Hodges PW, Stewart S. Interventions to prevent back pain and back injury in nurses: a systematic review. Occup Environ Med. 2007;64(10):642.PubMedPubMedCentralCrossRef
13.
Tveito TH, Hysing M, Eriksen HR. Low back pain interventions at the workplace: a systematic literature review. Occup Med. 2004;54(1):3–13.CrossRef
14.
Craig P, Dieppe P, Macintyre S, Michie S, Nazareth I, Petticrew M. Developing and evaluating complex interventions: The new Medical Research Council guidance. Int J Nurs Stud. 2013;50(5):587–92.PubMedCrossRef
15.
Molloy GJ, Noone C, Caldwell D, Welton NJ, Newell J. Network meta-analysis in health psychology and behavioural medicine: a primer. Health Psychol Rev. 2018;12(3):254–70.PubMedCrossRef
16.
Salanti G. Indirect and mixed-treatment comparison, network, or multiple-treatments meta-analysis: many names, many benefits, many concerns for the next generation evidence synthesis tool. Res Synth Methods. 2012;3(2):80–97.PubMedCrossRef
17.
Rücker G, Petropoulou M, Schwarzer G. Network meta-analysis of multicomponent interventions. Biometrical J. 2020;62(3):808–21.CrossRef
18.
Huang R, Ning J, Chuter VH, Taylor JB, Christophe D, Meng Z, et al. Exercise alone and exercise combined with education both prevent episodes of low back pain and related absenteeism: systematic review and network meta-analysis of randomised controlled trials (RCTs) aimed at preventing back pain. Br J Sports Med. 2020;54(13):766–70.PubMedCrossRef
19.
20.
Waongenngarm P, Areerak K, Janwantanakul P. The effects of breaks on low back pain, discomfort, and work productivity in office workers: a systematic review of randomized and non-randomized controlled trials. Appl Ergon. 2018;68:230–9.PubMedCrossRef
21.
Moher D, Shamseer L, Clarke M, Ghersi D, Liberati A, Petticrew M, et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Syst Rev. 2015;4(1):1.PubMedPubMedCentralCrossRef
22.
Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372:n71.PubMedPubMedCentralCrossRef
23.
Hutton B, Salanti G, Caldwell DM, Chaimani A, Schmid CH, Cameron C, et al. The PRISMA extension statement for reporting of systematic reviews incorporating network meta-analyses of health care interventions: checklist and explanations. Ann Intern Med. 2015;162(11):777–84.PubMedCrossRef
24.
Chaimani A, Caldwell DM, Li T, Higgins JPT, Salanti G. Additional considerations are required when preparing a protocol for a systematic review with multiple interventions. J Clin Epidemiol. 2017;83:65–74.PubMedCrossRef
25.
Krismer M, van Tulder M. Low back pain (non-specific). Best Pract Res Clin Rheumatol. 2007;21(1):77–91.PubMedCrossRef
26.
Lefebvre C, Glanville J, Briscoe S, Littlewood A, Marshall C, Metzendorf M-I, et al. Chapter 4: Searching for and selecting studies. In: Higgins J, Thomas J, Chandler J, Cumpston M, Li T, Page M, et al., editors. Cochrane Handbook for Systematic Reviews of Interventions version 61 (updated September 2020): Cochrane; 2020.
27.
28.
Parry SP, Coenen P, Shrestha N, O'Sullivan PB, Maher CG, Straker LM. Workplace interventions for increasing standing or walking for decreasing musculoskeletal symptoms in sedentary workers. Cochrane Database Syst Rev. 2019(11).
29.
Sterne JAC, Savović J, Page MJ, Elbers RG, Blencowe NS, Boutron I, et al. RoB 2: a revised tool for assessing risk of bias in randomised trials. BMJ. 2019;366:l4898.PubMedCrossRef
30.
Hooper R, Forbes A, Hemming K, Takeda A, Beresford L. Analysis of cluster randomised trials with an assessment of outcome at baseline. BMJ. 2018;360:k1121.PubMedCrossRef
31.
Higgins J, Eldridge S, Li T. Chapter 23: Including variants on randomized trials. In: Higgins J, Thomas J, Chandler J, Cumpston M, Li T, Page M, et al., editors. Cochrane Handbook for Systematic Reviews of Interventions version 61 (updated September 2020): Cochrane; 2020.
32.
33.
Higgins J, Li T, Deeks J. Chapter 6: Choosing effect measures and computing estimates of effect. In: Higgins J, Thomas J, Chandler J, Cumpston M, Li T, Page M, et al., editors. Cochrane Handbook for Systematic Reviews of Interventions version 61 (updated September 2020): Cochrane; 2020.
34.
Furukawa TA, Barbui C, Cipriani A, Brambilla P, Watanabe N. Imputing missing standard deviations in meta-analyses can provide accurate results. J Clin Epidemiol. 2006;59(1):7–10.PubMedCrossRef
35.
36.
37.
Sterne JA, Sutton AJ, Ioannidis JP, Terrin N, Jones DR, Lau J, et al. Recommendations for examining and interpreting funnel plot asymmetry in meta-analyses of randomised controlled trials. BMJ. 2011;343:d4002.PubMedCrossRef
38.
Schwingshackl L, Schwarzer G, Rücker G, Meerpohl JJ. Perspective: network meta-analysis reaches nutrition research: current status, scientific concepts, and future directions. Adv Nutr. 2019;10(5):739–54.PubMedPubMedCentralCrossRef
39.
Grimani A, Aboagye E, Kwak L. The effectiveness of workplace nutrition and physical activity interventions in improving productivity, work performance and workability: a systematic review. BMC Public Health. 2019;19(1):1676.PubMedPubMedCentralCrossRef
40.
41.
Deeks J, Higgins J, Altman D. Chapter 10: Analysing data and undertaking meta-analyses. In: Higgins J, Thomas J, Chandler J, Cumpston M, Li T, Page M, et al., editors. Cochrane Handbook for Systematic Reviews of Interventions version 61 (updated September 2020): Cochrane; 2020.
42.
43.
Balduzzi S, Rücker G, Schwarzer G. How to perform a meta-analysis with R: a practical tutorial. Evid Based Ment Health. 2019;22(4):153–60.PubMedCrossRef
44.
45.
46.
47.
Kroll LE. Construction and Validation of a General Index for Job Demands in Occupations Based on ISCO-88 and KldB-92 [Konstruktion und Validierung eines allgemeinen Index für die Arbeitsbelastung in beruflichen Tätigkeiten anhand von ISCO-88 und KldB-92]. Method Daten Analysen. 2011;5(1):63–90.
48.
Dias S, Sutton AJ, Welton NJ, Ades AE. Evidence synthesis for decision making 3: heterogeneity–subgroups, meta-regression, bias, and bias-adjustment. Med Decision Making. 2013;33(5):618–40.CrossRef
49.
Veroniki AA, Vasiliadis HS, Higgins JP, Salanti G. Evaluation of inconsistency in networks of interventions. Int J Epidemiol. 2013;42(1):332–45.PubMedCrossRef
50.
Dias S, Welton NJ, Caldwell DM, Ades AE. Checking consistency in mixed treatment comparison meta-analysis. Stat Med. 2010;29(7–8):932–44.PubMedCrossRef
51.
Brignardello-Petersen R, Bonner A, Alexander PE, Siemieniuk RA, Furukawa TA, Rochwerg B, et al. Advances in the GRADE approach to rate the certainty in estimates from a network meta-analysis. J Clin Epidemiol. 2018;93:36–44.PubMedCrossRef
52.
Puhan MA, Schünemann HJ, Murad MH, Li T, Brignardello-Petersen R, Singh JA, et al. A GRADE Working Group approach for rating the quality of treatment effect estimates from network meta-analysis. BMJ. 2014;349:g5630.PubMedCrossRef
Metadata
Title
Work-related interventions for preventing back pain—protocol for a systematic review and network meta-analysis
Authors
Angelika Eisele-Metzger
Daria S. Schoser
Kathrin Grummich
Guido Schwarzer
Lukas Schwingshackl
Bianca Biallas
Christiane Wilke
Joerg J. Meerpohl
Cordula Braun
Publication date
01-12-2021
Publisher
BioMed Central
Published in
Systematic Reviews / Issue 1/2021
Electronic ISSN: 2046-4053
DOI
https://doi.org/10.1186/s13643-021-01768-5

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