HRB-project Ireland

Non-specific chronic low back pain (NSCLBP) is the most common and costly work-related musculoskeletal disorder, but rehabilitation approaches vary. The NSCLBP population may consist of distinct subgroups, with management ideally tailored to each subgroup. One specific subgroup adopts provocative end-range lumbar flexion postures during functional activities. Most previous postural research has been conducted in laboratories.
Technological advances mean that postural monitoring and feedback in occupational settings is now possible. This could have significant implications for NSCLBP management and rehabilitation. Preliminary data suggests that one postural monitor - the Sels Posture Monitoring Device (SPMD) - is reliable. It is unclear however whether:

  • The SPMD is a valid measure of lumbar posture.
  • The laboratory-based differences (between controls and NSCLBP) in lumbar posture can be identified (using the SPMD) in occupational settings.
  • Providing postural feedback in occupational settings improves clinical outcomes.

This project aims to investigate the capacity of the SPMD to identify and train a subgroup with NSCLBP in occupational settings. This involves three studies:

  1. A laboratory-based, comparative evaluation of the concurrent validity of the SPMD. Mean lumbar posture values during simulated occupational tasks (laboratory-based) using the SPC will be correlated (ICC, limits of agreement) with a recognised motion analysis system.
  2. A cross-sectional study evaluating the discriminative validity of the SPMD. This will examine whether the SPMD can detect differences (Anova) in mean lumbar posture between NSCLBP subjects and healthy controls, while performing real occupational tasks.
  3. A randomised prospective study to evaluate whether the SPMD improves clinical outcomes in occupational settings. This will be compared (Anova) to a conventional ?control? treatment. Primary (e.g. pain, disability) and secondary (e.g. postural control) outcomes will be analysed between groups at completion of the intervention (6 weeks), and after 3 months.