Musculoskeletal signs in female homecare personnel: A longitudinal epidemiological study.
Gunnar Lundberg, Björn Gerdle
PMID 29036858WHAT IT FOUND
Pain provoked in lower lumbar segments at baseline was linked to higher low back pain and disability eight years later in female homecare workers.
Lumbar mobility showed small links, but signs explained only 6 to 10% of outcomes.
Key findings
01Female homecare workers with segmental pain at L4-L5 or L5-S1 at baseline had higher low back pain eight years later than those without the sign.
02Baseline segmental pain was also associated with higher disability at eight-year follow-up.
03Lumbar spinal mobility, segmental pain and age were the most important baseline variables for pain and disability, but they explained only 6 to 10% of the variation.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study included only female homecare workers in one Swedish municipality, so it may not apply to men, other occupations, or other countries. The follow-up was performed in 2005, and the authors note that work tasks and circumstances may have changed since then. Baseline signs were not assessed again at follow-up, so the study could not track whether the signs changed over the eight years. Pain was measured only at two time points eight years apart, so short-term pain fluctuation may have obscured relationships. The multivariate models explained only 6 to 10% of pain or disability variation, so the signs were not strong individual predictors. The study followed 528 of 607 baseline participants, with 13% dropouts, and 31% of those with low back pain changed pain status between baseline and follow-up. Several signs depended on patient-reported pain or examiner judgment, so they were not fully objective.
Declared interests
No conflicts of interest were reported.
The easy way to misread this
Do not read these signs as reliable predictors for an individual patient. The study found significant associations, but the signs explained only 6 to 10% of pain or disability variation, and posture and Beighton score were not useful prognostic signs in this cohort.