Back Pain: van der Beek AJ

Burton AK, Balagué F, Cardon G, Eriksen HR, Henrotin Y, Lahad A, Leclerc A, Müller G, van der Beek AJ, Anonymous00001. · No affiliation provided · Eur Spine J. · Pubmed #16550446 No free full text.

This publication has no abstract.

Burton AK, Balagué F, Cardon G, Eriksen HR, Henrotin Y, Lahad A, Leclerc A, Müller G, van der Beek AJ, Anonymous00032. · Centre for Health and Social Care Research, University of Huddersfield, 30 Queen Street, Huddersfield HD1 2SP, UK. · Best Pract Res Clin Rheumatol. · Pubmed #15949775 No free full text.

Abstract: This chapter summarizes the European Guidelines for Prevention in Low Back Pain, which consider the evidence in respect of the general population, workers and children. There is limited scope for preventing the incidence (first-time onset) of back pain and, overall, there is limited robust evidence for numerous aspects of prevention in back pain. Nevertheless, there is evidence suggesting that prevention of various consequences of back pain is feasible. However, for those interventions where there is acceptable evidence, the effect sizes are rather modest. The most promising approaches seem to involve physical activity/exercise and appropriate (biopsychosocial) education, at least for adults. Owing to its multidimensional nature, no single intervention is likely to be effective at preventing the overall problem of back pain, although there is likely to be benefit from getting all the players onside. However, innovative studies are required to better understand the mechanisms and delivery of prevention in low back pain.

Weevers HJ, van der Beek AJ, Anema JR, van der Wal G, van Mechelen W. · Department of Public and Occupational Health, Institute for Research in Extramural Medicine, VU University Medical Center, Amsterdam, The Netherlands. · Fam Pract. · Pubmed #15710641 links to  free full text

Abstract: OBJECTIVES: The objective was to answer the following questions: What is the prevalence of potentially work-related diseases in the general practice population? What is the incidence of consulting a GP for a potentially work-related disease? What is the relationship between diseases seen in general practice and work ability? METHODS: Cochrane standards and QUOROM principals were used. For this systematic review the available literature was identified in a computerized search of the bibliographical databases Medline, Embase and Osh-rom. A total of 22 publications (24 studies) met the inclusion criteria. RESULTS: In the general practice population high prevalence rates of potentially work-related diseases were found for low back pain, neck pain and shoulder pain. Incidence rates of consulting a GP for a potentially work-related disease were high also. Musculoskeletal disorders were the main reasons for work-related consultations in general practice. Work-related diseases can affect work ability. CONCLUSIONS: Work-related diseases are common, given the high incidence and prevalence of potentially work-related diseases found in the general practice population and seen by the GP. This review underlines the important role of GPs in identifying and managing work-related diseases. GPs should consider the work factor and pay special attention to the effects of work on health, because patients often link their work with their illness.

de Vet HC, Heymans MW, Dunn KM, Pope DP, van der Beek AJ, Macfarlane GJ, Bouter LM, Croft PR. · Institute for Research in Extramural Medicine, Vrije Universiteit Medical Centre, Amsterdam, The Netherlands. · Spine (Phila Pa 1976). · Pubmed #12438991 No free full text.

Abstract: STUDY DESIGN: Literature review and group discussions. OBJECTIVE: To propose uniform definitions for low back pain episodes to be used in research. BACKGROUND: Different definitions of episodes have been used in low back pain studies. This hampers comparison of study results. Definitions are proposed for episodes of low back pain, care for low back pain, and work absence because of low back pain. METHODS: In a Medline search, we identified about 1200 papers, of which 81 possibly contained a definition of episodes. In group discussions, we decided which definitions to propose and discussed their applicability. RESULTS: We found few definitions in the literature. In the group discussions we decided to define an episode of LBP as a period of pain in the lower back lasting for more than 24 hours, preceded and followed by a period of at least 1 month without low back pain. An episode of care for low back pain was defined as a consultation or a series of consultations for low back pain, preceded and followed by at least 3 months without consultation for low back pain. An episode of work absence due to low back pain was defined as a period of work absence due to low back pain, preceded and followed by a period of at least 1 day at work. CONCLUSIONS: In many studies, episodes of low back pain are mentioned without a clear definition. We consider our proposed definitions of episodes to be arbitrary but well considered. We advise that they be tested for use in future research.

Elders LA, van der Beek AJ, Burdorf A. · Department of Public Health, Erasmus University Rotterdam, The Netherlands. · Int Arch Occup Environ Health. · Pubmed #10963418 No free full text.

Abstract: OBJECTIVES: The aim was to review the literature with regard to the effectiveness of intervention programmes for the prevention of aggravation of back disorders or prolonged duration of sickness absence. METHODS: A systematic search of the literature was performed using three groups of key words and inclusion/exclusion criteria. Effectiveness was evaluated using two measures: the difference between intervention and referent groups in return to work, and the fraction of sickness absence among referent groups that could be prevented if these referents had undergone the same intervention (preventable fraction). RESULTS: Twelve articles with quantitative information on the effect of ergonomic interventions on return to work were included. In eight studies, introduction of a back-school programme was the preferred intervention, combining exercise and functional conditioning, and training in working methods and lifting techniques. In seven out of eight back-school studies, return to work was significantly better in the intervention group. Intervention after 60 days, in the subacute phase of back pain, showed the most promising results. In these studies the preventable fraction varied between -11% and 80%, largely depending on the stage and phase of back disorders and the time of follow-up. The success of intervention also depended on the profile of the referents when left untampered. In all studies compliance during the intervention was fairly good, but there was a lack of information on sustainability of the intervention during the follow-up and on recurrence of back complaints and consequent sickness absence. CONCLUSIONS: Few studies were performed to assess the outcome return to work after ergonomic intervention. However, there is evidence that intervention in the subacute phase of back pain is preferable. Future intervention studies should address intervention sustainability and recurrence of sickness absence due to back pain over at least a 1-year follow-up period.

Hamberg-van Reenen HH, Visser B, van der Beek AJ, Blatter BM, van Dieën JH, van Mechelen W. · Body@Work, Research Center Physical Activity, Work and Health, TNO - VU University Medical Center, Amsterdam, The Netherlands. · Appl Ergon. · Pubmed #19101664 No free full text.

Abstract: The aim of the study was to investigate the effectiveness of a resistance-training program on muscle strength of the back and neck/shoulder muscles, relative physical workload, muscle fatigue and musculoskeletal discomfort during a simulated assembly and lifting task. Twenty-two workers were randomized over an 8-week resistance-training group, and a control group. Isokinetic muscle strength was assessed using the Cybex dynamometer, muscle fatigue was measured using EMG, and perceived discomfort was measured using a 10-point scale. At the follow-up, we found no effect of the resistance-training program on isokinetic muscle strength of the back and shoulder muscles. Furthermore, we did not find any effect on EMG data, nor on musculoskeletal discomfort during the simulated work tasks. However, trained workers performed the lifting tasks for a longer time before reporting considerable discomfort than those in the control group.

Driessen MT, Anema JR, Proper KI, Bongers PM, van der Beek AJ. · Body@Work TNO VUmc, Research Center Physical Activity, Work and Health, VU University Medical Center, van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands. · BMC Musculoskelet Disord. · Pubmed #18959799 links to  free full text

Abstract: BACKGROUND: Low back pain (LBP) and neck pain (NP) are a major public health problem with considerable costs for individuals, companies and society. Therefore, prevention is imperative. The Stay@Work study investigates the (cost-)effectiveness of Participatory Ergonomics (PE) to prevent LBP and NP among workers. METHODS: In a randomised controlled trial (RCT), a total of 5,759 workers working at 36 departments of four companies is expected to participate in the study at baseline. The departments consisting of about 150 workers are pre-stratified and randomised. The control departments receive usual practice and the intervention departments receive PE. Within each intervention department a working group is formed including eight workers, a representative of the management, and an occupational health and safety coordinator. During a one day meeting, the working group follows the steps of PE in which the most important risk factors for LBP and NP, and the most adequate ergonomic measures are identified on the basis of group consensus. The implementation of ergonomic measures at the department is performed by the working group. To improve the implementation process, so-called 'ergocoaches' are trained. The primary outcome measure is an episode of LBP and NP. Secondary outcome measures are actual use of ergonomic measures, physical workload, psychosocial workload, intensity of pain, general health status, sick leave, and work productivity. The cost-effectiveness analysis is performed from the societal and company perspective. Outcome measures are assessed using questionnaires at baseline and after 6 and 12 months. Data on the primary outcome as well as on intensity of pain, sick leave, work productivity, and health care costs are collected every 3 months. DISCUSSION: Prevention of LBP and NP is beneficial for workers, employers, and society. If the intervention is proven (cost-)effective, the intervention can have a major impact on LBP and NP prevention and, thereby, on work disability prevention. Results are expected in 2010. TRIAL REGISTRATION: ISRCTN27472278.

Hooftman WE, Westerman MJ, van der Beek AJ, Bongers PM, van Mechelen W. · Department of Public and Occupational Health, EMGO Institute, VU University Medical Center, Van der Boechorststraat 7-9, Amsterdam, Netherlands. · Scand J Work Environ Health. · Pubmed #18470439 No free full text.

Abstract: OBJECTIVE: The objective of this study was to determine what makes men and women with musculoskeletal complaints decide to call in sick for work. METHODS: Qualitative, face-to-face interviews were used with employees (16 men and 14 women) who had called in sick due to a musculoskeletal complaint and who expected to be absent from work for at least 2 weeks on sick leave. RESULTS: The participants fell into the following two main groups: those who were off sick because of a diagnosed medical condition, such as a fracture, and those who were off sick because of an unidentifiable complaint, such as low-back pain. Employees in the former group called in sick because they were in the hospital or because they reckoned that their condition was too serious to warrant a continuation of work. Employees in the latter group felt hesitant and insecure and found it hard to judge whether absenteeism was justified. They decided either to "play it safe" and stay off work to prevent the complaints from worsening or to seek advice from medical professionals. Their advice did not include explicit instructions to stay at home, but were usually interpreted as such. Finally, women, but not men, were likely to call in sick if they felt that their home situation was being negatively affected by attempts to keep working while suffering physical complaints. CONCLUSIONS: The decision to call in sick is not taken lightly. Employees with nonspecific disorders base their decision on several factors, including advice from medical professionals. A factor found only among women was work-home interference.

Hamberg-van Reenen HH, van der Beek AJ, Blatter BM, van der Grinten MP, van Mechelen W, Bongers PM. · Body@Work, Research Center Physical Activity, Work and Health, TNO-VU University Medical Center, Amsterdam, The Netherlands. · Ergonomics. · Pubmed #18432442 No free full text.

Abstract: The objective of this prospective cohort study was to evaluate if peak or cumulative musculoskeletal discomfort may predict future low-back, neck or shoulder pain among symptom-free workers. At baseline, discomfort per body region was rated on a 10-point scale six times during a working day. Questionnaires on pain were sent out three times during follow-up. Peak discomfort was defined as a discomfort level of 2 at least once during a day; cumulative discomfort was defined as the sum of discomfort during the day. Reference workers reported a rating of zero at each measurement. Peak discomfort was a predictor of low-back pain (relative risk (RR) 1.79), neck pain (RR 2.56), right or left shoulder pain (RR 1.91 and 1.90). Cumulative discomfort predicted neck pain (RR 2.35), right or left shoulder pain (RR 2.45 and 1.64). These results suggest that both peak and cumulative discomfort could predict future musculoskeletal pain.

Hamberg-van Reenen HH, Ariëns GA, Blatter BM, van der Beek AJ, Twisk JW, van Mechelen W, Bongers PM. · Body@work, Research Center Physical Activity, Work and Health, TNO Vumc, Van der Boechorststraat 7, 1081 BT Amsterdam, Netherlands. · Scand J Work Environ Health. · Pubmed #16804621 No free full text.

Abstract: OBJECTIVES: This study investigates whether an imbalance between physical capacity and exposure to work-related physical factors is associated with low-back, neck, or shoulder pain. METHODS: Data of the longitudinal study on musculoskeletal disorders, absenteeism, stress, and health (SMASH), with a follow-up of 3 years (N=1789), were used. At baseline, physical capacity (isokinetic lifting strength, static muscle endurance, and mobility of the spine) and exposure to work-related physical factors were assessed. During the follow-up, low-back, neck, and shoulder pain were self-reported annually. "Imbalance" was defined as lower than median capacity combined with higher than median exposure, "high balance" was high capacity and high exposure, and "low balance" was low capacity and low exposure. RESULTS: For both the low-back and neck, imbalance between static endurance and working with flexed postures was a risk factor for pain [relative risk (RR) 1.35, 95% confidence interval (95% CI) 1.08-1.68, and RR 1.36, 95% CI 0.96-1.91, respectively]. Low balance was also associated with low-back pain (RR 1.29, 95% CI 1.04-1.68). Furthermore, low balance between isokinetic lifting strength and lifting exposure was a risk factor for low-back and neck pain [RR between 1.22 (95% CI 0.99-1.49) and 1.35 (95% CI 1.03-1.79)]. No associations were found with shoulder pain. CONCLUSIONS: Some relationship between low-back and neck pain and combined measures of physical capacity with exposure to work-related physical factors seems to exist, but an imbalance between physical capacity and exposure was not found to yield higher risks than high balance or low balance.

van der Beek AJ, Erik Mathiassen S, Windhorst J, Burdorf A. · Department of Public Health, Erasmus MC, University Medical Center, P.O. Box 1738, NL-3000 DR Rotterdam, The Netherlands. · Appl Ergon. · Pubmed #15694076 No free full text.

Abstract: Four methods assessing the physical demands of manual lifting were compared. The scaffolding job was evaluated and three distinct scaffolding tasks were ranked using: (1) the revised NIOSH lifting equation (NIOSH method), (2) lifting guidelines for the Dutch construction industry (Arbouw method), (3) rapid appraisal of the NIOSH lifting equation (practitioners' method), and (4) systematic observations. For the three first-mentioned methods the same dataset was used; observation took place in a different setting in the same company. At job level, all methods indicated that ergonomic interventions are required to protect scaffolders from an increased risk for low back pain. The NIOSH, Arbouw and practitioners' method resulted in a similar ranking order of tasks (transport>construction>dismantlement). In contrast, the observational method gave transport the lowest ranking. The underlying cause was probably that the observational method is more sensitive to durations of tasks and lifting within tasks than the three other methods.

Anema JR, Cuelenaere B, van der Beek AJ, Knol DL, de Vet HC, van Mechelen W. · Body@Work, Research Centre Physical Activity, Work and Health, TNO-VU University Medical Centre, Netherlands. · Occup Environ Med. · Pubmed #15031385 links to  free full text

Abstract: AIMS: To study occurrence and effectiveness of ergonomic interventions on return-to-work applied for workers with low back pain (LBP). METHODS: A multinational cohort of 1631 workers fully sicklisted 3-4 months due to LBP (ICD-9 codes 721, 722, 724) was recruited from sickness benefit claimants databases in Denmark, Germany, Israel, Sweden, the Netherlands, and the United States. Medical, ergonomic, and other interventions, working status, and return-to-work were measured using questionnaires and interviews at three months, one and two years after the start of sickleave. Main outcome measure was time to return-to-work. Cox's proportional hazards model was used to calculate hazard ratios regarding the time to return-to-work, adjusted for prognostic factors. RESULTS: Ergonomic interventions varied considerably in occurrence between the national cohorts: 23.4% (mean) of the participants reported adaptation of the workplace, ranging from 15.0% to 30.5%. Adaptation of job tasks and adaptation of working hours was applied for 44.8% (range 41.0-59.2%) and 46.0% (range 19.9-62.9%) of the participants, respectively. Adaptation of the workplace was effective on return-to-work rate with an adjusted hazard ratio (HR) of 1.47 (95% CI 1.25 to 1.72; p < 0.0001). Adaptation of job tasks and adaptation of working hours were effective on return-to-work after a period of more than 200 days of sickleave with an adjusted HR of 1.78 (95% CI 1.42 to 2.23; p < 0.0001) and 1.41 (95% CI 1.13 to 1.76; p = 0.002), respectively. CONCLUSIONS: Results suggest that ergonomic interventions are effective on return-to-work of workers long term sicklisted due to LBP.

Hoozemans MJ, van der Beek AJ, Fring-Dresen MH, van der Woude LH, van Dijk FJ. · Coronel Institute for Occupational and Environmental Health, Academic Medical Center/University of Amsterdam, The Netherlands. · Scand J Work Environ Health. · Pubmed #12432982 links to  free full text

Abstract: OBJECTIVES: Low-back and shoulder complaints were examined in relation to self-reported and objectively assessed exposure to work-related pushing and pulling. METHODS: Workers from several companies (eg, nursing homes and flower auctions) with pushing and pulling tasks and, as reference, workers without physically demanding tasks were invited to participate. Altogether 829 workers initially received a questionnaire, of whom 459 responded both initially and after 1 year of follow-up. Initially, self-reported exposure to pushing and pulling was assessed by questionnaire. Furthermore, a representative sample of 131 workers was observed at work using TRAC (task recording and analysis on computer) to assess exposure to pushing and pulling objectively. For exposure to pushing and pulling, the workers were classified into a reference group and medium and high exposure groups. Initially and in the follow-up, the 12-month prevalence of low-back and shoulder complaints was assessed. Complaints reported in the follow-up were separately used as dependent variables to calculate prevalence rate ratios (PR) in a Cox's proportional hazard regression analysis. RESULTS: The adjusted PR values were not significant for low-back complaints. For shoulder complaints, both the medium and high exposure groups showed significant adjusted PR values for self-reported exposure and observed duration of pushing and pulling when compared with the reference group (PR range 2.18-4.86). For the observed frequency of pushing and pulling, only the medium exposure group showed a significant PR, of 3.95. CONCLUSIONS: The findings suggest a rather strong relationship between pushing and pulling and shoulder complaints. The evidence for a relationship between pushing and pulling and low-back complaints is limited.

Hoozemans MJ, van der Beek AJ, Frings-Dresen MH, van der Woude LH, van Dijk FJ. · Coronel Institute for Occupational and Environmental Health, AmCOGG Amsterdam Centre for Research into Health and Health Care, Academic Medical Centre/University of Amsterdam, PO Box 22700, Netherlands. · Occup Environ Med. · Pubmed #12356931 links to  free full text

Abstract: AIMS: To examine the association between exposure to pushing/pulling at work and low back and shoulder complaints. METHODS: A cross sectional questionnaire survey was carried out among 434 workers from several companies with mainly pushing/pulling tasks. From the same companies 188 workers without physically demanding tasks served as reference. The questionnaire was used to assess the exposure to pushing/pulling and other physical risk factors for low back and shoulder complaints. Mean scores at company level were used to classify groups into medium and high exposed to pushing/pulling and a reference group. Psychosocial factors at work were also assessed. Several pain related questionnaires were used to assess the 12 month prevalence of low back and shoulder complaints in three dimensions: trouble (ache, pain, discomfort), pain intensity, and disability. Prevalence rate ratios (PRs) were calculated using Cox's proportional hazards regression analysis. RESULTS: The 12 month prevalence of low back complaints was almost equal for all three groups. The prevalence of shoulder complaints increased with an increase in exposure level. Adjusted PRs showed that the high exposed group had an increased risk for low back complaints compared to the reference group. For all dimensions of shoulder complaints a clear tendency towards a dose-response relation was observed. The high exposed group had significant PRs for shoulder complaints, ranging from 2.09 to 6.37. Generally, psychosocial factors had a confounding effect for pain intensity and disability, but not for trouble. CONCLUSIONS: For shoulder complaints a dose-response relation was observed for exposure to pushing/pulling. Low back complaints were less consistently associated with pushing/pulling. Stronger associations were observed for more severe cases of low back and shoulder complaints. It is hypothesised that work related psychosocial factors affect these associations.

van Dieën JH, Hoozemans MJ, van der Beek AJ, Mullender M. · Faculty of Human Movement Science, Institute of Fundamental and Clinical Human Movement Sciences, Vrije Universiteit Amsterdam, Van der Boechorststraat 9, NL-1081 BT Amsterdam, The Netherlands. · J Biomech. · Pubmed #12052401 No free full text.

Abstract: A bootstrap procedure was used to determine the statistical precision of estimates of mean and peak spinal loads during lifting as function of the numbers of subjects and measurements per subject included in a biomechanical study. Data were derived from an experiment in which 10 subjects performed 360 lifting trials each. The maximum values per lift of the lumbar flexion angle, L5S1 sagittal plane moment, and L5S1 compression force were determined. From the data set thus compiled, 3000 samples were randomly drawn for each combination of number of subjects and number of measurements considered. The coefficients of variation of mean and peak (defined as mean plus 2 standard deviations) spinal loads across these samples were calculated. The coefficients of variation of the means of the three parameters of spinal load decreased as a linear function of the number of subjects to a power of about -0.48 and number of measurements to a power of about -0.06, while the corresponding powers for peak loads were about -0.44 and -0.11.

Verbeek JH, van der Beek AJ. · Coronel Institute for Occupational and Environmental Health, University of Amsterdam, The Netherlands. · Int J Occup Med Environ Health. · Pubmed #10360082 No free full text.

Abstract: A prospective one-year follow-up study was carried out among 189 civil servants of a municipal social service department. Its aim was to investigate whether psychosocial factors at work predict back pain prevalence at follow-up. The workers were questioned twice about personal characteristics, psychosocial factors at work, physical workload, back pain experience, and general health and well-being. Back pain was assessed as twelve month prevalence and pain intensity on a visual analogue scale (VAS). In a univariate analysis the variables: high job demands, confinement to the workplace, depression, psychological complaints, and general health complaints, were positively related to back pain prevalence at follow-up. In a multivariate analysis, however, none of the odds ratios for psychosocial stressors differed significantly from one another. Among the back pain variables, pain intensity on the VAS was the best predictor of back pain at follow-up. In a final multivariate logistic regression model none of the above-mentioned variables contributed significantly, except for initial back pain. Initial back pain with low intensity and high intensity significantly predicted the prevalence of back pain at follow-up with odds ratios of 3.0 (90% CI: 1.5-6.0) and 10.3 (90% CI: 4.1-25.5), respectively. In conclusion, the present study does not provide clear evidence that psychosocial factors at work predict back pain.