Cumulative Spine Loading and Clinically Meaningful Declines in Low-Back Function

摘要

Objective: The objective was to assess the role of cumulative spine loading measures in the development of a clinically meaningful decline in low-back function. Background: Cumulative spine loading has been a suspected risk factor for low-back pain for many years, yet the measures that characterize risk have not been well delineated. Methods: A total of 56 cumulative exposure measures were collected in a prospective field study of distribution center workers. An individual's risk for a clinically meaningful decline in low-back function (true cases) was explored with daily, weekly, and job tenure cumulative exposure measures using univariate and multivariate statistical modeling techniques.True noncases were individuals with no decline in low-back function. Results: An individual's risk for a clinically meaningful decline in low-back function (true cases) was predicted well versus true noncases (sensitivity/specificity = 72%/73%) using initial low-back function (p(n)), cumulative rest time, cumulative load exposure, job satisfaction, and worker age. Conclusions: Cumulative rest time was identified as an important component for predicting an individual's risk for a clinically meaningful decline in low-back function. Application: This information can be used to assess cumulative spine loading risk and may help establish guidelines to minimize the risk of a clinically meaningful decline in low-back function.