STUDY DESIGN
Prognosis systematic review with meta-analysis.
OBJECTIVE
To evaluate whether lumbar spine flexion during lifting is a risk factor for low back pain (LBP) onset/persistence, or a differentiator of people with and without LBP.
LITERATURE SEARCH
Database search of Proquest, CINAHL, Medline and EMBASE until August 2018.
STUDY SELECTION CRITERIA
We included peer-reviewed articles, investigating lumbar spine position during lifting as a risk factor for LBP onset or persistence, or as a differentiator of people with and without LBP.
DATA SYNTHESIS
Lifting task comparison data were tabulated and summarised. For meta-analysis, we calculated an n-weighted pooled mean (SD) of the results for each of the LBP and no LBP groups. Where a study contained multiple comparisons (i.e. different lifting tasks that used various weights or directions), only one result for each study was included in the meta-analysis.
RESULTS
Four studies (one longitudinal study and three cross-sectional studies) measured lumbar flexion with intra-lumbar angles and found no differences in peak lumbar spine flexion when lifting (longitudinal 1.5 degree (95%CI -0.7 to 3.7), p=0.19 and cross-sectional -0.9 (95%CI -2.5 to 0.7), p=0.29). Seven cross-sectional studies measured lumbar flexion with thoraco-pelvic angles and found people with LBP lifted with 6.0 degrees less lumbar flexion than people without LBP (95%CI -11.2 to -.89, p<0.01). Most (9 of 11) studies reported no between-group differences in lumbar flexion during lifting. The included studies were low quality.
CONCLUSION
There was low quality evidence that greater lumbar spine flexion during lifting was not a risk factor for LBP onset/persistence, nor a differentiator of people with and without LBP. J Orthop Sports Phys Ther, Epub 28 Nov 2019. doi:10.2519/jospt.2020.9218.