Towards Developing Better Rehabilitation Protocols for Low Back Injured Workers
| Principal investigator(s): | Stuart M. McGill (University of Waterloo) |
| Co-investigator(s): | Jacek Cholewicki (Yale University); Erin Harvey, Richard Preuss, Sylvain Grenier (University of Waterloo); Mickey Kerr (Institute for Work and Health) |
| Institution: | University of Waterloo |
For more information on this study, please contact Stuart M. McGill: mcgill@healthy.uwaterloo.ca
Results
The main findings are:
- those who have a history of back troubles have a lack of muscle endurance specifically, a lack of balance in the endurance of different torso muscle groups
- absolute torso strength was not related to low back pain history but the ratio of flexor to extensor strength was related
- those who have a history of back troubles have a wide variety of motor control deficits including aberrant motor patterns during spine loading and challenged breathing (as would occur during challenging work), balancing, having to endure surprise loading, and other tasks
- those who have a history of low back troubles have some psychosocial markers but these do not dominate the physical characteristics that classify them as different from those with no troubles.
Conclusions
It is clear that personal, psychosocial, and biomechanical variables are associated with low back disability and are important in preventing low back injury and the ensuing chronicity collectively the evidence from several scientific perspectives is overwhelming. However, the specifics needed to establish both association and causality remain to be fully understood. Why do only some workers become patients? Some back troubles resolve, others continue along a cascade of change, pain, and ability to tolerate certain types of activity and loading. Understanding the role of personal characteristics, biomechanical parameters, psychosocial parameters, together with their interrelationships, will build the foundation for better prevention and rehabilitation approaches in the future.
Objectives
The objectives of the study were:
- to identify some physical, behavioural, and psychosocial characteristics of individuals with low back pain as compared to individuals with healthy backs
- to quantify these characteristics wherever possible through the use of sophisticated measuring apparatus
- to suggest changes to existing rehabilitation protocols.
Method
Some 70 workers, one-third of which had had low back pain in the previous year sufficiently severe to lose time from work, one-third low back pain not severe enough to lose time from work, and one-third no back pain in the previous year at all, performed a series of exercises and tests that allowed various physiological, biomechanical, and psychosocial parameters to be quantified.
Publications
McGill, S., Grenier, S., Bluhm, M., Preuss, R., Brown, S., and Russell, C., "Previous History of LBP with Work Loss Is Related to Lingering Deficits in Biomechanical, Physiological, and Motor Control Characteristics." Ergonomics 46(7):731-746 (2003). NEW
Preuss, R., Grenier, S., and McGill, S., "The Effect of Test Position on Lumbar Spine Position Sense". Journal of Orthopedic and Sports Physical Therapy 33(2):73-78 (2003).
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