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A longitudinal observational study of back pain incidence, risk factors and occupational physical activity in Swedish marine trainees
Karolinska Inst, Div Physiotherapy, Dept Neurobiol Care Sci & Soc, Huddinge, Sweden;Dalarna Univ, Sch Educ Hlth & Social Studies, Falun, Sweden;Mil Acad Karlberg, Swedish Armed Forces, Stockholm, Sweden.
Karolinska Inst, Div Physiotherapy, Dept Neurobiol Care Sci & Soc, Huddinge, Sweden;Swedish Armed Forces, Med Serv, Stockholm, Sweden.
Lund Univ, Dept Orthoped, Fac Med, Lund, Sweden.ORCID iD: 0000-0002-3850-7283
Univ Gavle, Dept Occupat Hlth Sci & Psychol, Ctr Musculoskeletal Res, Gavle, Sweden.
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2019 (English)In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 9, no 5, article id e025150Article in journal (Refereed) Published
Abstract [en]

Objectives To evaluate the occurrence of low back pain (LBP) and LBP that limits work ability, to identify their potential early risks and to quantify occupational physical activity in Swedish Armed Forces (SwAF) marines during their basic 4 month marine training course. Design Prospective observational cohort study with weekly follow-ups. Participants Fifty-three SwAF marines entering the training course. Outcomes Incident of LBP and its related effect on workability and associated early risks. Occupational physical activity, as monitored using accelerometers and self-reports. Results During the training course, 68% of the marines experienced at least one episode of LBP. This yielded a LBP and LBP limiting work ability incidence rate of 13.5 (95% CI 10.4 to 17.8) and 6.3 (95% CI 4.2 to 10.0) episodes per 1000 person-days, respectively. Previous back pain and shorter body height (<= 1.80 m) emerged as independent risks for LBP (HR 2.5, 95% CI 1.4 to 4.3; HR 2.0, 95% CI 1.2 to 3.3, respectively), as well as for LBP that limited work ability (HR 3.6, 95% CI 1.4 to 8.9; HR 4.5, 95% CI 2.0 to 10.0, respectively). Furthermore, managing fewer than four pull-ups emerged as a risk for LBP (HR 1.9, 95% CI 1.2 to 3.0), while physical training of fewer than three sessions per week emerged as a risk for LBP that limited work ability (HR 3.0, 95% CI 1.2 to 7.4). More than 80% of the work time measured was spent performing low levels of ambulation, however, combat equipment (>= 17.5 kg) was carried for more than half of the work time. Conclusions Incidents of LBP are common in SwAF marines' early careers. The link between LBP and previous pain as well as low levels of exercise highlights the need for preventive actions early on in a marine's career. The role of body height on LBP needs further investigation, including its relationship with body-worn equipment, before it can effectively contribute to LBP prevention.

Place, publisher, year, edition, pages
BMJ PUBLISHING GROUP , 2019. Vol. 9, no 5, article id e025150
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Occupational Health and Environmental Health
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URN: urn:nbn:se:uu:diva-390045DOI: 10.1136/bmjopen-2018-025150ISI: 000471192800105PubMedID: 31092646OAI: oai:DiVA.org:uu-390045DiVA, id: diva2:1340372
Available from: 2019-08-05 Created: 2019-08-05 Last updated: 2019-08-05Bibliographically approved

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