Conservative Interventions for Non-Specific Low Back Pain in Tactical Populations: A Systematic Review of Randomized Controlled Trials

Abstract

Limited evidence exists about non-specific low back pain (NSLBP) interventions among tactical personnel (police officers, firefighters, or army forces). The aim was to identify and systematically review the findings of randomized control trials (RCTs) investigating conservative interventions for the treatment NSLBP in tactical personnel. A search of seven databases for randomized controlled trials RCTs were conducted. Two independent reviewers extracted data and assessed the risk of bias (PEDro scale). Five RCTs (n = 387 military subjects; median PEDro score = 7/10) were included. The trials were highly heterogeneous, differing in pain and disability outcome measures, duration of NSLBP symptoms (acute, nonacute, nonchronic, and chronic), types of intervention (exercise, manual therapy, and physical therapy), types of control groups, and intervention durations (4–12 weeks). Two studies reported that strengthening exercise interventions were not effective for reducing pain or disability in military personnel with chronic or nonacute NSLBP. Manual therapy treatment was more effective than usual activities in current pain and pain typical symptoms in soldiers with acute NSLBP after four weeks. A multidimensional intervention reduced disability in military personnel with non-chronic NSLBP after four weeks. Strong evidence does not exist for the efficacy of any conservative interventions in the reduction of pain and disability in tactical populations with NSLBP.

Effectiveness of m-health-based core strengthening exercise and health education for public safety workers with non-specific chronic low back pain: study protocol for a superiority randomized controlled trial (SAFEBACK)

“…A systematic review of tactical populations (i.e., police, firefighters, and military personnel), including five randomized clinical trials testing conservative treatments for CLBP (i.e., exercise). Still, none of them included police and firefighters or used the telerehabilitation approach [27]. Stigma, geographic barriers, and lack of worker health sectors often prevent police and firefighters professionals from engaging in these evidence-based treatments.…”

Effectiveness of m-health-based core strengthening exercise and health education for public safety workers with chronic non-specific low back pain: study protocol for a superiority randomized controlled trial (SAFEBACK)

“…However, the effectiveness of exercise-based telerehabilitation strategies on biopsychosocial outcomes in police officers and firefighters with CLBP is not entirely established. Previous systematic review of non-conservative interventions in tactical populations (i.e., police, firefighters, and military personnel) showed that interventions using telerehabilitation approach in this population are scanty [ 30 ].…”

Assessment of Low Back Pain in Helicopter Pilots Using Electrical Bio-Impedance Technique: A Feasibility Study

“…A recent epidemiological survey reported that the 3-month and 12-month prevalence of LBP for military helicopter pilots was as high as 42.3 and 48.1% ( Posch et al, 2019 ), respectively. Meanwhile, aviation medicine research showed that early detection of LBP and timely implementation of medical intervention prior to the observation of apparent symptoms, such as physiotherapy and neuromuscular electrical stimulation, could particularly be beneficial to the health and well-being of pilots ( Palmer and Bovenzi, 2015 ; Alrwaily, 2017 ; Marins et al, 2020 ). Additionally, objective assessment of LBP severity is helpful for implementing appropriate and specific treatment.…”