Effectiveness of exercise programs to reduce low back pain among nurses and nursing assistants: A systematic review and meta-analysis.

ABSTRACT

INTRODUCTION: Nurses have a high prevalence of low back pain due to ergonomic hazards in healthcare workplaces. While exercise programs have been suggested as an intervention strategy, the effectiveness of low back pain programs has been inconsistent in the research literature. The purpose of study is to determine the effect of exercise programs to reduce low back pain among nursing staff. METHODS: A systematic review and meta-analysis was conducted with five databases and systematically searched. Following the PRISMA guidelines, included studies evaluated low back pain relief among nurses or nursing assistants and described the exercise program. Two reviewers independently appraised, extracted, and synthesized all available studies. The study protocol was registered in PROSPERO (CRD42022359511). RESULTS: A total of 296 articles with 1,355 nursing staff from nine countries were obtained. Nine randomized controlled trials with a moderate to low risk of bias quality were included. Exercise programs had a small but significant effect on low back pain of nursing staff (SMD = -0.48; 95% CI = -0.76 to -0.19; p = 0.03, I2 = 62%, p = 0.001). A subgroup analysis of nurses and nursing assistants showed moderate and small effects, respectively (I2 = 0% p < 0.0001, SMD -0.73 CI 95% [-0.97 to -0.48], p = 0.76, and I2 = 0% p = 0.002, SMD -0.23 CI 95% [-0.38 to -0.08], p < 0.88). Exercise for back and trunk exhibited a moderate effect on low back pain (SMD -0.56 CI 95% [-0.86 to -0.25], p = 0.01, I2 = 66%, p < 0.0004). A subgroup analysis comparing age, under 40 years old revealed a moderate effect size (SMD = -0.59; 95% CI = -0.83to -0.35; p = 0.06; I2 = 64%, p < 0.0001). CONCLUSIONS: Exercise programs are an effective treatment to reduce low back pain in nurses and nursing assistants, especially among younger staff. PRACTICAL APPLICATION Back and trunk exercise programs should be recommended for nursing staff with low back pain.