Worksite Exercise Interventions for Low Back Injury Prevention in Firefighters

NCT02362243 | Completed

• 1 other identifier: EMW-2013-FP-00723
• Study Type: interventional
• Target: 264
• Locations: 1 country
• Sites: 1

Brief Summary

Purpose and Aims: The purpose of this study is to assess the clinical effectiveness of back and core exercise interventions for low back injury prevention in firefighters. Aim 1. Compare the effectiveness of 2 worksite exercise interventions (supervised, web-based) relative to control to reduce lost work days related to low back injury and illness in firefighters. Relevance: Low back injury is one of the most common and disabling disorders in firefighters. Thus, novel interventions are needed to counteract the adverse consequences of this disorder and its impact on firefighter safety. Methods: A cluster randomized controlled trial will be conducted in career, full active duty firefighters (n = 345) who will be randomly assigned (by fire station) to 1 of 3 intervention groups - 1) supervised exercise (n = 115), 2) web-based exercise (n = 115), or 3) control (n = 115). Participants in the supervised and web-based exercise groups will perform back and core exercises previously tested in our recent FEMA-funded grant (EMW-2009-FP-00418), twice per week for 12 months while on duty, in addition to their usual physical fitness routine - The supervised group will perform exercise under direct supervision of certified exercise specialists, and the web-based group will utilize a web-based exercise system. The control group will not perform back and core exercises, but will continue their usual physical fitness routine and receive brief education on general exercise and physical activity principles. Outcome measures include low back injury and illness data obtained and cross-checked from various sources, other standard clinical outcome measures for low back pain and disability, and validated physical fitness tests. Anticipated Outcomes: We hypothesize that the supervised and web-based interventions will reduce lost work days related to low back injury and illness by 40% compared with control. Assuming positive results, this study will deliver an evidence-based exercise intervention for low back injury prevention specifically designed for firefighters and assessed in a full-scale randomized controlled trial.

Conditions

Low Back Pain

Keywords

low back pain; low back injury; firefighter; prevention; physical fitness; exercise training; worksite; web-based

Outcome Measures

Primary Outcomes (1)

• Mean number of lost work days per participant over a 12-month period due to work-related injury or illness in the low back region

  12 months

Secondary Outcomes (3)

• Incidence rate of lost work days due to work-related injury or illness in the low back region

  12 months

• Time to event of an episode of lost work days due to work-related injury or illness in the low back region

  12 months

• Number of episodes of lost work days due to work-related injury or illness in the low back region

  12 months

Other Outcomes (18)

• Onset of low back injury and illness

  Baseline, monthly; upon occurrence

• Severity of low back injury and illness

  Baseline, monthly; upon occurrence

• Mechanism of low back injury and illness

  Baseline, monthly; upon occurrence

Study Arms (3)

Control Group

PLACEBO COMPARATOR

Participants in the control arm will complete the placebo comparator intervention.

Other: Placebo Comparator

Supervised Exercise Group

EXPERIMENTAL

Participants in the supervised exercise intervention arm will perform the experimental intervention under direct 1-on-1 supervision of an exercise specialist.

Other: Experimental Intervention

Web-based Exercise Group

EXPERIMENTAL

Participants in the web-based exercise intervention arm will perform the experimental intervention with use of a web-based exercise system for exercise instruction and guidance, and without direct 1-on-1 on-site supervision.

Other: Experimental Intervention

Interventions

Experimental Intervention OTHER

Participants will perform the back and core exercises that were tested in our previous firefighter study (Mayer, 2015), in addition to their usual physical fitness routine. All participants at a given fire station will receive the same intervention and all interventions will be completed at the fire station. Participants will perform 2 exercise sessions each week (each time they are on duty) throughout the study's 12-month duration. The back and core exercise program consists of 1 set of 5 exercises - 4 core exercises on a floor mat and 1 back extension exercise on a variable angle Roman chair - which will take approximately 10 minutes to complete for each session (Mayer, 2015).

Supervised Exercise Group; Web-based Exercise Group

Placebo Comparator OTHER

Participants will receive a 45-60 minute, one-time educational session, which will be delivered to delivered by an exercise specialist in a 1-on-1 format while the participant is on-duty at the fire station, in addition to their usual physical fitness routine. Content for the educational session on evidence-based guidelines for exercise, physical fitness, and general physical activity will be derived from the American College of Sports Medicine (ACSM) Position Stand - Quantity and Quality of Exercise for Developing and Maintaining Cardiorespiratory, Musculoskeletal, and Neuromotor Fitness in Apparently Healthy Adults: Guidance for Prescribing Exercise (Garber, 2011).

Control Group

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Age 18 years or older.
• Full duty, regular service, career firefighter housed at a standard fire station from Hillsborough County Fire Rescue, St. Petersburg Fire \& Rescue, or Tampa Fire Rescue.

You may not qualify if:

• Current workers' compensation or personal injury case or litigation
• Research personnel (e.g. firefighter peer fitness trainers).
• Participant in the exercise intervention group of our previous FEMA-funded study (EMW-2009-FP-00418).

Sponsors & Collaborators

• University of South Florida: lead
• Federal Emergency Management Agency: collaborator

Study Sites (1)

University of South Florida

Tampa, Florida, 33612, United States

Location

Related Publications (3)

• Garber CE, Blissmer B, Deschenes MR, Franklin BA, Lamonte MJ, Lee IM, Nieman DC, Swain DP; American College of Sports Medicine. American College of Sports Medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. Med Sci Sports Exerc. 2011 Jul;43(7):1334-59. doi: 10.1249/MSS.0b013e318213fefb.

  PMID: 21694556 BACKGROUND

• Mayer JM, Quillen WS, Verna JL, Chen R, Lunseth P, Dagenais S. Impact of a supervised worksite exercise program on back and core muscular endurance in firefighters. Am J Health Promot. 2015 Jan-Feb;29(3):165-72. doi: 10.4278/ajhp.130228-QUAN-89.

  PMID: 24524384 BACKGROUND

• Dagenais S, Hayflinger DC, Mayer JM. Economic Evaluation of an Extended Telehealth Worksite Exercise Intervention to Reduce Lost Work Time from Low Back Pain in Career Firefighters. J Occup Rehabil. 2021 Jun;31(2):431-443. doi: 10.1007/s10926-020-09933-8. Epub 2021 Jan 4.

  PMID: 33394268 DERIVED

MeSH Terms

Conditions

Low Back Pain

Condition Hierarchy (Ancestors)

Back Pain; Pain; Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Study Officials

• John M Mayer, DC, PhD

  University of South Florida

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: February 6, 2015
• First Posted: February 12, 2015
• Study Start: March 1, 2016
• Primary Completion: April 30, 2018
• Study Completion: April 30, 2018
• Last Updated: July 2, 2018

Record last verified: 2018-06

Locations

US (1)