Effect of back school protocol on the referral rate of patients with low back pain to an industrial physiotherapy clinic

Abstract

Back schools are educational programmes originally developed in a work place (Volvo factory in Sweden) for patients with back pain, to enable them to manage their own back problems better. ‘Back school’ was originally aimed at modifying the behaviours of patients with low back pain (LBP), with the view to prevent relapses. In an effort to encourage and stimulate the use of ‘back school’ among health workers in Nigeria, this study was designed to evaluate the efficacy of a back school protocol in a Soap Making Industry in Lagos, Nigeria. One hundred and ten (110) workers of a Soap Making Industry in Lagos, Nigeria,  participated in this study. A pre-test, post-test experimental design was employed. The participants were divided into two groups - office workers and factory workers for the purpose of the training in the content of the back school protocol. The ‘back school’ consisted of classroom teaching and the use of two videotapes titled “lifting technique” and “back pain”. Data on demographic information, knowledge of back structures and back care were collected using a questionnaire with closed ended questions, which was completed before, immediately after and 8 weeks after the administrations of the contents of the back school protocol (Akinpelu and Odebiyi, 2004). The records of the factory’s clinic were also reviewed for the 12-months before and 12 months after the study. The mean values of the participants’ age, height, weight and body mass index (BMI) were 36.60 ± 9.10 years, 1.65 ± 0.10 m,69.13 ± 7.70 kg and 25.40 ± 3.30 kg/m2 respectively. The results showed that the 12-months prevalence of low back pain (LBP) among the workers was 71%. The result also showed that over 50% of the participants never had any  information or lesson on back care, and those that had some form of information obtained it by chance. There was 23% reduction in referral for care of back pain 12 months after the administration of the back school protocol. However, Chi square analysis showed that there was no significant difference (p = 0.23) between the number of  physiotherapy referrals to the factory’s clinic 12-months before the study and 12-months after the study
The findings of this study suggest that the back school protocol was able to impart some knowledge (of back pain and back care) in the industrial workers. This knowledge seems to have assisted this group of individuals to cultivate good postural habits, particularly at work. This might have led to the 23% reduction in the reported cases of patients with LBP to the factory’s Physiotherapy Clinic.