Development of a risk score for low back pain in office workers - a cross-sectional study

BACKGROUND: Low back pain (LBP) is common among office workers and is the most common cause of work-related disability in people under 45 years of age. The aetiology of LBP is widely accepted to be multi-factorial. Prognostic research into office workers at risk of developing LBP has received limited attention. The aims of this study were to develop a risk score to identify office workers likely to have LBP and to evaluate its predictive power. METHODS: 397 office workers filled out a self-administered questionnaire and underwent physical examination. The questionnaire gathered data on individual, work-related physical and psychosocial data as well as the presence of low back pain in the previous 4 weeks. The physical examination included measurement of body weight, height, waist circumference, hamstrings length, spinal scoliosis, spinal curve, Backache Index and lumbar stability. Logistic regression was used to select significant factors associated with LBP to build a risk score. The coefficients from the logistic regression model were transformed into the components of a risk score. RESULTS: The model included six items: previous history of working as an office worker, years of work experience, continuous standing for >2 hrs/d, frequency of forward bending during work day, chair having lumbar support and Backache Index outcome. The risk score for LBP in office workers (The Back pain Risk score for Office Workers: The BROW) was built with a risk score ranging from 0 to 9. A cut-off score of ≥4 had a sensitivity of 80% and a specificity of 58%. The positive predictive value and negative predictive values were 70% each. CONCLUSIONS: The BROW is easy and quick to administer. It appears to have reasonable sensitivity, specificity, positive predictive value and negative predictive values for the cut-off point of ≥4. The BROW is a promising tool for use to identify office workers in need of early interventions. Further prospective study is needed to validate the predictive performance of the BROW.