Full-text resources of PSJD and other databases are now available in the new Library of Science.
Visit https://bibliotekanauki.pl


Preferences help
enabled [disable] Abstract
Number of results


2011 | 12 | 2 | 133-138

Article title

Back Care Programmes: The Low Participation of Target Groups and Unclear Effectiveness as Primary Prevention


Title variants

Languages of publication



Purpose. Back care programmes (BCPs) for the prevention of back pain are widespread in Germany. They are intensively promoted and financed by health insurance organizations. The goal of the conducted research was to investigate whether BCPs adequately reach the targeted risk groups for primary and secondary prevention and whether the interventions employed are effective in reducing work disability and absenteeism due to back pain. Basic procedures. Absenteeism associated with back pain (ICD-10 codes M40-M54) and with participation in a BCP were evaluated based on data from 2004 through 2006 for a random sample of 9,781 persons insured with an mandatory health insurance organization. Main findings. 97% of all BCP participants in 2005 had not received a sick leave certificate due to back pain in the previous year. Furthermore, neither bivariate, nor risk-adjusted logistic regression models demonstrated a significant relationship with BCP participation and the subsequent risk of back pain. Conclusions. Current BCPs show low participation of target groups. The effectiveness in primary prevention of new cases is unclear.










Physical description


1 - 6 - 2011
21 - 6 - 2011


  • Orthopaedic Department, University Hospital Heidelberg, Conservative Orthopaedics, Heidelberg, Germany
  • Orthopaedic Department, University Hospital Heidelberg, Conservative Orthopaedics, Heidelberg, Germany


  • Bergenudd H., Nilsson B., Back pain in middle age; occupational workload and psychologic factors: an epidemiologic survey. Spine, 1988, 13, 58-60.[Crossref][PubMed]
  • Biering-Sørensen F., Thomsen C.E., Hilden J., Risk indicators for low back trouble. Scand J Rehabil Med, 1989, 21, 151-157.
  • Papageorgiou A.C., Croft P.R., Ferry S., Jayson M.I.V., Silman A., Estimating the prevalence of low back pain in the general population. Evidence from the South Manchester Back Pain Survey. Spine, 1995, 20, 1889-1894.[PubMed][Crossref]
  • Walsh K., Cruddas M., Coggon D., Low back pain in eight areas of Britain. J Epidemiol Community Health, 1992, 46, 227-230.[PubMed][Crossref]
  • Maetzel A., Li L., The economic burden of low back pain: a review of studies published between 1996 and 2001. Best Pract Res Clin Rheumatol, 2002, 16, 23-30, doi: 10.1053/berh.2001.0204.[Crossref]
  • Krismer M., van Tulder M., Strategies for prevention and management of musculoskeletal conditions. Low back pain (nonspecific). Best Pract Res Clin Rheumatol, 2007, 21, 77-91. doi: 10.1016/j.berh.2006.08.004.[Crossref]
  • Schweikert B., Wenig C., Schmidt C.O., Kohlmann T., Analysis of the medical costs in Germany [in German]. Schmerz, 2007, 21 (Suppl. 1), 46-47.
  • Balagué F., Mannion A.F., Pellisé F., Cedraschi C., Clinical update: low back pain. Lancet, 2007, 369, 726-728, doi: 10.1016/ S0140-6736(07)60340-7.[Crossref]
  • von Korff M., Dunn K.M., Chronic pain reconsidered. Pain, 2008, 138, 267-276, doi: 10.1016/j.pain.2007.12.010.[Crossref]
  • Burton A.K., Balagué F., Cardon G., Eriksen H.R., Henrotin Y., Lahad A. et al., How to prevent low back pain. Best Pract Res Clin Rheumatol, 2005, 19, 541-555, doi: 10.1016/j.bert.2005.03.001.[PubMed][Crossref]
  • van Tulder M.W., Waddell G., Conservative treatment of acute and subacute low back pain. In: Nachemson A.L., Jonsson E. (eds.) Neck and back pain: the scientific evidence of causes, diagnosis, and treatment. Lippincott Williams & Wilkins, Philadelphia 2000, 241-269.
  • Döring D., Dudenhöffer B., Herdt J., European health systems under globalisation pressure. Comparative consideration of the financing structures and reform options in the EU 15-states and the Swiss study by order of the Hans's Böckler endowment [in German]. Wiesbaden 2005.
  • Beaglehole R., Bonita R., Kjellström T., Basic Epidemiology. World Health Organization, Geneva 2007.
  • Schneider S., Randoll D., Buchner M., Why do women have back pain more than men? A representative prevalence study in the Federal Republic of Germany. Clin J Pain, 2006, 22, 138-147.
  • Waddell G., The back pain revolution. Churchill Livingstone, Edinburgh 2004.
  • Schneider S., Hauf C., Schiltenwolf M., Attendance at back care programs: a representative study of the working population in Germany [in German]. Soz Praventiv Med, 2005, 50, 95-106.
  • Schneider S., Schiltenwolf M., Preaching to the converted: deficits and surpluses in preventative pain therapy in German back care programs [in German]. Schmerz, 2005, 19, 477-482, doi: 10.1007/s00482-005-0414-y.[Crossref][PubMed]
  • Nachemson A.L., Jonsson E. (eds.), Neck and back pain: the scientific evidence of causes, diagnosis and treatment. Lippincott Williams & Wilkins, Philadelphia 2000.
  • Grosch J.W., Alterman T., Petersen M.R., Murphy L.R., Worksite health promotion programs in the U.S.: factors associated with availability and participation. Am J Health Promot, 1998, 13, 36-45.[Crossref][PubMed]
  • Elward K.S., Wagner E.H., Larson E.B., Participation by sedentary elderly persons in an exercise promotion session. Fam Med, 1992, 24, 607-612.
  • Rost K., Connell C., Schechtman K., Barzilai B., Fisher E.B., Predictors of employee involvement in a worksite health promotion program. Health Educ Q, 1990, 17, 395-407.[Crossref]
  • Schneider S., Hauf C., Schiltenwolf M., Back care programs for health promotion-representative user profiles and correlates of participation in Germany. Prev Med, 2005, 40, 227-238.[PubMed][Crossref]
  • Wagner E.H., Grothaus L.C., Hecht J.A., LaCroix A.Z., Factors associated with participation in a senior health promotion program. Gerontologist, 1991, 31, 598-602.[Crossref]
  • Wanek V., Born J., Novak P., Reime B., Attitudes and health-status as determinants of participation in individually oriented health promotion [in German]. Gesundheitswesen, 1999, 61, 346-352.[PubMed]
  • Wilson M.G., Factors associated with, issues related to, and suggestions for increasing participation in workplace health promotion programs. Health Values, 1990, 14, 29-36.[PubMed]
  • Oddy W.H., Holman C.D., Corti B., Donovan R.J., Epidemiological measures of participation in community health promotion projects. Int J Epidemiol, 1995, 24, 1013-1021.[Crossref][PubMed]
  • Marstedt G., Last R., Wahl W.B., Müller R., Health and quality of life. Result report to an investigation of the centre for social politics about work and spare time, health and illness in Bremen [in German]. Angestelltenkammer Bremen, Bremen 1993.
  • Warren-Findlow J., Prohaska T.R., Freedman D., Challenges and opportunities in recruiting and retaining underrepresented populations into health promotion research. Gerontologist, 2003, 43 (Suppl. 1), 37-46, doi: 10.1093/geront/43.supp___1.37.[Crossref]
  • European Commission Research Directorate General. European guidelines for prevention in low back pain 2004.
  • Waddell G., Waddell H., A review of social influences on neck and back pain and disability. In: Nachemson A.L., Jonsson E. (eds.) Neck and back pain: the scientific evidence of causes, diagnosis, and treatment. Lippincott Williams & Wilkins, Philadelphia 2000, 13-56.
  • Meschnig A., Reutter T., Thußbas C., Klotter C., Effects of health promotion [in German]. Betriebskrankenkasse, 1995, 11, 680-684.
  • Maier-Riehle B., Harter M., The effects of back schools - a meta-analysis. Int J Rehabil Res, 2001, 24, 199-206.[Crossref]
  • van Tulder M.W., Esmail R., Bombardier C., Koes B.W., Back schools for non-specific low back pain. Cochrane Database Syst Rev, 2000, 2, CD000261.[WoS]

Document Type

Publication order reference


YADDA identifier

JavaScript is turned off in your web browser. Turn it on to take full advantage of this site, then refresh the page.