A systematic review of the relation between physical capacity and future low back and neck/shoulder pain

The results of longitudinal studies reporting on the relation between physical capacity and the risk of musculoskeletal disorders have never been reviewed in a systematic way. The objective of the present systematic review is to investigate if there is evidence that low muscle strength, low muscle endurance, or reduced spinal mobility are predictors of future low back or neck/shoulder pain. Abstracts found by electronic databases were checked on several inclusion criteria. Two reviewers separately evaluated the quality of the studies. Based on the quality and the consistency of the results of the included studies, three levels of evidence were constructed. The results of 26 prospective cohort studies were summarized, of which 24 reported on the longitudinal relationship between physical capacity measures and the risk of low back pain and only three studies reported on the longitudinal relationship between physical capacity measures and the risk of neck/shoulder pain. We found strong evidence that there is no relationship between trunk muscle endurance and the risk of low back pain. Furthermore, due to inconsistent results in multiple studies, we found inconclusive evidence for a relationship between trunk muscle strength, or mobility of the lumbar spine and the risk of low back pain. Finally, due to a limited number of studies, we found inconclusive evidence for a relationship between physical capacity measures and the risk of neck/shoulder pain. Due to heterogeneity, the results of this systematic review have to be interpreted with caution. (C) 2006 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.