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Duque Vera IL, Montoya Restrepo EC, García Cristancho JI, Aguirre Echeverry JP, Urrutia Illera IM. Factores asociados al dolor lumbar en recolectores de café de Chinchina y Palestina (Colombia). Hacia Promoc. Salud [Internet]. 1 de enero de 2023 [citado 9 de mayo de 2024];28(1):159-72. Disponible en: https://revistasojs.ucaldas.edu.co/index.php/hacialapromociondelasalud/article/view/8308
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Iván Leonardo Duque Vera
Perfil Google Scholar
Esther Cecilia Montoya Restrepo
Jessica Isabel García Cristancho
Juan Pablo Aguirre Echeverry
Isabella Maria Urrutia Illera
Resumen
Objetivo. El estudio tuvo como objetivo determinar la prevalencia del dolor lumbar y los factores de riesgo asociados entre los recolectores de café. Métodos. Los participantes respondieron a una encuesta y se sometieron a pruebas para determinar la flexibilidad y el V̇ O2max. Resultados. Entre 98 recolectores de café de 44,7 años (±13,7), el 58,2% había experimentado dolor lumbar. La duración e intensidad promedio del dolor lumbar en los pacientes fue de 6,0 ± 6,5 años y 47,1 ± 21,0 mm/100 mm, respectivamente. Los valores promedio de grasa corporal y V̇ O2max fueron 13.2 ± 2.8% y 32.5 ± 8.6 ml.kg-1.min-1 respectivamente. El análisis de regresión demostró que para un valor alto de V̇ O2max la probabilidad de padecer dolor lumbar es menor mientras que para un valor alto de contenido de grasa corporal la probabilidad de sufrir dolor lumbar es mayor. Conclusiones. Existe una alta prevalencia de dolor lumbar entre los recolectores de café de Chinchiná y Palestina. Un mayor contenido de grasa corporal incrementa la probabilidad de padecer lumbalgia, mientras que niveles elevados de V̇ O2max la disminuye.
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1. Knezevic NN, Candido KD, Vlaeyen JWS, Van Zundert J, Cohen SP. Low back pain. Lancet [internet]. 2021 Jul 3;398(10294):78-92. Available at: http://dx.doi.org/10.1016/s0140-6736(21)00733-9
2. Miller D, Hasan K, Kirk A, Ayalew D, Walker W. Prevalence and characteristics of low back pain in a rural Ghana primary care clinic population. PM R [Internet]. 2020;12(3):251–6. Available at: http://dx.doi.org/10.1002/pmrj.12245
3. Duque I, Parra JH, Duvallet A. Maximal aerobic power in patients with chronic low back pain: a comparison with healthy subjects. Eur Spine J [internet]. 2010 Jan;20(1):87-93. Available at: http://dx.doi.org/10.1007/s00586-010-1561-0
4. Peng T, Perez A, Pettee Gabriel K. The Association Among Overweight, Obesity, and Low Back Pain in U.S. Adults: A Cross-Sectional Study of the 2015 National Health Interview Survey. J Manipulative Physiol Ther [internet]. 2018 May;41(4):294-303. Available at: http://dx.doi.org/10.1016/j.jmpt.2017.10.005
5. Uçar İ, Karartı C, Cüce İ, Veziroğlu E, Özüdoğru A, Koçak FA, et al. The relationship between muscle size, obesity, body fat ratio, pain and disability in individuals with and without nonspecific low back pain. Clin Anat [Internet]. 2021;34(8):1201–7. Available at: http://dx.doi.org/10.1002/ca.23776
6. Shiri R, Lallukka T, Karppinen J, Viikari-Juntura E. Obesity as a risk factor for sciatica: a meta-analysis. Am J Epidemiol [internet]. 2014 Apr 15;179(8):929-37. Available at: http://dx.doi.org/10.1093/aje/kwu007
7. Demos K, Sazakli E, Jelastopulu E, Charokopos N, Ellul J, Leotsinidis M. Does farming have an effect on health status? A comparison study in west Greece. Int J Environ Res Public Health [internet]. 2013 Feb 26;10(3):776-92. Available at: http://dx.doi.org/10.3390/ijerph10030776
8. Munala JM, Olivier B, Karuguti WM, Karanja SM. Prevalence of musculoskeletal disorders amongst flower farm workers in Kenya. S Afr J Physiother [internet]. 2021;77(1):1515. http://dx.doi.org/10.4102/sajp.v77i1.1515
9. Kahere M, Hlongwa M, Ginindza TG. A Scoping Review on the Epidemiology of Chronic Low Back Pain among Adults in Sub-Saharan Africa. Int J Environ Res Public Health [internet]. 2022 Mar 3;19(5):2964. Available at: https://pubmed.ncbi.nlm.nih.gov/35270657/
10. Chokprasit P, Yimthiang S, Veerasakul S. Predictors of Low Back Pain Risk among Rubber Harvesters. Int J Environ Res Public Health [internet]. 2022 Aug 23;19(17): 10492. Available at: http://dx.doi.org/10.3390/ijerph191710492
11. Rabey M, Buldo B, Duesund Helland M, Pang C, Kendell M, Beales D. Significant other interactions in people with chronic low back pain: Subgrouping and multidimensional profiles. Br J Pain [internet]. 2022 Jun;16(3):326-40. Available at: http://dx.doi.org/10.1177/20494637211062045
12. Kongtawelert A, Buchholz B, Sujitrarath D, Laohaudomchok W, Kongtip P, Woskie S. Prevalence and Factors Associated with Musculoskeletal Disorders among Thai Burley Tobacco Farmers. Int J Environ Res Public Health [internet]. 2022 Jun 1;19(11):6779. Available at: http://dx.doi.org/10.3390/ijerph19116779
13. Heneweer H, Staes F, Aufdemkampe G, van Rijn M, Vanhees L. Physical activity and low back pain: a systematic review of recent literature. Eur Spine J [internet]. 2011 Jun;20(6):826-45. Available at: http://dx.doi.org/10.1007/s00586-010-1680-7
14. Sheng B, Feng C, Zhang D, Spitler H, Shi L. Associations between Obesity and Spinal Diseases: A Medical Expenditure Panel Study Analysis. Int J Environ Res Public Health [internet]. 2017 Feb 13;14(2). Available at: http://dx.doi.org/10.3390/ijerph14020183
15. Zhou J, Mi J, Peng Y, Han H, Liu Z. Causal Associations of Obesity With the Intervertebral Degeneration, Low Back Pain, and Sciatica: A Two-Sample Mendelian Randomization Study. Front Endocrinol (Lausanne) [internet]. 2021;12:740200. Available at: http://dx.doi.org/10.3389/fendo.2021.740200
16. Soe KT, Laosee O, Limsatchapanich S, Rattanapan C. Prevalence and risk factors of musculoskeletal disorders among Myanmar migrant workers in Thai seafood industries. Int J Occup Saf Ergon [internet]. 2015;21(4):539-46. Available at: http://dx.doi.org/10.1080/10803548.2015.1096609
17. Tobasura I, Restrepo L. Características socioeconómicas del recolector temporal de café en el municipio de Chinchiná (Caldas). Agronomía. 1991;4(2):32-6.
18. Garzón Duque MO, Vásquez Trespalacios EM, Molina Vásquez J, Muñoz Gómez SG. Work conditions, ergonomic risks and the presence of musculoskeletal disorders in coffee collectors in a municipality in Colombia. Rev Asoc Esp Espec Med Trab [internet]. 2017;26(2):127-36. Available at: https://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1132-62552017000200127
19. Villegas-Bueno MJ, Montoya-Restrepo EC, Vélez-Zape JC, Oliveros-Tascón CE. Desempeño de los recolectores de café con el método mejorado de cosecha según la altura de la plantación. Cenicafé. 2005;56(1):19-36.
20. Ramírez Jaramillo P, Bonilla Mendoza, L. F., Buitrago Salazar, J. C., Múnera Ramírez, S., Uribe Quintero, M. L., Noguera Cabrales, M. D., Molina Restrepo, I., Garzón Duque, M. O. Musculoskeletal disorders in coffee collectors. Rev Colomb Salud Ocup [internet]. 2019;12(1):7143. Available at: https://doi.org/10.18041/2322-634X/rcso.1.2022.7143
21. Borg GA. Psychophysical bases of perceived exertion. Med Sci Sports Exerc [internet]. 1982;14(5):377-81. Available at: https://pubmed.ncbi.nlm.nih.gov/7154893/
22. Carlsson AM. Assessment of chronic pain. I. Aspects of the reliability and validity of the visual analogue scale. Pain [internet]. 1983 May;16(1):87-101. Available at: http://dx.doi.org/10.1016/0304-3959(83)90088-X
23. Rothman KJ. BMI-related errors in the measurement of obesity. Int J Obes (Lond) [internet]. 2008 Aug;32 Suppl 3:S56-9. Available at: http://dx.doi.org/10.1038/ijo.2008.87
24. Faulkner JA. Physiology of swimming. Res Q [internet]. 1966 Mar;37(1):41-54. Available at: https://pubmed.ncbi.nlm.nih.gov/5217133/
25. Kaminsky LA, Imboden MT, Arena R, Myers J. Reference Standards for Cardiorespiratory Fitness Measured With Cardiopulmonary Exercise Testing Using Cycle Ergometry: Data From the Fitness Registry and the Importance of Exercise National Database (FRIEND) Registry. Mayo Clin Proc [internet]. 2017 Feb;92(2):228-33. Available at: http://dx.doi.org/10.1016/j.mayocp.2016.10.003
26. Vélez JC, Montoya EC, Oliveros CE. Times and movements study for improvement of coffee manual harvest . Boletín Técnico Cenicafé [internet].1999;21:91p. Available at: http://hdl.handle.net/10778/593
27. 27. National Administrative Department of Statistics [Departamento Administrativo Nacional de Estadística -DANE]. Distribución de la población por ubicación. 2018 [internet]. [cited 2022 06/08/2022]; Available at: https://www.dane.gov.co/index.php/estadisticas-por-tema/demografia-y-poblacion/censo-nacional-de-poblacion-y-vivenda-2018/donde-estamos
28. Tejada RR, F. Wong, P. Alarcon, J. Risk work practices among rice farmers of Alto Mayo valley, San Martin, Peru. Rev Peru Epidemiol [internet]. 2011;15(1). Available at: https://www.redalyc.org/pdf/2031/203119644008.pdf
29. Wu A, Dong W, Liu S, Cheung JPY, Kwan KYH, Zeng X, et al. The prevalence and years lived with disability caused by low back pain in China, 1990 to 2016: findings from the global burden of disease study 2016. Pain [internet]. 2019 Jan;160(1):237-45. Available at: http://dx.doi.org/10.1097/j.pain.0000000000001396
30. Cho NH, Jung YO, Lim SH, Chung CK, Kim HA. The prevalence and risk factors of low back pain in rural community residents of Korea. Spine (Phila Pa 1976) [internet]. 2012 Nov 15;37(24):2001-10. Available at: http://dx.doi.org/10.1097/BRS.0b013e31825d1fa8
31. Barrero LH, Hsu YH, Terwedow H, Perry MJ, Dennerlein JT, Brain JD, et al. Prevalence and physical determinants of low back pain in a rural Chinese population. Spine (Phila Pa 1976) [internet]. 2006 Nov 1;31(23):2728-34. Available at: http://dx.doi.org/10.1097/01.brs.0000244583.35982.ea
32. Keawduangdee P, Puntumetakul R, Swangnetr M, Laohasiriwong W, Settheetham D, Yamauchi J, et al. Prevalence of low back pain and associated factors among farmers during the rice transplanting process. J Phys Ther Sci [internet]. 2015 Jul;27(7):2239-45. Available at: http://dx.doi.org/10.1589/jpts.27.2239
33. Farhana A, Lappin SL. Biochemistry, Lactate Dehydrogenase. 2022 May 8. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–. PMID: 32491468. Available at: https://pubmed.ncbi.nlm.nih.gov/32491468/
34. Sonkodi B. Should We Void Lactate in the Pathophysiology of Delayed Onset Muscle Soreness? Not So Fast! Let’s See a Neurocentric View! Metabolites [internet]. 2022 Sep 13;12(9). Available at: http://dx.doi.org/10.3390/metabo12090857
35. Lv Z, Cui J, Zhang J. Smoking, alcohol and coffee consumption and risk of low back pain: a Mendelian randomization study. Eur Spine J [internet]. 2022 Nov;31(11):2913-9. Available at: http://dx.doi.org/10.1007/s00586-022-07389-3
36. Alnaami I, Awadalla NJ, Alkhairy M, Alburidy S, Alqarni A, Algarni A, et al. Prevalence and factors associated with low back pain among health care workers in southwestern Saudi Arabia. BMC Musculoskelet Disord [internet]. 2019 Feb 8;20(1):56. Available at: http://dx.doi.org/10.1186/s12891-019-2431-5
37. Verbrugghe J, Agten A, Stevens S, Hansen D, Demoulin C, B OE, et al. Exercise Intensity Matters in Chronic Nonspecific Low Back Pain Rehabilitation. Med Sci Sports Exerc [internet]. 2019 Dec;51(12):2434-42. Available at: http://dx.doi.org/10.1249/MSS.0000000000002078
38. Sultana RN, Sabag A, Keating SE, Johnson NA. The Effect of Low-Volume High-Intensity Interval Training on Body Composition and Cardiorespiratory Fitness: A Systematic Review and Meta-Analysis. Sports Med [internet]. 2019 Nov;49(11):1687-721. Available at: https://doi.org/10.1007/s40279-019-01167-w
39. Nilsen TI, Holtermann A, Mork PJ. Physical exercise, body mass index, and risk of chronic pain in the low back and neck/shoulders: longitudinal data from the Nord-Trondelag Health Study. Am J Epidemiol [internet]. 2011 Aug 1;174(3):267-73. Available at: http://dx.doi.org/10.1093/aje/kwr087
40. Saraceni N, Kent P, Ng L, Campbell A, Straker L, O’Sullivan P. To Flex or Not to Flex? Is There a Relationship Between Lumbar Spine Flexion During Lifting and Low Back Pain? A Systematic Review with Meta-analysis. J Orthop Sports Phys Ther [internet]. 2020 Mar;50(3):121-30. Available at: http://dx.doi.org/10.2519/jospt.2020.9218
2. Miller D, Hasan K, Kirk A, Ayalew D, Walker W. Prevalence and characteristics of low back pain in a rural Ghana primary care clinic population. PM R [Internet]. 2020;12(3):251–6. Available at: http://dx.doi.org/10.1002/pmrj.12245
3. Duque I, Parra JH, Duvallet A. Maximal aerobic power in patients with chronic low back pain: a comparison with healthy subjects. Eur Spine J [internet]. 2010 Jan;20(1):87-93. Available at: http://dx.doi.org/10.1007/s00586-010-1561-0
4. Peng T, Perez A, Pettee Gabriel K. The Association Among Overweight, Obesity, and Low Back Pain in U.S. Adults: A Cross-Sectional Study of the 2015 National Health Interview Survey. J Manipulative Physiol Ther [internet]. 2018 May;41(4):294-303. Available at: http://dx.doi.org/10.1016/j.jmpt.2017.10.005
5. Uçar İ, Karartı C, Cüce İ, Veziroğlu E, Özüdoğru A, Koçak FA, et al. The relationship between muscle size, obesity, body fat ratio, pain and disability in individuals with and without nonspecific low back pain. Clin Anat [Internet]. 2021;34(8):1201–7. Available at: http://dx.doi.org/10.1002/ca.23776
6. Shiri R, Lallukka T, Karppinen J, Viikari-Juntura E. Obesity as a risk factor for sciatica: a meta-analysis. Am J Epidemiol [internet]. 2014 Apr 15;179(8):929-37. Available at: http://dx.doi.org/10.1093/aje/kwu007
7. Demos K, Sazakli E, Jelastopulu E, Charokopos N, Ellul J, Leotsinidis M. Does farming have an effect on health status? A comparison study in west Greece. Int J Environ Res Public Health [internet]. 2013 Feb 26;10(3):776-92. Available at: http://dx.doi.org/10.3390/ijerph10030776
8. Munala JM, Olivier B, Karuguti WM, Karanja SM. Prevalence of musculoskeletal disorders amongst flower farm workers in Kenya. S Afr J Physiother [internet]. 2021;77(1):1515. http://dx.doi.org/10.4102/sajp.v77i1.1515
9. Kahere M, Hlongwa M, Ginindza TG. A Scoping Review on the Epidemiology of Chronic Low Back Pain among Adults in Sub-Saharan Africa. Int J Environ Res Public Health [internet]. 2022 Mar 3;19(5):2964. Available at: https://pubmed.ncbi.nlm.nih.gov/35270657/
10. Chokprasit P, Yimthiang S, Veerasakul S. Predictors of Low Back Pain Risk among Rubber Harvesters. Int J Environ Res Public Health [internet]. 2022 Aug 23;19(17): 10492. Available at: http://dx.doi.org/10.3390/ijerph191710492
11. Rabey M, Buldo B, Duesund Helland M, Pang C, Kendell M, Beales D. Significant other interactions in people with chronic low back pain: Subgrouping and multidimensional profiles. Br J Pain [internet]. 2022 Jun;16(3):326-40. Available at: http://dx.doi.org/10.1177/20494637211062045
12. Kongtawelert A, Buchholz B, Sujitrarath D, Laohaudomchok W, Kongtip P, Woskie S. Prevalence and Factors Associated with Musculoskeletal Disorders among Thai Burley Tobacco Farmers. Int J Environ Res Public Health [internet]. 2022 Jun 1;19(11):6779. Available at: http://dx.doi.org/10.3390/ijerph19116779
13. Heneweer H, Staes F, Aufdemkampe G, van Rijn M, Vanhees L. Physical activity and low back pain: a systematic review of recent literature. Eur Spine J [internet]. 2011 Jun;20(6):826-45. Available at: http://dx.doi.org/10.1007/s00586-010-1680-7
14. Sheng B, Feng C, Zhang D, Spitler H, Shi L. Associations between Obesity and Spinal Diseases: A Medical Expenditure Panel Study Analysis. Int J Environ Res Public Health [internet]. 2017 Feb 13;14(2). Available at: http://dx.doi.org/10.3390/ijerph14020183
15. Zhou J, Mi J, Peng Y, Han H, Liu Z. Causal Associations of Obesity With the Intervertebral Degeneration, Low Back Pain, and Sciatica: A Two-Sample Mendelian Randomization Study. Front Endocrinol (Lausanne) [internet]. 2021;12:740200. Available at: http://dx.doi.org/10.3389/fendo.2021.740200
16. Soe KT, Laosee O, Limsatchapanich S, Rattanapan C. Prevalence and risk factors of musculoskeletal disorders among Myanmar migrant workers in Thai seafood industries. Int J Occup Saf Ergon [internet]. 2015;21(4):539-46. Available at: http://dx.doi.org/10.1080/10803548.2015.1096609
17. Tobasura I, Restrepo L. Características socioeconómicas del recolector temporal de café en el municipio de Chinchiná (Caldas). Agronomía. 1991;4(2):32-6.
18. Garzón Duque MO, Vásquez Trespalacios EM, Molina Vásquez J, Muñoz Gómez SG. Work conditions, ergonomic risks and the presence of musculoskeletal disorders in coffee collectors in a municipality in Colombia. Rev Asoc Esp Espec Med Trab [internet]. 2017;26(2):127-36. Available at: https://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1132-62552017000200127
19. Villegas-Bueno MJ, Montoya-Restrepo EC, Vélez-Zape JC, Oliveros-Tascón CE. Desempeño de los recolectores de café con el método mejorado de cosecha según la altura de la plantación. Cenicafé. 2005;56(1):19-36.
20. Ramírez Jaramillo P, Bonilla Mendoza, L. F., Buitrago Salazar, J. C., Múnera Ramírez, S., Uribe Quintero, M. L., Noguera Cabrales, M. D., Molina Restrepo, I., Garzón Duque, M. O. Musculoskeletal disorders in coffee collectors. Rev Colomb Salud Ocup [internet]. 2019;12(1):7143. Available at: https://doi.org/10.18041/2322-634X/rcso.1.2022.7143
21. Borg GA. Psychophysical bases of perceived exertion. Med Sci Sports Exerc [internet]. 1982;14(5):377-81. Available at: https://pubmed.ncbi.nlm.nih.gov/7154893/
22. Carlsson AM. Assessment of chronic pain. I. Aspects of the reliability and validity of the visual analogue scale. Pain [internet]. 1983 May;16(1):87-101. Available at: http://dx.doi.org/10.1016/0304-3959(83)90088-X
23. Rothman KJ. BMI-related errors in the measurement of obesity. Int J Obes (Lond) [internet]. 2008 Aug;32 Suppl 3:S56-9. Available at: http://dx.doi.org/10.1038/ijo.2008.87
24. Faulkner JA. Physiology of swimming. Res Q [internet]. 1966 Mar;37(1):41-54. Available at: https://pubmed.ncbi.nlm.nih.gov/5217133/
25. Kaminsky LA, Imboden MT, Arena R, Myers J. Reference Standards for Cardiorespiratory Fitness Measured With Cardiopulmonary Exercise Testing Using Cycle Ergometry: Data From the Fitness Registry and the Importance of Exercise National Database (FRIEND) Registry. Mayo Clin Proc [internet]. 2017 Feb;92(2):228-33. Available at: http://dx.doi.org/10.1016/j.mayocp.2016.10.003
26. Vélez JC, Montoya EC, Oliveros CE. Times and movements study for improvement of coffee manual harvest . Boletín Técnico Cenicafé [internet].1999;21:91p. Available at: http://hdl.handle.net/10778/593
27. 27. National Administrative Department of Statistics [Departamento Administrativo Nacional de Estadística -DANE]. Distribución de la población por ubicación. 2018 [internet]. [cited 2022 06/08/2022]; Available at: https://www.dane.gov.co/index.php/estadisticas-por-tema/demografia-y-poblacion/censo-nacional-de-poblacion-y-vivenda-2018/donde-estamos
28. Tejada RR, F. Wong, P. Alarcon, J. Risk work practices among rice farmers of Alto Mayo valley, San Martin, Peru. Rev Peru Epidemiol [internet]. 2011;15(1). Available at: https://www.redalyc.org/pdf/2031/203119644008.pdf
29. Wu A, Dong W, Liu S, Cheung JPY, Kwan KYH, Zeng X, et al. The prevalence and years lived with disability caused by low back pain in China, 1990 to 2016: findings from the global burden of disease study 2016. Pain [internet]. 2019 Jan;160(1):237-45. Available at: http://dx.doi.org/10.1097/j.pain.0000000000001396
30. Cho NH, Jung YO, Lim SH, Chung CK, Kim HA. The prevalence and risk factors of low back pain in rural community residents of Korea. Spine (Phila Pa 1976) [internet]. 2012 Nov 15;37(24):2001-10. Available at: http://dx.doi.org/10.1097/BRS.0b013e31825d1fa8
31. Barrero LH, Hsu YH, Terwedow H, Perry MJ, Dennerlein JT, Brain JD, et al. Prevalence and physical determinants of low back pain in a rural Chinese population. Spine (Phila Pa 1976) [internet]. 2006 Nov 1;31(23):2728-34. Available at: http://dx.doi.org/10.1097/01.brs.0000244583.35982.ea
32. Keawduangdee P, Puntumetakul R, Swangnetr M, Laohasiriwong W, Settheetham D, Yamauchi J, et al. Prevalence of low back pain and associated factors among farmers during the rice transplanting process. J Phys Ther Sci [internet]. 2015 Jul;27(7):2239-45. Available at: http://dx.doi.org/10.1589/jpts.27.2239
33. Farhana A, Lappin SL. Biochemistry, Lactate Dehydrogenase. 2022 May 8. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–. PMID: 32491468. Available at: https://pubmed.ncbi.nlm.nih.gov/32491468/
34. Sonkodi B. Should We Void Lactate in the Pathophysiology of Delayed Onset Muscle Soreness? Not So Fast! Let’s See a Neurocentric View! Metabolites [internet]. 2022 Sep 13;12(9). Available at: http://dx.doi.org/10.3390/metabo12090857
35. Lv Z, Cui J, Zhang J. Smoking, alcohol and coffee consumption and risk of low back pain: a Mendelian randomization study. Eur Spine J [internet]. 2022 Nov;31(11):2913-9. Available at: http://dx.doi.org/10.1007/s00586-022-07389-3
36. Alnaami I, Awadalla NJ, Alkhairy M, Alburidy S, Alqarni A, Algarni A, et al. Prevalence and factors associated with low back pain among health care workers in southwestern Saudi Arabia. BMC Musculoskelet Disord [internet]. 2019 Feb 8;20(1):56. Available at: http://dx.doi.org/10.1186/s12891-019-2431-5
37. Verbrugghe J, Agten A, Stevens S, Hansen D, Demoulin C, B OE, et al. Exercise Intensity Matters in Chronic Nonspecific Low Back Pain Rehabilitation. Med Sci Sports Exerc [internet]. 2019 Dec;51(12):2434-42. Available at: http://dx.doi.org/10.1249/MSS.0000000000002078
38. Sultana RN, Sabag A, Keating SE, Johnson NA. The Effect of Low-Volume High-Intensity Interval Training on Body Composition and Cardiorespiratory Fitness: A Systematic Review and Meta-Analysis. Sports Med [internet]. 2019 Nov;49(11):1687-721. Available at: https://doi.org/10.1007/s40279-019-01167-w
39. Nilsen TI, Holtermann A, Mork PJ. Physical exercise, body mass index, and risk of chronic pain in the low back and neck/shoulders: longitudinal data from the Nord-Trondelag Health Study. Am J Epidemiol [internet]. 2011 Aug 1;174(3):267-73. Available at: http://dx.doi.org/10.1093/aje/kwr087
40. Saraceni N, Kent P, Ng L, Campbell A, Straker L, O’Sullivan P. To Flex or Not to Flex? Is There a Relationship Between Lumbar Spine Flexion During Lifting and Low Back Pain? A Systematic Review with Meta-analysis. J Orthop Sports Phys Ther [internet]. 2020 Mar;50(3):121-30. Available at: http://dx.doi.org/10.2519/jospt.2020.9218
