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To the Editor.—We find numerous severe faults with the article by Ms van Poppel and colleagues¹ that sharply limit its contribution to the scientific understanding of the efficacy of lumbar supports. Complaint of back pain was not separated from the critical questions of whether the back was injured while the subject was at work and how to prevent such injuries. As fewer than half the persons assigned to wear the support actually wore it, the findings are necessarily suspect. Both compliance and days lost due to back pain were self-reported rather than being assessed objectively, whether back pain occurred while wearing or not wearing a support was not shown, and whether supports when worn were worn properly was not indicated. Statistical power was compromised by the large and unequal numbers of participants who lost interest or withdrew and the likelihood that this occurred nonrandomly. Moreover, it seems that the . . . [Full Text of this Article]

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RELATED ARTICLE

Lumbar Supports and Education for the Prevention of Low Back Pain in Industry: A Randomized Controlled Trial
Mireille N. M. van Poppel, Bart W. Koes, Trudy van der Ploeg, Tjabe Smid, and Lex M. Bouter
JAMA. 1998;279(22):1789-1794.
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