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Lincoln Endowed Chair

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Lincoln Endowed Chair

Firefighter Research

Low back injury prevention in firefighters

Overview

The current research efforts of the Lincoln Chair’s program are aimed at developing and assessing the effectiveness of targeted exercise approaches for the back and core muscles to reduce risk of back injury and improve resilience in high risk occupations, such as emergency responders and military personnel. Dr. Mayer was part of a team that developed and implemented the San Diego (CA) Firefighter Regional Wellness Program, and is currently the principal investigator on a FEMA-funded Fire Prevention & Safety grant initiative on low back injury prevention in firefighters, which is being conducted in collaboration with Tampa Fire Rescue (FL), Hillsborough County Fire Rescue (FL), and St. Petersburg Fire & Rescue (FL).

Project 3

Abstract

Purpose and Objectives (with rationale)

Low back injury is one of the most common and disabling disorders in firefighters. Thus, novel interventions are needed to counteract the adverse consequences of this disorder and its impact on firefighter safety. Our long-term objective is to develop and test interventions to reduce the incidence, morbidity, economic, and other adverse consequences of low back injury and illness in firefighters. Our previous studies funded by the FEMA Assistance to Firefighters Grant Program demonstrated that: 1) a relationship exists between poor back muscular endurance and increased prevalence of low back pain in firefighters (project 1); and 2) a worksite intervention including back and core exercise training is safe and effective in improving back and core muscular endurance in firefighters (project 2). The purpose of the current study (project 3) is to compare the effectiveness of 3 worksite exercise interventions (supervised, web-based, control) to reduce lost work days related to low back injury and illness in firefighters.

Study Design and Methods

A cluster randomized controlled trial will be conducted in career, full active duty firefighters (n = 362 enrolled, n = 345 randomized) who will be randomly assigned (by fire station) to 1 of 3 arms - 1) exercise intervention - supervised arm (n = 115), 2) exercise intervention - web-based arm (n = 115), or 3) control (n = 115). Participants assigned to the exercise will perform back and core exercises previously tested in our recent FEMA-funded study (EMW-2009-FP-00418) (Project 2), 2 times per week for 12 months while on duty, in addition to their usual physical fitness routine: The exercise intervention - supervised arm will perform exercise under direct supervision of exercise specialists, and the exercise intervention - web-based arm will utilize a web-based exercise system. Participants assigned to the control arm will receive brief education on general exercise and physical activity principles, and continue their usual physical fitness routine. Outcome measures include low back injury and illness data obtained and cross-checked from various sources, other standard clinical outcome measures for low back pain and disability, and validated physical fitness tests.

Results (projected)

We hypothesis that the exercise intervention (delivered via supervised or web-based) will reduce the number of lost work days related to low back injury and illness over the 12-month intervention period by 40% compared with control.

Conclusions (projected)

The proposed study will provide pivotal evidence for dissemination and implementation throughout the fire service. Assuming positive results, this study will deliver the first evidence-based exercise intervention for low back injury prevention specifically designed for firefighters. If successfully implemented, a low back injury prevention program including this intervention will improve firefighter safety and health in order to enhance resilience and preparedness, so that they can more effectively carry out their duties to protect the community. Further, this low back injury prevention exercise program will help improve off-duty and long-term quality of life for firefighters


RESEARCH STRATEGY

Firefighter Research - Lincoln Endowed Chair

SUPPORT

Project 1: Assistance to Firefighter Grant, FEMA, US Department of Homeland Security (awarded to San Diego Fire Rescue, CA)

Project 2: Fire Prevention & Safety grant, FEMA, US Department of Homeland Security (awarded to USF, PI: JM Mayer, grant #: EMW-2009-FP-00418).

Project 3: Fire Prevention & Safety grant, FEMA, US Department of Homeland Security (awarded to USF, PI: JM Mayer, grant #: EMW-2013-FP-00723).


Dissemination & Peer-Reviewed Manuscripts (selected)

Other Publications (selected) 

Scientific Presentations

  • Mayer JM. Low back injury prevention in firefighters. FEMA Assistance to Firefighters Grants Research & Development Annual Meeting, Chicago, IL, August 2010.
  • Mayer JM. Improving back muscle endurance and core stability in firefighters: a randomized trial. FEMA Assistance to Firefighters Grants Research & Development Annual Meeting, New York, NY, August 2011.
  • Nuzzo JL, Quillen WS, Mayer JM. Relationship between trunk muscular endurance and anthropometric measures in firefighters. University of South Florida Health Research Day. Tampa, FL, February 2012.
  • Mayer JM, Chen R, Nuzzo JL, Dagenais S, Verna JL, Quillen WS. Relationship of back muscular endurance with anthropometric measures in firefighters. American College of Sports Medicine Annual Meeting. San Francisco, CA, June 2012.
  • Mayer JM. Improving back muscular endurance and core stability in firefighters: a randomized trial - preliminary findings. FEMA Assistance to Firefighters Grants Research & Development Annual Meeting, Denver, CO, August 2012.
  • Libous JL, Dagenais S, Quillen WS, Mayer JM. Assessment of barriers and facilitators to worksite exercise in firefighters. University of South Florida Health Research Day. Tampa, FL, February 2013.
  • Mayer JM, Quillen WS. Effect of worksite exercise on development of back and core muscular endurance in firefighters. American Occupational Health Conference, American College of Occupational and Environmental Medicine. Orlando, FL, April 2013.
  • Mayer JM, Quillen WS, Dagenais S. Effect of worksite exercise on back and core muscular endurance in firefighters. International Society for the Study of the Lumbar Spine Annual Conference, Scottsdale, AZ, May 2013.
  • Mayer JM. Worksite exercise and education programs for prevention of musculoskeletal injuries in firefighters. Firefighter Safety and Health Conference, Florida Fire Chiefs Association, Orlando, FL, December 2013.
  • Mayer JM. Worksite exercise interventions for low back injury prevention in firefighters FEMA Assistance to Firefighters Grants Research & Development Annual Meeting, Dallas, TX, August 2014.

Other Scholarly Products

  • Mayer JM. Exercise Training Manual: Back and Core Exercises for Firefighters. University of South Florida, Tampa, FL, 2012. p 1-22.