What Psychosocial and Physical Characteristics Differentiate Office Workers Who Develop Standing-Induced Low Back Pain? A Cross-Sectional Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Participants
2.2. Study Procedure
2.3. Physical Outcome Measures
2.4. Self-Report Outcome Measures
2.5. Data Analysis
2.6. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
- Hoy, D.; March, L.; Brooks, P.; Blyth, F.; Woolf, A.; Bain, C.; Williams, G.; Smith, E.; Vos, T.; Barendregt, J.; et al. The global burden of low back pain: Estimates from the Global Burden of Disease 2010 study. Ann. Rheum. Dis. 2014, 73, 968–974. [Google Scholar] [CrossRef] [Green Version]
- Hartvigsen, J.; Hancock, M.J.; Kongsted, A.; Louw, Q.; Ferreira, M.L.; Genevay, S.; Hoy, D.; Karppinen, J.; Pransky, G.; Sieper, J.; et al. What low back pain is and why we need to pay attention. Lancet 2018, 391, 2356–2367. [Google Scholar] [CrossRef] [Green Version]
- Roffey, D.M.; Wai, E.K.; Bishop, P.; Kwon, B.K.; Dagenais, S. Causal assessment of occupational sitting and low back pain: Results of a systematic review. Spine J. 2010, 10, 252–261. [Google Scholar] [CrossRef] [PubMed]
- De Carvalho, D.E.; de Luca, K.; Funabashi, M.; Breen, A.; Wong, A.Y.L.; Johansson, M.S.; Ferreira, M.L.; Swab, M.; Neil Kawchuk, G.; Adams, J.; et al. Association of Exposures to Seated Postures With Immediate Increases in Back Pain: A Systematic Review of Studies With Objectively Measured Sitting Time. J. Manip. Physiol. Ther. 2020, 43, 1–12. [Google Scholar] [CrossRef] [Green Version]
- Ryan, C.G.; Grant, P.M.; Dall, P.M.; Granat, M.H. Sitting patterns at work: Objective measurement of adherence to current recommendations. Ergonomics 2011, 54, 531–538. [Google Scholar] [CrossRef] [Green Version]
- Patterson, R.; McNamara, E.; Tainio, M.; de Sá, T.H.; Smith, A.D.; Sharp, S.J.; Edwards, P.; Woodcock, J.; Brage, S.; Wijndaele, K. Sedentary behaviour and risk of all-cause, cardiovascular and cancer mortality, and incident type 2 diabetes: A systematic review and dose response meta-analysis. Eur. J. Epidemiol. 2018, 33, 811–829. [Google Scholar] [CrossRef] [Green Version]
- Buckley, J.P.; Hedge, A.; Yates, T.; Copeland, R.J.; Loosemore, M.; Hamer, M.; Bradley, G.; Dunstan, D.W. The sedentary office: An expert statement on the growing case for change towards better health and productivity. Br. J. Sport. Med. 2015, 49, 1357–1362. [Google Scholar] [CrossRef]
- Coenen, P.; Willenberg, L.; Parry, S.; Shi, J.W.; Romero, L.; Blackwood, D.M.; Maher, C.G.; Healy, G.N.; Dunstan, D.W.; Straker, L.M. Associations of occupational standing with musculoskeletal symptoms: A systematic review with meta-Analysis. Br. J. Sports Med. 2018, 52, 174–181. [Google Scholar] [CrossRef] [Green Version]
- Waters, T.R.; Dick, R.B. Evidence of health risks associated with prolonged standing at work and intervention effectiveness. Rehabil. Nurs. 2015, 40, 148–165. [Google Scholar] [CrossRef] [Green Version]
- Roffey, D.M.; Wai, E.K.; Bishop, P.; Kwon, B.K.; Dagenais, S. Causal assessment of occupational standing or walking and low back pain: Results of a systematic review. Spine J. 2010, 10, 262–272. [Google Scholar] [CrossRef]
- Coenen, P.; Parry, S.; Willenberg, L.; Shi, J.W.; Romero, L.; Blackwood, D.M.; Healy, G.N.; Dunstan, D.W.; Straker, L.M. Associations of prolonged standing with musculoskeletal symptoms—A systematic review of laboratory studies. Gait Posture 2017, 58, 310–318. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Villafañe, J.H.; Gobbo, M.; Peranzoni, M.; Naik, G.; Imperio, G.; Cleland, J.A.; Negrini, S. Validity and everyday clinical applicability of lumbar muscle fatigue assessment methods in patients with chronic non-specific low back pain: A systematic review. Disabil. Rehabil. 2016, 38, 1859–1871. [Google Scholar] [CrossRef] [PubMed]
- Marshall, P.W.M.; Patel, H.; Callaghan, J.P. Gluteus medius strength, endurance, and co-activation in the development of low back pain during prolonged standing. Hum. Mov. Sci. 2011, 30, 63–73. [Google Scholar] [CrossRef] [PubMed]
- Viggiani, D.; Callaghan, J.P. Hip Abductor Fatigability and Recovery Are Related to the Development of Low Back Pain During Prolonged Standing. J. Appl. Biomech. 2018, 34, 39–46. [Google Scholar] [CrossRef]
- Nelson-Wong, E.; Callaghan, J.P. Is muscle co-activation a predisposing factor for low back pain development during standing? A multifactorial approach for early identification of at-risk individuals. J. Electromyogr. Kinesiol. 2010, 20, 256–263. [Google Scholar] [CrossRef]
- Sorensen, C.J.; George, S.Z.; Callaghan, J.P.; Van Dillen, L.R. Psychological Factors Are Related to Pain Intensity in Back-Healthy People Who Develop Clinically Relevant Pain During Prolonged Standing: A Preliminary Study. PM R 2016, 8, 1031–1038. [Google Scholar] [CrossRef] [Green Version]
- Sorensen, C.J.; Johnson, M.B.; Norton, B.J.; Callaghan, J.P.; Van Dillen, L.R. Asymmetry of lumbopelvic movement patterns during active hip abduction is a risk factor for low back pain development during standing. Hum. Mov. Sci. 2016, 50, 38–46. [Google Scholar] [CrossRef] [Green Version]
- Hwang, C.T.; Van Dillen, L.R.; Haroutounian, S. Do Changes in Sensory Processing Precede Low Back Pain Development in Healthy Individuals? Clin. J. Pain 2018, 34, 525–531. [Google Scholar] [CrossRef]
- Nelson-Wong, E.; Timothy, F.; Callaghan, J.P. Development of active hip abduction screening test for identifying occupational low back pain. J. Orthop. Sports Phys. Ther. 2009, 39, 649–657. [Google Scholar] [CrossRef] [Green Version]
- Bussey, M.D.; Kennedy, J.E.; Kennedy, G. Gluteus medius coactivation response in field hockey players with and without low back pain. Phys. Ther. Sport 2016, 17, 24–29. [Google Scholar] [CrossRef]
- Nelson-Wong, E.; Callaghan, J.P. Repeatability of Clinical, Biomechanical, and Motor Control Profiles in People with and without Standing-Induced Low Back Pain. Rehabil. Res. Pract. 2010, 2010, 289278. [Google Scholar] [CrossRef] [PubMed]
- Ringheim, I.; Austein, H.; Indahl, A.; Roeleveld, K. Postural strategy and trunk muscle activation during prolonged standing in chronic low back pain patients. Gait Posture 2015, 42, 584–589. [Google Scholar] [CrossRef] [PubMed]
- Manchikanti, L.; Singh, V.; Falco, F.J.E.; Benyamin, R.M.; Hirsch, J.A. Epidemiology of Low Back Pain in Adults. Neuromodulation Technol. Neural Interface 2014, 17, 3–10. [Google Scholar] [CrossRef] [PubMed]
- Janwantanakul, P.; Sitthipornvorakul, E.; Paksaichol, A. Risk Factors for the Onset of Nonspecific Low Back Pain in Office Workers: A Systematic Review of Prospective Cohort Studies. J. Manip. Physiol. Ther. 2012, 35, 568–577. [Google Scholar] [CrossRef]
- Erdfelder, E.; FAul, F.; Buchner, A.; Lang, A.G. Statistical power analyses using G*Power 3.1: Tests for correlation and regression analyses. Behav. Res. Methods 2009, 41, 1149–1160. [Google Scholar] [CrossRef] [Green Version]
- Sorensen, C.J.; Johnson, M.B.; Callaghan, J.P.; George, S.Z.; Van Dillen, L.R. Validity of a Paradigm for Low Back Pain Symptom Development During Prolonged Standing. Clin. J. Pain 2015, 31, 652–659. [Google Scholar] [CrossRef] [Green Version]
- Von Korff, M.; Jensen, M.P.; Karoly, P. Assessing global pain severity by self-report in clinical and health services research. Spine 2000, 25, 3140–3151. [Google Scholar] [CrossRef]
- Davis, A.M.; Bridge, P.; Miller, J.; Nelson-Wong, E. Interrater and intrarater reliability of the active hip abduction test. J. Orthop. Sports Phys. Ther. 2011, 41, 953–960. [Google Scholar] [CrossRef] [Green Version]
- Mens, J.M.; Vleeming, A.; Snijders, C.J.; Koes, B.W.; Stam, H.J. Reliability and validity of the active straight leg raise test in posterior pelvic pain since pregnancy. Spine 2001, 26, 1167–1171. [Google Scholar] [CrossRef] [Green Version]
- Luomajoki, H.; Kool, J.; de Bruin, E.D.; Airaksinen, O. Movement control tests of the low back; evaluation of the difference between patients with low back pain and healthy controls. BMC Musculoskelet Disord 2008, 9, 170. [Google Scholar] [CrossRef] [Green Version]
- McGill, S.M.; Childs, A.; Liebenson, C. Endurance times for low back stabilization exercises: Clinical targets for testing and training from a normal database. Arch. Phys. Med. Rehabil. 1999, 80, 941–944. [Google Scholar] [CrossRef]
- Schellenberg, K.L.; Lang, J.M.; Chan, K.M.; Burnham, R.S. A clinical tool for office assessment of lumbar spine stabilization endurance: Prone and supine bridge maneuvers. Am. J. Phys. Med. Rehabil. 2007, 86, 380–386. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Van Cant, J.; Dumont, G.; Pitance, L.; Demoulin, C.; Feipel, V. Test-retest reliability of two clinical tests for the assessment of hip abductor endurance in healthy females. Int. J. Sports Phys. Ther. 2016, 11, 24–33. [Google Scholar] [PubMed]
- Kuorinka, I.; Jonsson, B.; Kilbom, A.; Vinterberg, H.; Biering-Sørensen, F.; Andersson, G.; Jørgensen, K. Standardised Nordic questionnaires for the analysis of musculoskeletal symptoms. Appl. Erg. 1987, 18, 233–237. [Google Scholar] [CrossRef]
- Silsbury, Z.; Goldsmith, R.; Rushton, A. Systematic review of the measurement properties of self-report physical activity questionnaires in healthy adult populations. BMJ Open 2015, 5, e008430. [Google Scholar] [CrossRef]
- Jancey, J.; Tye, M.; McGann, S.; Blackford, K.; Lee, A.H. Application of the Occupational Sitting and Physical Activity Questionnaire (OSPAQ) to office based workers. BMC Public Health 2014, 14, 762. [Google Scholar] [CrossRef] [Green Version]
- Karasek, R.; Brisson, C.; Kawakami, N.; Houtman, I.; Bongers, P.; Amick, B. The Job Content Questionnaire (JCQ): An instrument for internationally comparative assessments of psychosocial job characteristics. J. Occup. Health Psychol. 1998, 3, 322–355. [Google Scholar] [CrossRef]
- Gandek, B.; Ware, J.E.; Aaronson, N.K.; Apolone, G.; Bjorner, J.B.; Brazier, J.E.; Bullinger, M.; Kaasa, S.; Leplege, A.; Prieto, L.; et al. Cross-validation of item selection and scoring for the SF-12 Health Survey in nine countries: Results from the IQOLA Project. International Quality of Life Assessment. J. Clin. Epidemiol. 1998, 51, 1171–1178. [Google Scholar] [CrossRef]
- Sullivan, M.J.; Bishop, S.R.; Pivik, J. The pain catastrophizing scale: Development and validation. Psychol. Assess. 1995, 74, 524–532. [Google Scholar] [CrossRef]
- Ostelo, R.W.; Deyo, R.A.; Stratford, P.; Waddell, G.; Croft, P.; Von Korff, M.; Bouter, L.M.; de Vet, H.C. Interpreting change scores for pain and functional status in low back pain: Towards international consensus regarding minimal important change. Spine 2008, 33, 90–94. [Google Scholar] [CrossRef] [Green Version]
- Kass, R.E.; Raftery, A.E. Bayes factors. J. Am. Stat. Assoc. 1995, 90, 773–795. [Google Scholar] [CrossRef]
- Demoulin, C.; Vanderthommen, M.; Duysens, C.; Crielaard, J.M. Spinal muscle evaluation using the Sorensen test: A critical appraisal of the literature. Jt. Bone Spine 2006, 73, 43–50. [Google Scholar] [CrossRef] [PubMed]
- Nelson-Wong, E.; Gregory, D.E.; Winter, D.A.; Callaghan, J.P. Gluteus medius muscle activation patterns as a predictor of low back pain during standing. Clin. Biomech. 2008, 23, 545–553. [Google Scholar] [CrossRef] [PubMed]
- da Silva, T.; Mills, K.; Brown, B.T.; Herbert, R.D.; Maher, C.G.; Hancock, M.J. Risk of Recurrence of Low Back Pain: A Systematic Review. J. Orthop. Sport. Phys. Ther. 2017, 47, 305–313. [Google Scholar] [CrossRef]
- Taylor, J.B.; Goode, A.P.; George, S.Z.; Cook, C.E. Incidence and risk factors for first-time incident low back pain: A systematic review and meta-analysis. Spine J. 2014, 14, 2299–2319. [Google Scholar] [CrossRef]
- de Sousa, C.S.; de Jesus, F.L.A.; Machado, M.B.; Ferreira, G.; Ayres, I.G.T.; de Aquino, L.M.; Fukuda, T.Y.; Gomes-Neto, M. Lower limb muscle strength in patients with low back pain: A systematic review and meta-analysis. J. Musculoskelet. Neuronal Interact. 2019, 19, 69–78. [Google Scholar]
- Gallagher, K.M.; Campbell, T.; Callaghan, J.P. The influence of a seated break on prolonged standing induced low back pain development. Ergonomics 2014, 57, 555–562. [Google Scholar] [CrossRef]
- Johnston, V.; Gane, E.M.; Brown, W.; Vicenzino, B.; Healy, G.N.; Gilson, N.; Smith, M.D. Feasibility and impact of sit-stand workstations with and without exercise in office workers at risk of low back pain: A pilot comparative effectiveness trial. Appl. Ergon. 2019, 76, 82–89. [Google Scholar] [CrossRef]
- Agarwal, S.; Steinmaus, C.; Harris-Adamson, C. Sit-stand workstations and impact on low back discomfort: A systematic review and meta-analysis. Ergonomics 2018, 61, 538–552. [Google Scholar] [CrossRef]
NPD (n = 26) | PD (n = 14) | |||
---|---|---|---|---|
p | Bf | |||
Age (years), mean ± SD | 36.3 ± 8.6 | 39.4 ±11.5 | 0.51 | 2.2 |
Sex (female), n (%) | 13 (50.0) | 9 (64.3) | 0.39 | |
BMI (kg/m2), mean ± SD | 26.2 ± 4.3 | 26.5 ± 7.8 | 0.49 | 3.1 |
IPAQ, MET—min/week (median) | 2138.5 ± 1897.5 | 2357.0 ± 978 | 0.80 | 2.7 |
History of LBP | ||||
LBP Lifetime | 0.04 | 0.35 | ||
No (n, %) | 18 (69.2) | 5 (35.7) | ||
Yes (n, %) | 8 (30.8) | 9 (64.3) | ||
LBP last year | 0.03 | 0.31 | ||
No (n, %) | 10 (38.5) | 1 (7.1) | ||
Yes (n, %) | 16 (61.5) | 13 (92.9) | ||
LBP last 7 days | 0.02 | 0.14 | ||
No (n, %) | 16 (61.5) | 3 (21.4) | ||
Yes (n, %) | 10 (38.5) | 11 (78.6) | ||
LBP min 0 | 0.08 | - | ||
No (n, %) | 24 (92.3) | 10 (71.4) | ||
Yes (n, %) | 2 (7.7) | 4 (28.6) | ||
LBP severity, last 7 days (0–100), mean ± SD | 30.4 (31.2) | 51.2 (21.8) | 0.08 | 0.86 |
LBP severity, start of testing (0–100), mean ± SD | 12.7 (3.7) | 10.0 (7.5) | 0.68 | - |
OSPAQ, mean ± SD | ||||
Sitting per week (min) | 2126.1 ± 517.6 | 1929.9 ± 175.8 | 0.09 | 1.50 |
Sitting per workday (min) | 430.6 ± 102.8 | 391.9 ± 85 | 0.16 | 1.80 |
Standing per week (min) | 281 ± 250.2 | 221.2 ± 190.8 | 0.64 | 2.50 |
Standing per workday (min) | 57.1 ± 50.3 | 40.5 ± 30 | 0.54 | 1.9 |
Walking per week (min) | 179.3 ± 144.2 | 210.4 ± 281.2 | 0.68 | 2.9 |
Walking per workday (min) | 36.3 ± 28.6 | 39.7 ± 43.1 | 0.67 | 3.0 |
PCS, mean ± SD | ||||
Rumination | 3.5 ±3.4 | 5.3 ±4.2 | 0.18 | 1.32 |
Magnification | 1.7 ±1.3 | 2.9 ±2.9 | 0.29 | 0.84 |
Helplessness | 2.7 ±3.7 | 4.6 ±4.8 | 0.16 | 1.51 |
PCS total (0–52) | 7.8 ±7.2 | 12.8 ±10.2 | 0.12 | 0.93 |
JCQ, mean ± SD | ||||
Job Control (24–96) | 46.7 ± 13.2 | 42.4 ± 10.5 | 0.31 | 2.0 |
Psychological Job Demands (3–12) | 8 ± 1.7 | 7.6 ± 1.4 | 0.34 | 2.5 |
Social Support (4–16) | 7.5 ± 1.7 | 7.1 ± 1.8 | 0.62 | 2.8 |
Physical Demands (2–8) | 7.5 ± 0.8 | 7.6 ± 0.9 | 0.40 | 2.9 |
SF-12, Normal-Based Scores (50 ± 10) | ||||
Vitality | 52.1 ± 9.1 | 54.0 ± 9.3 | 0.29 | 2.68 |
Social Function | 51.1 ± 7.9 | 49.3 ± 9.1 | 0.44 | 2.64 |
Role Emotional | 43.9 ± 12.5 | 47.0 ± 11.7 | 0.34 | 2.48 |
Mental Health | 48.1 ± 9.6 | 53.1 ± 6.5 | 0.09 | 0.96 |
Mental Component Summary | 45.6 ± 9.7 | 51.4 ± 8.7 | 0.06 | 0.83 |
Physical Function | 55.8 ± 2.9 | 49.8 ± 10 | 0.01 | 0.13 |
Role Physical | 49.8 ± 9.3 | 49.3 ± 12.9 | 0.66 | 3.10 |
Bodily Pain | 52.5 ± 5.8 | 47.4 ± 10.5 | 0.12 | 0.69 |
General Health | 52.2 ± 8.8 | 49.9 ± 12.1 | 0.72 | 2.59 |
Physical Component Summary | 55.4 ± 5.0 | 48.8 ± 10.6 | 0.09 | 0.21 |
NPDs (n = 26) | PDs (n = 14) | |||
---|---|---|---|---|
p | Bf | |||
Tests of trunk and hip muscle endurance | ||||
Side bridge right side (s) | 57.3 ± 28.9 | 39.4 ± 29.9 | 0.07 | 0.84 |
Side bridge left side (s) | 52.6 ± 25.6 | 38.1 ± 30.1 | 0.05 | 1.14 |
Isometric hip abduction (right leg) (s) | 90.7 ± 25.6 | 62.4 ± 36.5 | 0.01 | 0.15 |
Isometric hip abduction (left leg) (s) | 97.8 ± 27.9 | 62.2 ± 32.2 | 0.001 | 0.02 |
Supine bridge (s) | 101.1 ± 51 | 89.2 ± 61.3 | 0.39 | 2.64 |
Abdominal (s) | 172.1 ± 86.4 | 112.0 ± 69.6 | 0.05 | 0.47 |
Sorensen (s) | 78.6 ± 36.3 | 48.7 ± 31.9 | 0.01 | 0.25 |
Tests of movement control | ||||
AHAbd, right side, examiner score (0–3) | 1.4 ± 0.7 | 1.6 ± 1 | 0.69 | 2.74 |
AHAbd, left side, examiner score (0–3) | 1.6 ± 0.6 | 1.8 ± 0.9 | 0.33 | 1.99 |
AHAbd, right side, participant score (0–5) | 1.5 ± 0.9 | 2.2 ± 0.9 | 0.04 | 0.56 |
AHAbd, left side, participant score (0–5) | 1.5 ± 0.9 | 2.4 ± 1.1 | 0.03 | 0.21 |
ASLR, total examiner score (0–10) | 2.5 ± 1 | 2.8 ± 1.1 | 0.42 | 2.38 |
ASLR, total participant score (0–10) | 2.2 ± 1.4 | 3.4 ± 1.7 | 0.03 | 0.39 |
PKF, right side, examiner score (0–1) | 0.7 ± 0.4 | 0.6 ± 0.4 | 0.39 | 2.30 |
PKF, left side, examiner score (0–1) | 0.4 ± 0.4 | 0.6 ± 0.4 | 0.06 | 0.81 |
LBP—Last Year (n = 29) | No LBP—Last Year (n = 11) | p | |
---|---|---|---|
Test of trunk and hip muscle endurance | |||
Side bridge right side (s) | 48.9 ± 29.9 | 56.7 ± 31.6 | 0.52 |
Side bridge left side (s) | 44.0 ± 26.0 | 56.9 ± 31.2 | 0.31 |
Isometric hip abduction (right leg) (s) | 78.5 ± 36.2 | 86.8 ± 19.6 | 0.67 |
Isometric hip abduction (left leg) (s) | 81.1 ± 35.3 | 96.5 ± 27.7 | 0.06 |
Supine bridge (s) | 88.1 ± 57.4 | 120.3 ± 38.3 | 0.09 |
Abdominal (s) | 143.2 ± 78.9 | 171.8 ± 100.6 | 0.44 |
Sorensen (s) | 66.4 ± 36.7 | 72.4 ± 40.4 | 0.52 |
Test of movement control | |||
AHAbd, right side, examiner score (0–3) | 1.5 ± 0.8 | 1.2 ± 0.7 | 0.14 |
AHAbd, left side, examiner score (0–3) | 1.7 ± 0.7 | 1.5 ± 0.7 | 0.32 |
AHAbd, right side, participant score (0–5) | 1.9 ± 0.9 | 1.3 ± 0.8 | 0.10 |
AHAbd, left side, participant score (0–5) | 1.9 ± 1.1 | 1.4 ± 0.8 | 0.15 |
ASLR, total examiner score (0–10) | 2.9 ± 0.9 | 1.9 ± 1.0 | 0.01 |
ASLR, total participant score (0–10) | 2.6 ± 1.6 | 2.3 ± 1.5 | 0.99 |
PKF, right side, examiner score (0–1) | 0.7 ± 0.4 | 0.5 ± 0.5 | 0.12 |
PKF, left side, examiner score (0–1) | 0.6 ± 0.4 | 0.2 ± 0.3 | 0.006 |
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Rodríguez-Romero, B.; Smith, M.D.; Quintela-del-Rio, A.; Johnston, V. What Psychosocial and Physical Characteristics Differentiate Office Workers Who Develop Standing-Induced Low Back Pain? A Cross-Sectional Study. Int. J. Environ. Res. Public Health 2020, 17, 7104. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17197104
Rodríguez-Romero B, Smith MD, Quintela-del-Rio A, Johnston V. What Psychosocial and Physical Characteristics Differentiate Office Workers Who Develop Standing-Induced Low Back Pain? A Cross-Sectional Study. International Journal of Environmental Research and Public Health. 2020; 17(19):7104. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17197104
Chicago/Turabian StyleRodríguez-Romero, Beatriz, Michelle D Smith, Alejandro Quintela-del-Rio, and Venerina Johnston. 2020. "What Psychosocial and Physical Characteristics Differentiate Office Workers Who Develop Standing-Induced Low Back Pain? A Cross-Sectional Study" International Journal of Environmental Research and Public Health 17, no. 19: 7104. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17197104