Neuromuscular Exercise and Counseling Decrease Absenteeism Due to Low Back Pain in Young Conscripts

Summary of Background Data

Basic military training is physically demanding on the back and requires adequate physical fitness. Low back pain causes significant morbidity and absence from military service.

Study Design

Controlled intervention with group randomization.


To investigate the effectiveness of a 6-month neuromuscular exercise and counseling program for reducing the incidence of low back pain and disability in young conscripts with a healthy back at the beginning of their compulsory military service.


Participants were conscripts of 4 successive age cohorts (n = 1409). In the pre study year, before adoption of the intervention, 2 successive cohorts of conscripts of 4 companies (n = 719) were followed prospectively for 6 months to study the baseline incidence followed for 6 months.

The intervention program aimed to improve conscripts’ control of their lumbar neutral zone and specifically to avoid full lumbar flexion in all daily tasks.


Total number and incidence of off-duty days due to low back pain were significantly decreased in the intervention companies compared with controls (adjusted hazard ratio = 0.42, 95% confidence interval = 0.18–0.94, P = 0.035).

The number of low back pain cases, number of health clinic visits due to low back pain, and number of the most severe cases showed a similar decreasing trend but without statistical significance.


These findings provide evidence that exercise and education to improve control of the lumbar neutral zone have a prophylactic effect on low back pain related off-duty service days in the military environment when implemented as part of military service among young healthy men



Research group

Jaana H. Suni, PT, PhD, UKK Institute
Henri Taanila, BM, UKL Institute
Ville M. Mattila, MD, PhD, The Finnish Defence Forces
Olli Ohrankämmen, MSci Mil, The Finnish Defence Forces
Petteri Vuorinen, Captain, The Finnish Defence Forces
Harri Pihlajamäki, MD, PhD, The Finnish Defence Forces
Jari Parkkari, MD, PhD, UKK Institute



Jaana Suni, Head of Health-Enhancing Physical Activity Unit



Suni JH, Taanila H, Mattila VM, Ohrankämmen O, Vuorinen P, Pihlajamäki H, Parkkari J, Neuromuscular Exercise and Counseling Decrease Absenteeism Due to Low Back Pain in Young Conscripts. A Randomized, Population-Based Primary Prevention Study. Spine 2013; XX: 1—10 DOI: 10.1097/BRS.0b013e318270a12d

Last Modified: 27.11.2014


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