Functional Biomarkers Associated with Risk of Low Back Pain in Firefighters: A Systematic Review

Area of Science:

• Occupational Health
• Biomedical Science
• Physical Therapy

Background:

• Firefighters face a high risk of low back pain (LBP).
• Predictors, mechanisms, and interventions for LBP in this group are not well-understood.
• Evidence on functional biomarkers for LBP risk in firefighters is limited.

Purpose of the Study:

• To systematically review and synthesize evidence on functional biomarkers associated with LBP risk in firefighters.
• To identify key predictors and potential intervention targets for LBP in the fire service.

Main Methods:

• Searched major databases (PubMed, EMBASE, CINAHL, PEDro) for relevant studies.
• Included studies evaluating functional biomarkers in firefighters with or without LBP.
• Generated evidence statements for eight biomarker domains.

Main Results:

• Eighteen studies (n=32,977) were included, mostly cross-sectional with fair quality and risk of bias.
• Higher disability/kinesiophobia and poorer functional work task performance were associated with increased LBP risk.
• Associations for other biomarkers were inconsistent; trunk-focused exercise showed benefits in two studies.

Conclusions:

• The current literature on functional biomarkers and LBP in firefighters is fragmented, limiting clinical recommendations.
• Future research should focus on integrated functional biomarkers for tailored prevention and care programs.
• Developing patient-centered programs can improve safety and health for firefighters experiencing LBP.