Purpose Low back pain (LBP) is a leading cause of lost work time (LWT) in firefighters and is related to poor muscle endurance. Although exercise can improve muscle endurance, it must be continued to sustain benefits, and it is unknown if it can reduce LWT. This study conducted an economic evaluation of an extended worksite exercise intervention in career firefighters. Methods A randomized controlled trial allocated 264 firefighters to telehealth with remote instruction (“telehealth”), direct exercise supervision (“direct”), or brief education (“control”). The telehealth and direct groups performed worksite exercises twice weekly for 12 months. Outcomes included quality adjusted life years, LWT from LBP (24-h shifts), costs of LWT from LBP, and net monetary benefits. Results A total of 216 firefighters were included in the economic analysis (telehealth n = 71, direct n = 75, control n = 70). Sixteen experienced LWT from LBP (telehealth n = 4, direct n = 4, control n = 8). The mean number of 24-h shifts lost from LBP were 0.05 (telehealth), 0.28 (direct), and 0.43 (control). Mean study intervention costs per participant were $1984 (telehealth), $5269 (direct), and $384 (control). Net monetary benefit was $3573 for telehealth vs. direct, − $1113 for telehealth vs. control, and − $4686 for direct vs. control. Conclusions Worksite exercise reduced LWT from LBP in firefighters. Telehealth was less costly and more effective at reducing LWT from LBP than direct exercise supervision. If the costs of telehealth were further reduced, a positive net monetary benefit might also be achieved when compared to no intervention.

Clinical trial registration: (clinicaltrials.gov): NCT02362243.

目的腰痛 (LBP) 是导致消防员失去工作时间 (LWT) 的主要原因，并且与肌肉耐力差有关。运动虽然可以提高肌肉耐力，但必须持续维持，才能降低LWT，尚不得而知。本研究对职业消防员的扩展工作现场演习干预进行了经济评估。方法一项随机对照试验将 264 名消防员分配到远程医疗（“远程医疗”）、直接运动监督（“直接”）或简短教育（“控制”）。远程医疗和直接小组每周进行两次工作场所练习，持续 12 个月。结果包括质量调整生命年、LBP 的 LWT（24 小时轮班）、LBP 的 LWT 成本和净货币收益。结果共有 216 名消防员被纳入经济分析（远程医疗 n = 71，直接 n = 75，控制 n = 70）。十六个来自 LBP 的 LWT（远程医疗 n = 4，直接 n = 4，控制 n = 8）。从 LBP 中损失的 24 小时轮班平均次数为 0.05（远程医疗）、0.28（直接）和 0.43（控制）。每个参与者的平均研究干预成本为 1984 美元（远程医疗）、5269 美元（直接）和 384 美元（控制）。远程医疗与直接医疗相比，净货币收益为 3573 美元，远程医疗与控制相比为 - 1113 美元，直接与控制相比为 - 4686 美元。结论工地演习减少了消防员 LBP 造成的 LWT。与直接锻炼监督相比，远程医疗在减少 LBP 造成的 LWT 方面成本更低，更有效。如果远程医疗的成本进一步降低，与没有干预相比，也可能实现正的净货币收益。

临床试验注册：（clinicaltrials.gov）：NCT02362243。