University of South Florida

USF Physical Therapy launches $1.3M FEMA back injury prevention study with Tampa Bay firefighters

The 13-month trial assessing targeted exercises to reduce the risk of low back injury begins with Tampa Fire Rescue and will expand to fire departments in St. Petersburg and Hillsborough County

Tampa, FL (April 11, 2016) — USF Health and Tampa Fire Rescue have launched a randomized controlled trial to assess the effectiveness of a worksite exercise regimen targeted to reduce the risk of low back injury and disability in firefighters — a physically demanding occupation particularly prone to back problems that can lead to chronic pain and early retirement.

If this pivotal trial proves successful, the exercise training program could be implemented across the country to improve the health, safety and preparedness of the nation’s firefighters.

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At the recent press conference, Dr. John Mayer of the USF School of Physical Therapy and Rehabilitation Sciences, shares details about the new $1.3 million back injury prevention study enrolling local firefighters. Behind Dr. Mayer, all with Tampa Fire Rescue, from l to r, are Chief Tom Forward, Tiffany Kline, RN, COHN, occupational health nurse supervisor, and Edward Ortiz and John Cannon, both firefighters.

The full-scale prevention study is supported by a $1.3-million Federal Emergency Management Agency (FEMA) Assistance to Firefighters Grant, including a 5-percent extramural funding match from the Florida Chiropractic Foundation for Education and Research. It marks the third and most comprehensive project of ongoing FEMA-funded research by John Mayer, DC, PhD, Lincoln Endowed Chair of Biomechanical and Chiropractic Research at the USF Health Morsani College of Medicine’s School of Physical Therapy and Rehabilitation Sciences.

Tampa Fire Rescue Chief Tom Forward and study lead investigator Dr. Mayer stood with firefighters April 11 in the City of Tampa Fire Station #1 in downtown Tampa to announce the study and demonstrate the exercises for local news media.

“This study is the largest that’s ever been funded by FEMA looking directly at back injury prevention in firefighters,” Dr. Mayer told reporters and videographers. “Back injuries don’t kill people but it’s the #1 cause of opioid use in the population of firefighters, and we’ve all heard the horror stories about opioid use. We hope this study helps prevent things like that.”

From a frontline perspective, firefighter John Cannon summed it up another way for reporters.

“A healthy back is a healthy firefighter,” Cannon said.

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Firefighter John Cannon demonstrates the heavy protective clothing and gear that must to donned  to fight fires, including an air tank weighing 35 pounds.

Starting next week with participants recruited from Tampa Fire Rescue, the study will roll out to St. Petersburg Fire Rescue and Hillsborough County Fire Rescue over the next four months.  More than 300 firefighters from these three fire departments – the Tampa Bay region’s largest – will join the 13-month trial. Results of the study are expected in Fall 2017.

“Assuming positive results,” Dr. Mayer said, “this study will deliver the first evidence-based exercise intervention to prevent low back injury in firefighters, so that they can more effectively and safely carry out their duties to protect the community.”

“Career preservation is our goal. The current study provides an excellent platform to achieve this and serves as an impetus to expand our firefighter wellness initiatives,” said Charity L. Lane, MS, project manager, USF Health.

Back injuries are the leading cause of permanent disability and early retirement among firefighters, who often carry more than 50 pounds of protective gear in their jobs, haul heavy fire hoses and lift and maneuver stretchers around tight corners or contort themselves to extract accident victims from cars.

“We are pleased to partner with USF on this study, which aims to improve the quality of life for our firefighters and enhance their readiness to serve our citizens as first responders,” said Tampa Fire Rescue Chief Thomas Forward.

The standardized exercise protocol being tested was specifically designed to strengthen back and core muscles, including training on a specialized machine that isolates lower back muscles.

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Tampa Fire Rescue Captain Jeremy Finney demonstrates the exercise routine designed to strengthen back and core muscles, while firefighter John Cannon counts the prescribed pacing.

Cameras surround an explanation of the exercises by study project manager Charity Lane.

Cameras surround an explanation of the exercises by USF study project manager Charity Lane, MS, CPT.

The USF researchers will compare the clinical outcomes in three groups of randomly assigned firefighters — one receiving a directly supervised exercise regimen at the fire station two times a week for one year, another guided through the same worksite exercise regimen, but as a remote, web-based interaction (a telehealth system that encourages exercise adherence), and a control group given brief instruction on general exercise principles. All study participants, whether undergoing the exercise intervention or not, will continue their usual physical fitness routines.

To assess the exercise program’s effectiveness, the researchers will measure such factors as low back injury incidences and illness data, validated physical fitness tests, lost work days and costs.

The new study builds upon Dr. Mayer’s earlier FEMA-funded studies, demonstrating:

– A link between weak back muscle endurance and increased prevalence of low back pain in firefighters.

– Supervised worksite exercise training targeting back and core muscle endurance in firefighters was safe and appeared to work, indicating the intervention could protect against future low back pain. The preliminary study was reported in the American Journal of Health Promotion.

If this new study confirms the investigational exercise protocol’s benefit in Tampa Bay firefighters, the findings could also have implications for countering substantial adverse consequences of chronic back pain and injury in the general population, including health care and work-related costs, Dr. Mayer noted.

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Lead study investigator Dr. John Mayer is interviewed by Fox 13 News health reporter Dr. Joette Giovinco.

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Firefighter John Cannon demonstrates the loads and weight of their required gear.

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In addition to more than 50 pounds of gear, firefighters might also need to lift heavy equipment, like this Jaws of Life hydraulic apparatus used to pry apart the wreckage of crashed vehicles to free people.

Fire Chief Tom Forward is interviewed by Bay News 9.

Fire Chief Tom Forward is interviewed by Bay News 9.

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Jeremy Finney answers reporters’ questions about the risk of lower-back injury for firefighters.

                                                                      -USF Health-
USF Health’s mission is to envision and implement the future of health. It is the partnership of the USF Health Morsani College of Medicine, the College of Nursing, the College of Public Health, the College of Pharmacy, the School of Physical Therapy and Rehabilitation Sciences, and the USF Physician’s Group. The University of South Florida is a Top 50 research university in total research expenditures among both public and private institutions nationwide, according to the National Science Foundation.  For more information, visit

                                                           -About Tampa Fire Rescue-
Tampa Fire Rescue’s 647 sworn firefighters and paramedics provide fire protection, fire suppression, and emergency medical services throughout the City of Tampa. Tampa Fire Rescue operates out of 22 fire stations providing aircraft rescue and firefighting (ARFF) services at Tampa International Airport, hazardous materials response, marine firefighting, and fire and life safety education to the public. The Fire Marshal’s office, a division of Tampa Fire Rescue, investigates causes of fire, conducts building code reviews and enforces fire and life safety codes.

Video by Sandra C. Roa and photos by Eric Younghans, USF Health Office of Communications
Sarah Worth contributed to this story.

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