BACKGROUND: Although leisure-time physical activity is important for health, adherence to regular exercise is challenging for many adults. The workplace may provide an optimal setting to reach a large proportion of the adult population needing regular physical exercise. This study evaluates the effect of implementing strength training at the workplace on non-specific neck and shoulder pain among industrial workers.
METHODS: Cluster-randomized controlled trial involving 537 adults from occupations with high prevalence of neck and shoulder pain (industrial production units). Participants were randomized to 20 weeks of high-intensity strength training for the neck and shoulders three times a week (n = 282) or a control group receiving advice to stay physically active (n = 255). The strength training program followed principles of progressive overload and periodization. The primary outcome was changes in self-reported neck and shoulder pain intensity (scale 0-9).
RESULTS: 85% of the participants followed the strength training program on a weekly basis. In the training group compared with the control group, neck pain intensity decreased significantly (-0.6, 95% CI -1.0 to -0.1) and shoulder pain intensity tended to decrease (-0.2, 95% CI -0.5 to 0.1, P = 0.07). For pain-cases at baseline (pain intensity > = 3) the odds ratio - in the training group compared with the control group--for being a non-case at follow-up (pain intensity < 3) was 2.0 (95% CI 1.0 to 4.2) for the neck and 3.9 (95% CI 1.7 to 9.4) for the shoulders.
CONCLUSION: High-intensity strength training relying on principles of progressive overload can be successfully implemented at industrial workplaces, and results in significant reductions of neck and shoulder pain.
TRIAL REGISTRATION: NCT01071980.
QUESTION: Are postural exercises delivered by Mensendieck/Cesar therapists more effective in decreasing pain, reducing disability and improving health-related quality of life in visual display unit workers with early non-specific work-related upper limb disorders than strength and fitness exercises delivered by physiotherapists?
DESIGN: Randomised trial with concealed allocation and intention-to-treat analysis.
PARTICIPANTS: Eighty-eight (6 drop-outs) visual display unit workers with early non-specific work-related upper limb disorders.
INTERVENTION: One group received 10 weeks of postural exercises while the other group received 10 weeks of strength and fitness exercises.
OUTCOME MEASURES: Pain was measured with a 10-cm visual analogue scale, disability was measured with the Disabilities of Arm, Shoulder and Hand questionnaire, and health-related quality of life was measured with the Short Form-36. Number of participants experiencing upper limb complaints was also collected. Outcome measures were collected at baseline and again at 3, 6, and 12 months.
RESULTS: There was no significant difference in decrease in pain between the groups at 3 months (0.6 cm, 95% CI 0.0 to 1.2), 6 months (0.2, 95% CI -0.3 to 0.7), or at 12 months (0.1, 95% CI -0.6 to 0.8). Differences between the groups in upper limb complaints, disability, and health related quality of life were also small and not significant at any measurement occasion.
CONCLUSION: Postural exercises did not result in a better outcome than strength and fitness exercises. However, 55% of visual display unit workers with early non-specific work-related upper limb disorders reported being free of complaints one year after both interventions were commenced.
TRIAL REGISTRATION: ISRCTN15872455.
INTRODUCTION: Return to work following an occupational injury is a multifactoral process although many traditional clinic-based rehabilitation programs do not appreciate the importance of workplace factors. A randomized controlled trial was conducted to investigate the effect of workplace-based rehabilitation program on the return to work outcome of work-related rotator cuff disorder, which is based on the therapeutic use of actual work facilities and work environment. METHODS: A total of 103 workers were recruited and randomly assigned into Clinic-based Work Hardening (CWH) or Workplace-based Work Hardening (WWH) groups. The CWH group were given traditional generic work hardening training while WWH group received workplace-based work hardening training with rehabilitative principles of athletic rotator cuff pathology, biomechanics and specific job activities. RESULTS: After four weeks, a higher return to work rate was obtained in WWH group compared to CWH group (71.4% vs. 37%, p < 0.01). A statistically significant difference (p < 0.05) was also noted in lowering of self-reported shoulder problems and functional work capabilities in the WWH group versus the CWH group. CONCLUSION: Workplace-based rehabilitation program appeared to be more effective in facilitating the return to work process of the injured worker as assessed immediately following intervention. In particular this approached was associated with many of the psychosocial workplace factors related to separation from the work routine. The influence of peer group and/or employer could be minimized. This initial attempt with rotator cuff injuries appears promising however long-term outcome needs to be determined.
In practice the secondary prevention of work-related upper extremity (WRUE) symptoms generally targets biomechanical risk factors. Psychosocial risk factors have also been shown to play an important role in the development of WRUE symptom severity and future disability. The addition of a stress management component to biomechanically focused interventions may result in greater improvements in WRUE symptoms and functional limitations than intervening in the biomechanical risk factors alone. Seventy office workers with WRUE symptoms were randomly assigned to an ergonomics intervention group (assessment and modification of work station and stretching exercises) or a combined ergonomic and job stress intervention group (ergonomic intervention plus two 1-h workshops on the identification and management of workplace stress). Baseline, 3- and 12-month follow-up measures of observed ergonomic risks and self-reported ergonomic risks, job stress, pain, symptoms, functional limitation, and general physical and mental health were obtained from all participants. While both groups experienced significant decreases in pain, symptoms, and functional limitation from baseline to three months with improvements continuing to 12 months post baseline, no significant differences between groups were observed for any outcome measures. Findings indicate that the additional two-session job stress management component did not significantly enhance the short- or long-term improvements brought about by the ergonomic intervention alone.
OBJECTIVES: This study evaluated the effects on work-related neck and upper-limb disorders among computer workers stimulated (by a software program) to take regular breaks and perform physical exercises. Possible effects on sick leave and productivity were studied as well. A randomized controlled design was used with cluster randomization. Altogether 268 computer workers with complaints in the neck or an upper limb from 22 office locations were randomized into a control group, one intervention group stimulated to take extra breaks and one intervention group stimulated to perform exercises during the extra breaks during an 8-weekperiod. Questionnaires were administered before andafter the intervention, and questions were generated by the software during the intervention period. Computer usage was recorded online. RESULTS: The data on self-reported recovery suggested a favorable effect; more subjects in the intervention groups than in the control group reported recovery (55% versus 34%) from their complaints and fewer reported deterioration (4% versus 20%). However, a comparison between the reported pre- and postintervention scores on the severity and frequency of the complaints showed no significant differences in the change among the three groups. No effects on sick leave were observed. The subjects in the intervention groups showed higher productivity. CONCLUSIONS: The use of a software program stimulating workers to take regular breaks contributes to perceived recovery from neck or upper-limb complaints. There seems to be no additional effects from performing physical exercises during these breaks.
Although leisure-time physical activity is important for health, adherence to regular exercise is challenging for many adults. The workplace may provide an optimal setting to reach a large proportion of the adult population needing regular physical exercise. This study evaluates the effect of implementing strength training at the workplace on non-specific neck and shoulder pain among industrial workers.
METHODS:
Cluster-randomized controlled trial involving 537 adults from occupations with high prevalence of neck and shoulder pain (industrial production units). Participants were randomized to 20 weeks of high-intensity strength training for the neck and shoulders three times a week (n = 282) or a control group receiving advice to stay physically active (n = 255). The strength training program followed principles of progressive overload and periodization. The primary outcome was changes in self-reported neck and shoulder pain intensity (scale 0-9).
RESULTS:
85% of the participants followed the strength training program on a weekly basis. In the training group compared with the control group, neck pain intensity decreased significantly (-0.6, 95% CI -1.0 to -0.1) and shoulder pain intensity tended to decrease (-0.2, 95% CI -0.5 to 0.1, P = 0.07). For pain-cases at baseline (pain intensity > = 3) the odds ratio - in the training group compared with the control group--for being a non-case at follow-up (pain intensity < 3) was 2.0 (95% CI 1.0 to 4.2) for the neck and 3.9 (95% CI 1.7 to 9.4) for the shoulders.
CONCLUSION:
High-intensity strength training relying on principles of progressive overload can be successfully implemented at industrial workplaces, and results in significant reductions of neck and shoulder pain.
