On the effects of a workplace fitness program upon pain perception: a case study encompassing office workers in a Portuguese context

A Comprehensive Workplace Exercise Intervention to Reduce Musculoskeletal Pain and Improve Functional Capacity in Office Workers: A Randomized Controlled Study

The high levels of musculoskeletal pain, in conjunction with the low levels of functional capacity, may negatively affect workers' health, efficiency, and productivity. This randomized controlled study investigated the efficacy of a 6-month comprehensive workplace exercise program on musculoskeletal pain and functional capacity in office workers. Seventy male and female office workers with musculoskeletal pain in any body area were randomly assigned to either an intervention (IG; n = 35) or a control group (CG; n = 35). The IG participated every working day (during working hours) in a 6-month supervised combined (flexibility, strength, and balance) exercise program (120 training sessions; five times/week) for the total body. The CG did not participate in any intervention. Musculoskeletal pains in nine body areas and functional capacity (flexibility, balance, and strength) of the lower and upper body were measured before and following the intervention. The IG significantly reduced duration and intensity of pain (43.1-70%; p = 0.000) as well as days of work absenteeism (84.6%; p = 0.000), while improving work capacity (87.1%; p = 0.000). Furthermore, the IG significantly increased cervical, handgrip, back, and leg maximal strength (10.3-27.1%; p = 0.000) and flexibility and balance (12.3-73.7%; p = 0.000). In CG, all musculoskeletal pain and functional capacity indices remained unchanged. In conclusion, this program may be effectively used to reduce musculoskeletal pain and improve functional capacity.

Diaphragmatic breathing exercises in recovery from fatigue-induced changes in spinal mobility and postural stability: a study protocol

Prolonged periods of sitting at work can increase trunk muscle fatigue from the continuous contraction of deep trunk muscles. Insufficient activity of these muscles can decrease muscular support to the spine and increases stress on its passive structures. This can lead to reduced spinal mobility and impaired postural stability. It may also stimulate nociceptor activity leading to pain. However, frequently used recovery modalities such as muscle strengthening and stretching exercises, can be time-consuming, impractical, and difficult to implement in the workplace. Diaphragmatic breathing exercises, which increase the activity of the deep trunk muscles by raising intra-abdominal pressure, seem to be a suitable alternative. However, little is known as to what extent diaphragmatic breathing exercises contribute to the reduction of fatigue induced by prolonged sitting. This paper presents a study protocol that aims to investigate the acute effect of diaphragmatic breathing exercises on recovery of fatigue-induced changes in spinal mobility and postural stability in sedentary middle-aged adults at risk of developing non-specific low back pain. Twenty sedentary adults aged between 25 and 44 years will perform Abt's fatigue protocol, followed by 1) active recovery using diaphragmatic breathing exercises and 2) passive recovery in the form of lying on the bed, respectively. There will be 1 week of rest in-between. Pre-fatigue, post-fatigue, and after the active and passive recovery, spinal mobility and postural stability will be evaluated using the spinal mouse device and a posturography system, respectively. The electromyography will be used to determine the muscle-fatigue conditions. We hypothesize that active recovery in a form of diaphragmatic breathing exercises would be more effective in restoring spinal mobility and postural stability followed by the fatigue of back and hamstring muscles compared to passive recovery in sedentary adults. Increasing core and respiratory muscle strength via these exercises could be beneficial for overall mobility and stability of the spine. Reducing compressive stress on the passive structures of the spine may be also beneficial for lowering low back pain. Therefore, we believe that diaphragmatic breathing exercises have the possibility to be incorporated into the workplace and contribute to better back health in sedentary middle-aged adults. Clinical Trial Registration: [https://www.irct.ir/trial/67015], identifier [IRCT20221126056606N1].

Impact assessment of e-trainings in occupational safety and health: a literature review

BACKGROUND

Implementing workplace preventive interventions reduces occupational accidents and injuries, as well as the negative consequences of those accidents and injuries. Online occupational safety and health training is one of the most effective preventive interventions. This study aims to present current knowledge on e-training interventions, make recommendations on the flexibility, accessibility, and cost-effectiveness of online training, and identify research gaps and obstacles.

METHOD

All studies that addressed occupational safety and health e-training interventions designed to address worker injuries, accidents, and diseases were chosen from PubMed and Scopus until 2021. Two independent reviewers conducted the screening process for titles, abstracts, and full texts, and disagreements on the inclusion or exclusion of an article were resolved by consensus and, if necessary, by a third reviewer. The included articles were analyzed and synthesized using the constant comparative analysis method.

RESULT

The search identified 7,497 articles and 7,325 unique records. Following the title, abstract, and full-text screening, 25 studies met the review criteria. Of the 25 studies, 23 were conducted in developed and two in developing countries. The interventions were carried out on either the mobile platform, the website platform, or both. The study designs and the number of outcomes of the interventions varied significantly (multi-outcomes vs. single-outcome). Obesity, hypertension, neck/shoulder pain, office ergonomics issues, sedentary behaviors, heart disease, physical inactivity, dairy farm injuries, nutrition, respiratory problems, and diabetes were all addressed in the articles.

CONCLUSION

According to the findings of this literature study, e-trainings can significantly improve occupational safety and health. E-training is adaptable, affordable, and can increase workers' knowledge and abilities, resulting in fewer workplace injuries and accidents. Furthermore, e-training platforms can assist businesses in tracking employee development and ensuring that training needs are completed. Overall, this analysis reveals that e-training has enormous promise in the field of occupational safety and health for both businesses and employees.

Effects of Whole-Body Stretching Exercise during Lunch Break for Reducing Musculoskeletal Pain and Physical Exertion among Healthcare Professionals

Background and Objectives: To investigate the effect of whole-body stretching (WBS) exercise during lunch break for reducing musculoskeletal pain and physical exertion among healthcare professionals. Methods: Full-time healthcare professionals working in hospitals with more than one year of experience were invited to participate. Sixty healthcare professionals (age 37.15  ±  3.9 Years, height 1.61  ±  0.04 m, body mass 67.8  ±  6.3 kg, and BMI 26.5 ± 2.1 kg/m²) participated in this single-blinded, two-arm randomized controlled trial (RCT). Participants were divided into WBS (n = 30) and control (n = 30) groups. The WBS group performed a range of stretching exercises targeting the entire body during a lunch break period for 3 times a week for 6 weeks. The control group received an education program. Musculoskeletal pain and physical exertion were assessed using the Nordic musculoskeletal questionnaire and Borg rating of perceived exertion scale, respectively. Results: The 12-month prevalence of musculoskeletal discomfort among all healthcare professionals was highest in the low back region (46.7%), followed by the neck (43.3%), and then the knee (28.3%). About 22% of participants said that their neck discomfort impacted their job, while about 18% reported that their low back pain impacted their job. Results indicate that the WBS and education program had a beneficial impact on pain and physical exertion (p < 0.001). When comparing the two groups, the WBS group experienced a significantly greater decrease in pain intensity (mean difference 3.6 vs. 2.5) and physical exertion (mean difference 5.6 vs. 4.0) compared to an education program only. Conclusions: This study suggests that doing WBS exercises during lunchtime can help lessen musculoskeletal pain and fatigue, making it easier to get through the workday.

A Survey on Stretching Practices in Women and Men from Various Sports or Physical Activity Programs

Recommendations for prescribing stretching exercises are regularly updated. It appears that coaches progressively follow the published guidelines, but the real stretching practices of athletes are unknown. The present study aimed to investigate stretching practices in individuals from various sports or physical activity programs. A survey was completed online to determine some general aspects of stretching practices. The survey consisted of 32 multiple-choice or open-ended questions to illustrate the general practices of stretching, experiences and reasons for stretching. In total, 3546 questionnaires were analyzed (47.3% women and 52.7% men). Respondents practiced at the national/international level (25.2%), regional level (29.8%), or recreationally (44.9%). Most respondents (89.3%) used stretching for recovery (74.9%) or gains of flexibility (57.2%). Stretching was generally performed after training (72.4%). The respondents also indicated they performed stretching as a pre-exercise routine (for warm-up: 49.9%). Static stretching was primarily used (88.2%) but when applied for warm-up reasons, respondents mostly indicated performing dynamic stretching (86.2%). Only 37.1% of the respondents indicated being supervised. Finally, some gender and practice level differences were noticed. The present survey revealed that the stretching practices were only partly in agreement with recent evidence-based recommendations. The present survey also pointed out the need to improve the supervision of stretching exercises.

Effectiveness of workplace exercise interventions in the treatment of musculoskeletal disorders in office workers: a protocol of a systematic review

INTRODUCTION

Physical inactivity due to changes in our society towards more sedentary behaviours is leading to health problems. Increasing physical activity might be a good strategy to improve physical strength and reduce the prevalence of illnesses associated with prolonged sitting. Office workers exhibit a sedentary lifestyle with short rest periods or even without pauses during the workday. It is important to perform workplace interventions to treat musculoskeletal disorders caused by prolonged sitting and lack of movement adopted on the office setting. This article describes a protocol for a systematic review to evaluate the effectiveness of exercise interventions on office workers in their work environment.

METHODS AND ANALYSIS

A literature search will be performed in the PubMed, CINAHL Plus, Cochrane Library, Scopus, ISI WoS and PeDRO databases for randomised controlled trials and studies published from 1 January 2010 to 31 July 2020 in English or Spanish. The participants will be office workers who spend most of their work time in a sitting position. The interventions performed will include any type of exercise intervention in the workplace. The outcome measures will vary in accordance with the aim of the intervention observed. The results of the review and the outcomes from the studies reviewed will be summarised with a narrative synthesis. The review protocol was developed according to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines.

ETHICS AND DISSEMINATION

Ethical approval is not required. The review outcomes and the additional data obtained will be disseminated through publications and in scientific conferences.

PROSPERO REGISTRATION NUMBER

CRD42020177462.

Effectiveness of a progressive resistance exercise program for industrial workers during breaks on perceived fatigue control: a cluster randomized controlled trial

BACKGROUND

There is strong evidence that physical exercise in the workplace is effective for reducing workers' musculoskeletal complaints. Studies with industrial workers and studies on progressive resistance exercises during breaks are scarce. Our aim was to evaluate the effects of a resistance exercise program on perceived fatigue control among industrial workers.

METHODS

204 employees from the dairy industry were allocated to two groups, the intervention group (IG) (n = 98) and the control group (CG) (n = 106). The primary outcome measures were perceived fatigue control and maximum muscle strength, measured through the Need for Recovery Scale and one-repetition maximum contraction (1-RM), respectively. Secondary outcome measures were musculoskeletal complaints, physical activity level, perceived risk factors, physical fitness (BMI, vital signs, and body fat percentage), and workers´ productivity. All outcomes were assessed at baseline and then again after 4 months. The IG performed resistance exercises using progressively greater loads while the CG performed general exercise using elastic bands. The exercise protocols were performed three times per week for 20 min. An intention-to-treat analysis was performed using the mixed linear model. Results were considered significant when p < 0.05.

RESULTS

The IG did not show to be superior to the CG, although both groups improved perceived fatigue control and muscle strength after the resistance physical exercise program in the worplace. There was also no significant difference between the groups for musculoskeletal complaints and other secondary variables analyzed. However, both groups showed significant improvements between baseline and after 4 months of intervention for all evaluated outcomes (p < 0.05).

CONCLUSION

The implementation of a progressive resistance exercise program during work breaks for perceived fatigue control was no more effective than exercises using elastic bands. However, resistance exercises during work breaks presented better results on all measured outcomes regardless of the exercise protocol used.

TRIAL REGISTRATION

U.S. National Institutes of Health, ClinicalTrials.gov Identifier: NCT02172053. Registered 19 June 2014.

Effects of a worksite physical activities program among men and women: An interventional study in a footwear industry

The study aims to assess the association between various levels of engagement in a worksite physical activities program and variables related to musculoskeletal symptoms, psychophysiological well-being, difficulty to perform tasks, willingness to work, and interpersonal relationships, among men and women in a footwear industry. This program involved 1113 workers. Data were analysed using an ordinal logistic regression model. In women, an increase in the frequency of participation in the worksite physical activities program was associated with less musculoskeletal pain (OR = 3.12; 2.07-4.71), better relationships among colleagues (OR = 2.83; 1.67-4.81), and a higher level of psychophysiological well-being (OR = 1.98; 1.06-3.70). In men, an increase in the frequency participation in the worksite physical activities program was associated with less difficulty in performing occupational tasks (OR = 0.49; 0.27-0.87). Thus, the association between occupational exercises and studied variables differed between genders.

Physical Exercise Is Confirmed to Reduce Low Back Pain Symptoms in Office Workers: A Systematic Review of the Evidence to Improve Best Practices in the Workplace

This systematic review aimed to analyze the effects of a physical exercise (PE) program on low back pain (LBP) symptoms of office workers and the modification of flexibility and range of motion (ROM), muscular strength, and quality of life (QoL). A literature research was performed on PubMed, Scopus, MEDLINE, and SPORTDiscus from April to May 2018. The keyword "low back pain" was associated with "office worker" OR "VDT operators" OR "office employees" OR "workplace" AND "exercise", OR "exercise therapy" OR "physical activity". Inclusion criteria were a home- or work-based exercise protocol for office workers with LBP symptoms and pre- to post-intervention evaluation of LBP symptoms. Three researchers independently examined all abstracts. The modified Cochrane methodological quality criteria were used for quality assessment and 11 articles were included. Exercise protocols were performed from 6 weeks to 12 months, 1-5 day per week, lasting 10-60 min for each session. Physical Exercise in the workplace improved all the considered outcomes. The best improvement was recorded in supervised protocols and in video-supported protocols performed in the workplace. The effect may be generated with small duration sessions during the working day, with only 10-15 min of adapted exercise to be performed 3-5 days per week.

Effects of physical exercise at the workplace for treatment of low back pain: a systematic review with meta-analysis

Background

The prevalence of low back pain is high among the economically active population. Low back pain reduces productivity and causes absenteeism, impaired quality of life and leaves of absence. Several measures were suggested to reduce the occurrence of this occupational condition, among which physical exercise at the workplace stands out.

Aim

To analyze studies which assessed physical exercise at the workplace for treatment of low back pain.

Methods

The present study consisted of a systematic review with meta-analysis. An electronic search was conducted on database MEDLINE using keywords "workplace," "low back pain" and "exercise," synonyms and headings located on Health Sciences Descriptors and Medical Subject Headings. We considered all the studies that included physical exercise at the workplace and defined low back pain as outcome.

Results

We located 499 potential studies and finally included 15 for review. The duration of treatment varied from 3 weeks to 18 months, and the main interventions were strength and stretching exercises and muscle relaxation.

Conclusions

The meta-analysis showed that physical exercise at the workplace did not reduce the occurrence of low back pain (difference of means=0.62, 95%CI -0.8-2.04, p<0.4). The present systematic review was registered in database PROSPERO, registration number CRD42017071563.

Borg CR-10 scale as a new approach to monitoring office exercise training

BACKGROUND

There are many potential training exercises for office workers in an attempt to prevent musculoskeletal disorders. However, to date a suitable tool to monitor the perceived exertion of those exercises does not exist.

OBJECTIVE

The primary objective of this study was to examine the validity and reliability of the Borg CR-10 scale to monitor the perceived exertion of office exercise training.

METHODS

The study involved 105 staff members employed in a government office with an age range from 25 to 50 years. The Borg CR-10 scale was self-administered two times, with an interval of two weeks in order to evaluate the accuracy of the original findings with a retest. Face validity and content validity were also examined.

RESULTS

Reliability was found to be high for the Borg CR-10 scale (0.898). Additionally a high correlation between the Borg CR-10 scale and Visual Analog Scale (VAS) was identified (rs = 0.754, P < 0.01).

CONCLUSIONS

This study found the Borg CR-10 scale to be a reliable and valid tool for monitoring the perceived exertion of office exercise training and may potentially be useful for occupational therapists to measure physical activity intensity levels.

The BASE-Program-A Multidimensional Approach for Health Promotion in Companies

Multidimensional assessments for conducting interventions are needed to achieve positive health effects within companies. BASE is an acronym, consisting of B = "Bedarfsbestimmung" (requirements); A = "Arbeitsplatzorganisation" (organisation of work); S = "Schulung des belastungsverträglichen Alltagshandelns" (coaching preventive behaviour at work); E = "Eigenverantwortung und Selbstwirksamkeit" (self-responsibility and self-efficacy). It is a prevention program designed to avoid and reduce work-related musculoskeletal diseases. It was developed to support prevention strategies within companies. It comprises aspects of health protection, ergonomics, exercise and self-efficacy. A comprehensive assessment will identify strain e.g., musculoskeletal discomforts due to body positions or psychological stress. Moreover, the general health status, preferences and barriers for participating in health promotion programs are evaluated. This analysis leads to practical and goal-oriented recommendations and interventions which suit the needs of companies and employees. These are executed onsite in real workplace situations and involve the introduction of first-hand experience in behavioural change. Therefore, this practical approach enhances the employees' acceptance and self-efficacy for health promotion. This can result in long-term health promoting behaviour. This article presents the outcome and sustainability effects of BASE in three different application fields (logistic, industrial and office workers).

Association between upper extremity musculoskeletal disorders and mental health status in office workers

BACKGROUND

Musculoskeletal Disorders (MSDs) can lead to potential adverse consequences for individuals and their organizations, and in various research, its relationship to physical and mental health of workforce has been studied.

OBJECTIVE

The purpose of this study was to determine the prevalence of MSDs of upper extremities among office workers and its association with mental health status.

METHODS

In this cross sectional study, 1488 out of 1630 office workers completed the Standardized Nordic Musculoskeletal Disorders Ques-tionnaire and General Health Questionnaire (GHQ-28) (response rate = 91.3%).

RESULTS

Upper extremity MSDs were reported in 410 (27.5%) office workers, including 269 (18.1%) shoulder, 79 (5.3%) elbow and 207 (13.9%) hand/wrist symptoms. Based on GHQ-28, 254 (17.1%) participants were found to be at risk of developing a psychiatric disorder that were observed in 26.7% of workers with MSDs symptoms. Shoulder (p < 0.001), elbow (p < 0.001) and hand/wrist (p < 0.001) MSDs were associated with poor mental health. Among the four GHQ-28 subscales (somatic symptoms, anxiety/insomnia, social dysfunction, and depression), anxiety/insomnia was strongly correlated with shoulders (P < 0.001), elbows (P = 0.002), and hands/wrists (P < 0.001) symptoms.

CONCLUSION

Office workers with upper extremity MSDs were more likely to be experiencing mental distress. This indicates a need for greater emphasis on preventive programs at workplace to support their psychological well-being.

Workplace exercise for control of occupational neck/shoulder disorders: a review of prospective studies

A review was conducted of prospective studies (1997-2014) examining the efficacy of exercise as a workplace intervention to control neck/shoulder pain, symptoms, and disability. The review identified 38 relevant studies - 20 were classified with positive effects, 13 with null effects, and 5 as inconclusive. Of the positive studies, 12 were consistent with Level I evidence, 3 with Level II evidence, and 5 with Level IV evidence. Specific resistance training (SRT) exercise appeared to be associated with more positive studies (eight Level I studies) than other exercise modalities such as general resistance training, general physical exercise, stretching, and movement awareness exercises. Studies of longer trial duration tended toward more null findings and lower program compliance. Evidence for a primary preventive effect of workplace exercise is minimal. The findings of this review suggest that workplace exercise can be effective as tertiary prevention and therapeutic relief of neck/shoulder symptoms, at least over the shorter term.

Effects of exercise on pain of musculoskeletal disorders: a systematic review

Work related musculoskeletal disorders are a major concern for public health and pain is the most important symptom. The aim of this study was to verify the effectiveness of workplace exercises to control musculoskeletal pain and its frequency, intensity, duration and type of exercises used. The search was conducted systematically in Medline, Pubmed, Embase, Bireme, Web of Knowledge and Pedro databases. The keywords "workplace", "exercise" and "musculoskeletal disorders" were used combined. Randomized control trials which performed worksite exercises were selected and the studies were assessed by their methodological soundness. Ten articles were selected which investigated the resistance training, cardio respiratory exercises, Pilates, stretching, postural orientation and exercises for relaxation. Workplace resistance training performed at 70-85% RM, three times a week for 20 minutes promotes reduction of the pain in shoulders, wrists, cervical, dorsal and lumbar spine. However, there is no consensus regarding the total duration of the intervention for the decrease of musculoskeletal pain in these regions. Level of Evidence I, Therapeutic Studies Investigating the Results of Treatment, Systematic Review of RCTs (Randomized and Controlled Clinical Studies).

Topics and trends in research on non-clinical interventions aimed at preventing prolonged work disability in workers compensated for work-related musculoskeletal disorders (WRMSDs): a systematic, comprehensive literature review

PURPOSE

This study sought to provide an overview of the main topics and trends in contemporary research on successful non-clinical interventions for preventing prolonged work disability in workers compensated for work-related musculoskeletal disorders (WRMSDs).

METHODS

A systematic electronic search (English and French) was performed in ten scientific databases using keywords and descriptors. After screening the identified titles and abstracts using specific sets of criteria, categorical and thematic analyses were performed on the retained articles.

RESULTS

Five main topics appear to dominate the research: (1) risk factors and determinants; (2) effectiveness of interventions (programmes, specific components, strategies and policies); (3) viewpoints, experiences and perceptions of specific actors involved in the intervention process; (4) compensation issues; and (5) measurement issues. A currently widespread trend is early screening to identify risks factors for appropriate intervention and multidisciplinary, multimodal approaches. Morover, workplace-related psychosocial and ergonomic factors are considered vital to the success and sustainability of return-to-work (RTW) interventions. Finally, involving workplace actors, and more specifically, affected workers, in the RTW process appears to be a powerful force in improving the chances of moving workers away from disabled status.

CONCLUSIONS

The findings of this literature review provide with information about the main topics and trends in research on rehabilitation interventions, revealing some successful modalities of intervention aimed at preventing prolonged work disability.

IMPLICATIONS FOR REHABILITATION

Successful intervention for preventing prolonged work disability in workers compensated for WRMSDs address workplace issues: physical and psychosocial demands at work, ability of the workers to fill these demands, work organization and support of the worker, and worker' beliefs and attitudes related to work. Successful intervention promotes collaboration, coordination between all actors and stakeholders involved in the process of rehabilitation. Strategies able to mobilize the employees, employers, insurers and health care providers are still needed to be implemented.

Musculoskeletal fitness and health-related quality of life characteristics among sedentary office workers affected by sub-acute, non-specific low back pain: a cross-sectional study

OBJECTIVES

To establish the level of musculoskeletal fitness and health-related quality of life (HRQoL) in sedentary office workers with sub-acute, non-specific low back pain, and compare the results with reference data for healthy sedentary office workers.

DESIGN

Cross-sectional study.

SETTING

Occupational secondary prevention setting.

PARTICIPANTS

One-hundred and ninety sedentary office workers: 118 suffering from sub-acute, non-specific low back pain (47 men and 71 women) and 72 age-matched healthy controls (30 men and 42 women).

MAIN OUTCOME MEASURES

Participants were assessed using a musculoskeletal fitness battery (sit-and-reach test, hand grip strength, lumbar and abdominal trunk muscle endurance, and back scratch test), the EuroQol-5D-3L, Oswestry Disability Questionnaire, and Roland Morris Disability Questionnaire. Data for both genders and conditions were compared.

RESULTS

Subjects with low back pain achieved lower scores in most of the fitness tests compared with healthy, age-matched controls. Trunk flexor and extensor endurance demonstrated the greatest difference in both men {flexion: median difference 59 [95% confidence interval (CI) 26 to 90]seconds; extension: median difference 24 [95% CI 20 to 68]} and women [flexion: median difference 59 (95% CI 5 to 85.50)seconds; extension: median difference 41 (95% CI 30 to 55)seconds]. Differences in HRQoL were also demonstrated between groups for both men and women, with the exception of the pain/discomfort dimension in women.

CONCLUSIONS

Sedentary office workers with sub-acute, non-specific low back pain had lower musculoskeletal fitness than healthy, age-matched controls, with the main difference found in endurance of the trunk muscles. HRQoL was also lower in workers with low back pain.

A web-based intervention to improve and prevent low back pain among office workers: a randomized controlled trial

STUDY DESIGN

Randomized controlled trial.

OBJECTIVES

To test the feasibility, safety, and efficacy of a web-based multidisciplinary intervention for office workers with subacute, nonspecific low back pain.

BACKGROUND

Low back pain is one of the most frequent ailments seen in primary care consultations.

METHODS

The trial included 100 office workers with subacute low back pain. The intervention group had access to both the study intervention and standard care. The control group had access to standard care only. Standard care was defined as all existing non-web-based interventions offered by the University of Extremadura's Preventive Medicine Service. The web-based program was offered via the Preventive Medicine Service website. The participants in the intervention group were asked to engage in the web-based program at their work site for 11 minutes each day, 5 days a week. Primary outcomes were functional disability, as measured by the Roland-Morris Disability Questionnaire, and health-related quality of life, as measured by the European Quality of Life-5 Dimensions-3 Levels. Secondary outcomes were the number of episodes of low back pain and trunk muscle endurance. Outcomes were measured before and after the 9-month intervention period.

RESULTS

Over the 9-month study, the score on the Roland-Morris Disability Questionnaire for the participants in the web-based intervention group improved by a mean of -7.36 points (95% confidence interval [CI]: -8.41, -6.31) compared to a worsening of 1.89 points (95% CI: 0.71, 2.65) in the control group. The between-group difference in change on the Roland-Morris Disability Questionnaire over the study period was -9.25 points (95% CI: -10.57, -7.89). Similarly, over the 9-month study, the intervention group had a significant improvement in quality of life of 0.24 points (95% CI: 0.20, 0.29) compared to the control group.

CONCLUSION

A 9-month web-based intervention is feasible and effective to improve function and health-related quality of life and to decrease episodes of low back pain among office workers with a history of subacute, nonspecific low back pain.