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Madeleine P, Szeto GPY, Heredia-Rizo AM. Effects of biofeedback and strength training interventions on neck-shoulder sensory-motor responses among visual display unit users. A narrative review. J Electromyogr Kinesiol 2024; 79:102936. [PMID: 39321540 DOI: 10.1016/j.jelekin.2024.102936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 08/23/2024] [Accepted: 09/18/2024] [Indexed: 09/27/2024] Open
Abstract
Workplace biofeedback and strength training interventions have been conducted to treat neck-shoulder pain among visual display unit users. Biofeedback has been given using surface electromyography, mechanomyography, oculometrics, and spinal posture to promote either muscle relaxation, muscle activation or change in posture. Strength training has been performed mostly using basic exercise equipment according to various progression principles. These two types of interventions would thus result in increased ability to cope with physical workload or improved individual resources. In this narrative review, we analyzed the design, methods, and results of the retrieved studies on neck-shoulder sensory-motor responses among visual display unit users. A few studies have reported both an immediate decrease in neck-shoulder pain and an improvement after the end of the intervention following biofeedback, often based on surface electromyography, and strength training interventions targeting the shoulder girdle. Biofeedback and strength training interventions can respectively modify ability to cope with physical workload and individual resources resulting in increased physical capacity among visual display unit users. The long-term effects and the applicability of these approaches remain to be demonstrated at workplace settings. Future studies could combine both modalities to increase versatility of the interventions.
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Affiliation(s)
- Pascal Madeleine
- ExerciseTech, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, 9260 Klarup, Denmark.
| | - Grace P Y Szeto
- School of Medical and Health Sciences, Tung Wah College, Hong Kong, China.
| | - Alberto Marcos Heredia-Rizo
- Instituto de Biomedicina de Sevilla, IBiS, Departamento de Fisioterapia, Universidad de Sevilla, Sevilla, Spain; CTS 1110: Understanding Movement and Self in Health from Science (UMSS) Research Group, Andalusia, Spain.
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Garcia MG, Estrella M, Peñafiel A, Arauz PG, Martin BJ. Impact of 10-Min Daily Yoga Exercises on Physical and Mental Discomfort of Home-Office Workers During COVID-19. HUMAN FACTORS 2023; 65:1525-1541. [PMID: 34595984 PMCID: PMC11107138 DOI: 10.1177/00187208211045766] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 08/18/2021] [Accepted: 08/24/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE Evaluate the effects of 10 min/day of yoga for 1 month on musculoskeletal discomfort and mood disturbance of home-office workers. BACKGROUND The COVID-19 pandemic forced many people to switch to teleworking. The abrupt change from an office setting to an improvised home-office may negatively affect the musculoskeletal and emotional health of workers. By providing mental and physical exercises, yoga may be effective in reducing adverse effects. METHOD Fifty-four participants (42 women, 12 men) followed a 1-month yoga program, while 40 participants (26 women, 14 men) continued with their common work routine. The Cornell Musculoskeletal Discomfort Questionnaire was used to evaluate severity, interference with work and frequency of pain, and to obtain a total discomfort score for 25 body areas. Mood disturbance was evaluated with the Profile of Mood States questionnaire. Both groups completed both questionnaires, before and after the experimentation period. RESULTS After 1 month, for the yoga group only, significant reductions were observed in the discomfort of eyes, head, neck, upper and lower back, right wrist, and hips/buttocks, as well as reductions in discomfort severity, frequency and interference for the neck, upper and lower back. Total mood disturbance was also significantly reduced for the yoga group only. No favorable changes occurred for the control group. CONCLUSION The yoga intervention program appears to reduce musculoskeletal discomfort and mood disturbance of home-office workers. APPLICATION Sedentary workers may benefit from 10 min/day of yoga during the workday to attenuate potential physical and emotional discomfort during the current pandemic and beyond.
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Teichert F, Karner V, Döding R, Saueressig T, Owen PJ, Belavy DL. Effectiveness of Exercise Interventions for Preventing Neck Pain: A Systematic Review With Meta-analysis of Randomized Controlled Trials. J Orthop Sports Phys Ther 2023; 53:594–609. [PMID: 37683100 DOI: 10.2519/jospt.2023.12063] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/10/2023]
Abstract
OBJECTIVE: To update the evidence on the effectiveness of exercise interventions to prevent episodes of neck pain. DESIGN: Systematic review with meta-analysis. LITERATURE SEARCH: MEDLINE, Embase, CENTRAL, CINAHL, SPORTDiscus, PEDro, and trial registries from inception to December 2, 2022. Forward and backward citation searches. STUDY SELECTION CRITERIA: Randomized controlled trials (RCTs) that enrolled adults without neck pain at baseline and compared exercise interventions to no intervention, placebo/sham, attention control, or minimal intervention. Military populations and astronauts were excluded. DATA SYNTHESIS: Random-effects meta-analysis. Risk of bias was assessed using the Cochrane RoB 2 tool. The certainty of evidence was judged according to the GRADE approach. RESULTS: Of 4703 records screened, 5 trials (1722 participants at baseline) were included and eligible for meta-analysis. Most (80%) participants were office workers. Risk of bias was rated as some concerns for 2 trials and high for 3 trials. There was moderate-certainty evidence that exercise interventions probably reduce the risk of a new episode of neck pain (OR, 0.49; 95% confidence interval: 0.31, 0.76) compared to no or minimal intervention in the short-term (≤12 months). The results were not robust to sensitivity analyses for missing outcome data. CONCLUSION: There was moderate-certainty evidence supporting exercise interventions for reducing the risk for an episode of neck pain in the next 12 months. The clinical significance of the effect is unclear. J Orthop Sports Phys Ther 2023;53(10):1-16. Epub: 8 September 2023. doi:10.2519/jospt.2023.12063.
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Affiliation(s)
- Florian Teichert
- Division of Physiotherapy, Department of Applied Health Sciences, Hochschule für Gesundheit (University of Applied Sciences), Bochum, Germany
| | - Vera Karner
- Division of Physiotherapy, Department of Applied Health Sciences, Hochschule für Gesundheit (University of Applied Sciences), Bochum, Germany
| | - Rebekka Döding
- Division of Physiotherapy, Department of Applied Health Sciences, Hochschule für Gesundheit (University of Applied Sciences), Bochum, Germany
| | | | - Patrick J Owen
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Daniel L Belavy
- Division of Physiotherapy, Department of Applied Health Sciences, Hochschule für Gesundheit (University of Applied Sciences), Bochum, Germany
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Sjøgaard G, Søgaard K, Hansen AF, Østergaard AS, Teljigovic S, Dalager T. Exercise Prescription for the Work-Life Population and Beyond. J Funct Morphol Kinesiol 2023; 8:73. [PMID: 37367237 PMCID: PMC10299214 DOI: 10.3390/jfmk8020073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 05/21/2023] [Accepted: 05/23/2023] [Indexed: 06/28/2023] Open
Abstract
The background for this paper concerns a high frequency of work-related disorders that may result from physical exposure at work being highly sedentary, repetitive-monotonous, or physically demanding. This may result in levels of physical inactivity or strenuous activity impairing health. The aim is to present an evidence-based exercise prescription for the work-life population and beyond. The exercise program is designed to be feasible for use at the workplace and/or during leisure time and to improve health, workability, productivity, sickness absence, etc. The specific concept of Intelligent Physical Exercise Training, IPET, includes the assessment of several health-related variables, including musculoskeletal disorders, physical capacity, and physical exposure at work and/or daily life activity. An algorithm with cut-points for prescribing specific exercises is provided. Exercise programs in praxis are addressed through descriptions of precise executions of various prescribed exercises and possible alternatives to optimize variation and adherence. Finally, perspectives on the significance of introducing IPET and the ongoing, as well as future lines of development, are discussed.
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Affiliation(s)
- Gisela Sjøgaard
- Department of Sports Science and Clinical Biomechanics, Faculty of Health Sciences, University of Southern Denmark, DK-5230 Odense M, Denmark; (K.S.); (A.F.H.); or (S.T.); (T.D.)
| | - Karen Søgaard
- Department of Sports Science and Clinical Biomechanics, Faculty of Health Sciences, University of Southern Denmark, DK-5230 Odense M, Denmark; (K.S.); (A.F.H.); or (S.T.); (T.D.)
| | - Anne Faber Hansen
- Department of Sports Science and Clinical Biomechanics, Faculty of Health Sciences, University of Southern Denmark, DK-5230 Odense M, Denmark; (K.S.); (A.F.H.); or (S.T.); (T.D.)
| | | | - Sanel Teljigovic
- Department of Sports Science and Clinical Biomechanics, Faculty of Health Sciences, University of Southern Denmark, DK-5230 Odense M, Denmark; (K.S.); (A.F.H.); or (S.T.); (T.D.)
| | - Tina Dalager
- Department of Sports Science and Clinical Biomechanics, Faculty of Health Sciences, University of Southern Denmark, DK-5230 Odense M, Denmark; (K.S.); (A.F.H.); or (S.T.); (T.D.)
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Yang H, Lv Y, Chen S, Xing B, Wu J. An Evaluation Study of a New Designed Oscillating Hydraulic Trainer of Neck. Healthcare (Basel) 2023; 11:healthcare11101518. [PMID: 37239804 DOI: 10.3390/healthcare11101518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 05/07/2023] [Accepted: 05/18/2023] [Indexed: 05/28/2023] Open
Abstract
In view of the importance of neck strength training and the lack of adequate training equipment, this study designed a new oscillating hydraulic trainer (OHT) of neck based on oscillating hydraulic damper. We used surface electromyography (sEMG) and subjective ratings to evaluate the neck OHT and compared the results with a simple hat trainer (HATT) and traditional weight trainer (TWT) to verify the feasibility and validity of the OHT. Under similar exercise conditions, 12 subjects performed a set of neck flexion and extension exercise with these 3 trainers. The sEMG signals of targeted muscles were collected in real time, and subjects were asked to complete subjective evaluations of product usability after exercise. The results showed that the root mean square (RMS%) of sEMG indicated that the OHT could provide two-way resistance and train the flexors and extensors simultaneously. The overall degree of muscle activation with OHT was higher than that with the other two trainers in one movement cycle. In terms of resistance characteristics exhibited by the sEMG waveform, duration (D) with OHT was significantly longer than HATT and TWT when exercising at a high speed, while Peak Timing (PT) was later. The ratings of product usability and performing usability of OHT were remarkably higher than that of HATT and TWT. Based on the above results, the OHT was proved to be more suitable for strength training, such as neck muscles, which were getting more attention gradually, but lacked mature and special training equipment.
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Affiliation(s)
- Hongchun Yang
- Design and Research Institute, Zhejiang University of Technology, Hangzhou 310023, China
| | - Yawei Lv
- School of Design and Architecture, Zhejiang University of Technology, Hangzhou 310023, China
| | - Sisi Chen
- School of Design and Architecture, Zhejiang University of Technology, Hangzhou 310023, China
| | - Baixi Xing
- Design and Research Institute, Zhejiang University of Technology, Hangzhou 310023, China
| | - Jianfeng Wu
- Design and Research Institute, Zhejiang University of Technology, Hangzhou 310023, China
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Jafarian Tangrood Z, Spontelli Gisselman A, Sole G, Cury Ribeiro D. Clinical course of pain and function in subacromial shoulder pain: a systematic review with meta-analysis. PHYSICAL THERAPY REVIEWS 2023. [DOI: 10.1080/10833196.2023.2192620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/01/2023]
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Overbye M, Wagner U. Momentum lost or creating new constellations? Insights from an exercise-at-work project during the COVID-19 pandemic - a mixed methods approach. INTERNATIONAL REVIEW FOR THE SOCIOLOGY OF SPORT 2023; 58:278-307. [PMID: 38603367 PMCID: PMC9198563 DOI: 10.1177/10126902221101154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Abstract
Exercise-at-work programmes have been identified as venues to decrease inequalities in physical activity and exercise between socioeconomic groups and to improve employees' health and wellbeing. Drawing on a multiple institutional logics perspective and adopting a mixed-methods approach, this paper investigates how employees, exercise-ambassadors and managers at five Danish workplaces experience Covid-19 induced changes to a 1-year exercise-at-work project, and how these changes impacted upon the workplace. Our results suggest that Covid-19 and the altered format of exercise and delivery polarized employees' opportunities for exercise at work. However, the generally positive experiences of exercise-at-work activities and their influence on social environment and collaboration (identified prior to Covid-19 lockdown) remained among those employees who continued with activities. Self-organized adaptions and models of employee exercise which emerged suggest that community logic endured despite the crisis. We show how Covid-19 induced organizational changes led to interplays between institutional logics, with family and state logics becoming more prominent. Specifically, the exercise-at-work programme changed from an aligned model, with complementary logics and minimal conflict, to a model where logics of profession and corporation became dominant at the expense of community logic (exercise-ambassadors activities), but constrained by a state and a family logic.
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Affiliation(s)
- Marie Overbye
- Marie Overbye, Faculty of Health Sciences
and Sport, University of Stirling, Stirling FK9 4LA, UK.
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Holzgreve F, Fraeulin L, Maurer-Grubinger C, Betz W, Erbe C, Weis T, Janssen K, Schulte L, de Boer A, Nienhaus A, Groneberg DA, Ohlendorf D. Effects of Resistance Training as a Behavioural Preventive Measure on Musculoskeletal Complaints, Maximum Strength and Ergonomic Risk in Dentists and Dental Assistants. SENSORS (BASEL, SWITZERLAND) 2022; 22:8069. [PMID: 36298418 PMCID: PMC9609802 DOI: 10.3390/s22208069] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 10/14/2022] [Accepted: 10/19/2022] [Indexed: 06/16/2023]
Abstract
INTRODUCTION For dental professionals, musculoskeletal disorders (MSD) are common health hazards and resistance training programmes have been promising approaches in the quest for a reduction in the pain intensity of these professionals. Therefore, the aim of the current study was to investigate the effect of a trunk-oriented 10-week resistance training programme. METHOD In total, the study was conducted with 17 dentists and dental assistants (3 m/14 f) over a course of 10 weeks, with workouts being performed 2 times a week using a 60 min intervention programme consisting of 11 resistance training exercises. The outcome values that were collected were the pain intensity (visual analogue scale (VAS) combined with a modified version of the Nordic Questionnaire), the MVIC and the rapid upper limb assessment (RULA) score (based on data from inertial motion units) during a standardised dental treatment protocol. RESULTS A significant reduction in pain intensity was found for each queried body region: the neck, upper back, lower back and the right and left shoulders. The maximum voluntary isometric contraction (MVIC) improved significantly in all outcome measures: flexion, extension, right and left lateral flexion and right and left rotation. CONCLUSIONS A 10-week resistance training programme for dentists and dental assistants had significant effects on pain intensity reduction and the MVIC of the musculature of the trunk and is, therefore, suitable as a behavioural preventive measure against MSD in dental professionals.
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Affiliation(s)
- Fabian Holzgreve
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University, Building 9a, Theodor-Stern-Kai 7, 60596 Frankfurt am Main, Germany
| | - Laura Fraeulin
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University, Building 9a, Theodor-Stern-Kai 7, 60596 Frankfurt am Main, Germany
| | - Christian Maurer-Grubinger
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University, Building 9a, Theodor-Stern-Kai 7, 60596 Frankfurt am Main, Germany
| | - Werner Betz
- Institute of Dentistry, Department of Dental Radiology, Goethe University, Theodor-Stern-Kai 7, 60596 Frankfurt am Main, Germany
| | - Christina Erbe
- Department of Orthodontics, University Medical Center of the Johannes Gutenberg-University Mainz, Augustusplatz 2, 55131 Mainz, Germany
| | - Tim Weis
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University, Building 9a, Theodor-Stern-Kai 7, 60596 Frankfurt am Main, Germany
| | - Keno Janssen
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University, Building 9a, Theodor-Stern-Kai 7, 60596 Frankfurt am Main, Germany
| | - Lisa Schulte
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University, Building 9a, Theodor-Stern-Kai 7, 60596 Frankfurt am Main, Germany
| | - Amaya de Boer
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University, Building 9a, Theodor-Stern-Kai 7, 60596 Frankfurt am Main, Germany
| | - Albert Nienhaus
- Principles of Prevention and Rehabilitation Department (GPR), Institute for Statutory Accident Insurance and Prevention in the Health and Welfare Services (BGW), 22089 Hamburg, Germany
| | - David A. Groneberg
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University, Building 9a, Theodor-Stern-Kai 7, 60596 Frankfurt am Main, Germany
| | - Daniela Ohlendorf
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University, Building 9a, Theodor-Stern-Kai 7, 60596 Frankfurt am Main, Germany
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Specific versus Non-Specific Exercises for Chronic Neck or Shoulder Pain: A Systematic Review. J Clin Med 2021; 10:jcm10245946. [PMID: 34945241 PMCID: PMC8706212 DOI: 10.3390/jcm10245946] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Revised: 12/07/2021] [Accepted: 12/11/2021] [Indexed: 02/02/2023] Open
Abstract
The current systematic review aimed to compare the effect of injury-focused (specific) exercises versus more general (non-specific) exercises on pain in patients with chronic neck or shoulder pain. We searched PubMed, EMBASE, and Web of Science. Two reviewers screened and selected studies, extracted outcomes, assessed risk of bias, and rated the quality of evidence. A total of nine eligible studies, represented in 13 articles, were identified, with a considerable risk of bias. One article investigated the acute effect of single bouts of exercise on pain and reported an immediate pain reduction after non-specific exercise. Regarding short-term effects, seven out of the nine studies found no differences in pain between interventions, with inconsistent results among two other studies. Concerning the long-term effects, while pain reduction seems to be favored by specific exercises (two out of four articles), the best format is still unclear. Based on the acute effects, a single bout of non-specific exercise seems to be a better option for pain-relief for patients with chronic neck or shoulder pain. For short-term effects, there are no differences in pain between specific and non-specific exercises. Regarding long-term effects, specific exercises seem to be the best option. Nevertheless, more studies are warranted.
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Picón SPB, Batista GDA, Pitangui ACR, de Araújo RC. Effects of Workplace-Based Intervention for Shoulder Pain: A Systematic Review and Meta-analysis. JOURNAL OF OCCUPATIONAL REHABILITATION 2021; 31:243-262. [PMID: 33006720 DOI: 10.1007/s10926-020-09927-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/18/2020] [Indexed: 06/11/2023]
Abstract
The main objective of this study is to update the evidence related to the effectiveness of exercise and ergonomic interventions in the perception of shoulder pain intensity in workers considering the shoulder pain intensity and the minimum clinically important change in the analysis. The bibliographic search was conducted in seven databases (Cochrane, EMBASE, SciELO, PubMed, PEDro, Web of Science and Scopus) from March to April 2019. The study selection included randomized controlled trials (RCTs) involving workers with shoulder pain who underwent physical exercises, ergonomics, and combined interventions. To analyze the RCTs, the intensity of pain was divided into two subgroups < 3 and ≥ 3 (0-10 points scale). A total of 27 RCTs were included in the qualitative synthesis considering the perception scales of shoulder pain intensity and the PEDro scale score of assessment of RCTs quality and risk of bias. Within these, seven RCTs were included in the quantitative synthesis. The overall effectiveness of interventions was calculated using a meta-analysis method, and the associated measurement used as a mean difference. The meta-analysis revealed that exercise interventions in workers with shoulder pain > 3 presented a minimally clincially important difference (MCID), but with no difference in workers with pain < 3. The interventions with exercise in workers with pain ≥ 3 at baseline reported a beneficial effect in reducing shoulder pain intensity, and a MCID. However, there was no significant difference for workers with pain < 3 and the effects of ergonomic interventions are still uncertain to reduce shoulder pain in workers.
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Affiliation(s)
| | | | | | - Rodrigo Cappato de Araújo
- Associated Graduate Program in Physical Education UPE/UFPB, Recife, Brazil
- Department of Physical Therapy, University of Pernambuco, Petrolina, Brazil
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Meacock J, Mukherjee S, Sheikh A. Increasing patient flow through neurosurgical critical care: the Leeds Improvement Method. BMJ Open Qual 2021; 10:bmjoq-2020-001143. [PMID: 34035127 PMCID: PMC8154938 DOI: 10.1136/bmjoq-2020-001143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 05/15/2021] [Indexed: 11/24/2022] Open
Abstract
At Leeds General Infirmary, a busy tertiary centre for neurosurgery, there has been little visibility of the step-down status of the patients from intensive care to high dependency or from the latter to a ward bed. The only record of the current situation was limited to the paper notes of the bed managers. Furthermore, accuracy of electronic systems used for staffing levels and bed state were underused. There were gaps in information and furthermore information within the system was unreliable (together defined as ‘defects’). These defects mandated bed managers’ physical presence on each ward to obtain reliable data. This led to unwarranted critical care stays and resultant high rates (up to 40%) of elective operation cancellations requiring a critical care bed. The Leeds Improvement Method using principles of the Toyota Production System aimed to improve patient flow through critical care and to assess the impact on elective case activity. Problems were identified and changes were implemented over a 1-week period. The changes included measures to reduce time taken for collation of critical bed-state information and improving patient and staffing data quality collected in the electronic patient management system (EPMS) and electronic staffing record (ESR). Impact was monitored for 30 days pre-implementation and post-implementation. Following intervention, the time taken by the bed manager to gather live bed-state information decreased from 50 to 9 min; the EPMS storing correct bed-state data was improved from 71% to 0% defect; the ESR was improved from 100% to 4% defects; critical care patient step-downs occurring at night (after 20:00) improved from 80% to 20%; and the number of cancelled elective cases over a 30-day period reduced from nine to one. Implementing these organisational efficiencies can significantly improve critical care patient flow and elective case throughput.
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Affiliation(s)
- James Meacock
- Neurosciences, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | | | - Asim Sheikh
- Neurosciences, Leeds Teaching Hospitals NHS Trust, Leeds, UK
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Waongenngarm P, van der Beek AJ, Akkarakittichoke N, Janwantanakul P. Effects of an active break and postural shift intervention on preventing neck and low-back pain among high-risk office workers: a 3-arm cluster-randomized controlled trial. Scand J Work Environ Health 2021; 47:306-317. [PMID: 33906239 PMCID: PMC8091075 DOI: 10.5271/sjweh.3949] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVE This study evaluated the effects of the promotion of active breaks and postural shifts on new onset of neck and low-back pain during a 6-month follow-up among high-risk office workers. METHODS A 3-arm cluster-randomized controlled trial with 6-month follow-up was conducted among healthy but high-risk office workers. Participants were recruited from six organizations in Bangkok, Thailand (N=193) and randomly assigned at cluster level into active break intervention (N=47), postural shift intervention (N=46), and control (N=100) groups. Participants in the intervention groups received a custom-designed apparatus to facilitate designated active breaks and postural shifts during work. Participants in the control group received a placebo seat pad. The primary outcome measure was new onset of neck and low-back pain during 6-month follow-up. Analyses were performed using Cox proportional hazard models. RESULTS One-hundred and eighty-six (96%) predominantly female participants were successfully followed up over six months. New onset of neck pain during the 6-month follow-up occurred in 17%, 17%, and 44% of the participants in the active break, postural shift, and control groups, respectively. For new onset of low-back pain, these percentages were 9%, 7%, and 33%, respectively. Hazard rate (HR) ratios after adjusting for biopsychosocial factors indicated a protective effect of the active break and postural shift interventions for neck pain [HRadj 0.45, 95% confidence interval (CI) 0.20-0.98 for active break and HRadj 0.41, 95% CI 0.18-0.94 for postural shift] and low-back pain (HRadj 0.34, 95% CI 0.12-0.98 for active break and HRadj 0.19, 95% CI 0.06-0.66 for postural shift). CONCLUSION Interventions to increase either active breaks or postural shifts reduced new onset of neck and low-back pain among high-risk office workers.
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Affiliation(s)
- Pooriput Waongenngarm
- Prawit Janwantanakul, Department of Physical Therapy, Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok, 10330, Thailand.
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Johnston V, Chen X, Welch A, Sjøgaard G, Comans TA, McStea M, Straker L, Melloh M, Pereira M, O'Leary S. A cluster-randomized trial of workplace ergonomics and neck-specific exercise versus ergonomics and health promotion for office workers to manage neck pain - a secondary outcome analysis. BMC Musculoskelet Disord 2021; 22:68. [PMID: 33435941 PMCID: PMC7805092 DOI: 10.1186/s12891-021-03945-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Accepted: 01/02/2021] [Indexed: 01/09/2023] Open
Abstract
Background Neck pain is prevalent among office workers. This study evaluated the impact of an ergonomic and exercise training (EET) intervention and an ergonomic and health promotion (EHP) intervention on neck pain intensity among the All Workers and a subgroup of Neck Pain cases at baseline. Methods A 12-month cluster-randomized trial was conducted in 14 public and private organisations. Office workers aged ≥18 years working ≥30 h per week (n = 740) received an individualised workstation ergonomic intervention, followed by 1:1 allocation to the EET group (neck-specific exercise training), or the EHP group (health promotion) for 12 weeks. Neck pain intensity (scale: 0–9) was recorded at baseline, 12 weeks, and 12 months. Participants with data at these three time points were included for analysis (n = 367). Intervention group differences were analysed using generalized estimating equation models on an intention-to-treat basis and adjusted for potential confounders. Subgroup analysis was performed on neck cases reporting pain ≥3 at baseline (n = 96). Results The EET group demonstrated significantly greater reductions in neck pain intensity at 12 weeks compared to the EHP group for All Workers (EET: β = − 0.53 points 95% CI: − 0.84– − 0.22 [36%] and EHP: β = − 0.17 points 95% CI: − 0.47–0.13 [10.5%], p-value = 0.02) and the Neck Cases (EET: β = − 2.32 points 95% CI: − 3.09– − 1.56 [53%] and EHP: β = − 1.75 points 95% CI: − 2.35– − 1.16 [36%], p = 0.04). Reductions in pain intensity were not maintained at 12 months with no between-group differences observed in All Workers (EET: β = − 0.18, 95% CI: − 0.53–0.16 and EHP: β = − 0.14 points 95% CI: − 0.49–0.21, p = 0.53) or Neck Cases, although in both groups an overall reduction was found (EET: β = − 1.61 points 95% CI: − 2.36– − 0.89 and EHP: β = − 1.9 points 95% CI: − 2.59– − 1.20, p = 0.26). Conclusion EET was more effective than EHP in reducing neck pain intensity in All Workers and Neck Cases immediately following the intervention period (12 weeks) but not at 12 months, with changes at 12 weeks reaching clinically meaningful thresholds for the Neck Cases. Findings suggest the need for continuation of exercise to maintain benefits in the longer term. Clinical trial registration hACTRN12612001154897 Date of Registration: 31/10/2012. Supplementary Information The online version contains supplementary material available at 10.1186/s12891-021-03945-y.
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Affiliation(s)
- Venerina Johnston
- The University of Queensland, School of Health and Rehabilitation Sciences, St Lucia, Brisbane, Queensland, 4067, Australia.
| | - Xiaoqi Chen
- The University of Queensland, School of Health and Rehabilitation Sciences, St Lucia, Brisbane, Queensland, 4067, Australia
| | - Alyssa Welch
- The University of Queensland, Centre for Health Services Research, Brisbane, Australia
| | - Gisela Sjøgaard
- University of Southern Denmark, Department of Sport Science and Clinical Biomechanics, Faculty of Health Sciences, Odense, Denmark
| | - Tracy A Comans
- The University of Queensland, Centre for Health Services Research, Brisbane, Australia
| | - Megan McStea
- The University of Queensland, Centre for Health Services Research, Brisbane, Australia
| | - Leon Straker
- Curtin University, School of Physiotherapy and Exercise Science, Perth, Australia
| | - Markus Melloh
- Zurich University of Applied Sciences, School of Health Professions, Institute of Health Sciences, Winterthur, Switzerland.,Curtin University, Curtin Medical School, Perth, Australia.,The University of Western Australia, UWA Medical School, Perth, Australia
| | - Michelle Pereira
- The University of Queensland, School of Health and Rehabilitation Sciences, St Lucia, Brisbane, Queensland, 4067, Australia.,National Healthcare Group, Health Services and Outcomes Research, 3 Fusionopolis Link #03-08, Singapore
| | - Shaun O'Leary
- The University of Queensland, School of Health and Rehabilitation Sciences, St Lucia, Brisbane, Queensland, 4067, Australia.,Royal Brisbane and Women's Hospital, Department of Physiotherapy, Metro North Hospital Health Service, Brisbane, Australia
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Murray M, Lange B, Søgaard K, Sjøgaard G. The Effect of Physical Exercise Training on Neck and Shoulder Muscle Function Among Military Helicopter Pilots and Crew: A Secondary Analysis of a Randomized Controlled Trial. Front Public Health 2020; 8:546286. [PMID: 33330303 PMCID: PMC7719717 DOI: 10.3389/fpubh.2020.546286] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 10/27/2020] [Indexed: 11/21/2022] Open
Abstract
Introduction: This study presents secondary outcome analyses, in terms of muscle function [i.e., maximal voluntary contraction (MVC) and rate of torque development (RTD)] from a parallel group, single blinded, randomized controlled trial introducing a physical exercise training intervention aiming to reduce neck pain among military helicopter pilots and crew-members. Methods: Participants (50 pilots, 58 crew-members) were recruited from the Royal Danish Air Force and randomized to either an exercise-training-group (ETG; n = 35) or a reference-group (REF; n = 34). Participants in ETG received 20 weeks of self-administered exercise training specifically tailored to target the neck and shoulder muscles. REF received no training. Outcome: (1) MVC was measured for cervical extension and flexion as well as shoulder elevation and abduction, (2) RTD was measured for cervical extension and flexion. Adherence to training was self-reported and categorized as regular if performed at least once a week. Results: MVC for cervical extension was significantly increased at follow-up in ETG (37.5 ± 11.2 Nm at baseline, change: 2.1 ± 8.3 Nm) compared to REF (38.1 ± 10.7 Nm at baseline, change: -2.4 ± 6.8 Nm) according to intension-to-treat analysis (p = 0.018). Likewise, RTD was significantly increased in ETG for cervical extension (149.6 ± 63.3 Nm/s at baseline, change: 14.7 ± 49.0 Nm/s) compared to REF (165.4 ± 84.7 Nm/s at baseline, change: -16.9±70.9 Nm/s) (p = 0.034). The cervical extension/flexion MVC-ratio was significantly different at follow-up (p = 0.039) between ETG (1.5 ± 0.5 at baseline, change: -0.0 ± 0.3) compared to REF (1.5 ± 0.5 at baseline, change: -0.2 ± 0.4). Per-protocol analysis of MVC, including only participants in ETG with regular training adherence (n = 10), showed a significant increase for cervical extension (33.2 ± 7.3 Nm at baseline, change: 6.0 ± 5.4 Nm) and shoulder elevation right side (143.0 ± 25.8 Nm at baseline, change: 15.8 ± 18.1 Nm). Conclusion: Physical exercise training significantly improved MVC and RTD in the upper neck extensors. Only approximately 1/3 of participants in ETG adhered to training regularly, which likely attenuated the effectiveness of the training intervention on neck and shoulder muscle function. Future studies should focus on the practical implementation of self-administered exercise training to improve adherence.
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Affiliation(s)
- Mike Murray
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Britt Lange
- Department of Anesthesia and Intensive Care Medicine, Odense University Hospital, Odense, Denmark
| | - Karen Søgaard
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Gisela Sjøgaard
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
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Frutiger M, Borotkanics R. Systematic Review and Meta-Analysis Suggest Strength Training and Workplace Modifications May Reduce Neck Pain in Office Workers. Pain Pract 2020; 21:100-131. [PMID: 32657531 DOI: 10.1111/papr.12940] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 07/05/2020] [Accepted: 07/08/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Neck pain is a burdensome musculoskeletal disorder in office workers. Workplace interventions aim to prevent and minimize the effect of neck pain and improve work quality. However, the summed effect of workplace interventions on neck pain in office workers remains unclear. This systematic review with meta-analysis and meta-regression evaluated the summed effect of workplace interventions on neck pain in office workers. METHODS We searched 7 electronic databases to January 2020 for randomized clinical trials. We selected studies, independently extracted data, and assessed risk of bias. Meta-analyses were carried out along with normalized trend plots. RESULTS Twenty-nine trials, including 8 of high quality, met our inclusion criteria. Normalized trend plots indicate that neck strengthening demonstrated the sharpest decrease in pain scores. The results of pre- and post-outcome measurement of the effect of activity performance and workplace modification showed significant improvements in self-reported neck pain (P ≤ 0.001). Meta-regression was used to evaluate the effect of time, but it was not significant. CONCLUSIONS There is low-quality evidence that neck strengthening and tailored workstation modifications are effective at reducing neck pain in office workers. Further high-quality research methodology, including clinicians, is important to evaluate this summed effect.
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Affiliation(s)
- Martin Frutiger
- Department of Chiropractic, Faculty of Science and Engineering, Macquarie University, North Ryde, NSW, Australia
| | - Robert Borotkanics
- Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand
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16
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Saeterbakken AH, Makrygiannis P, Stien N, Solstad TEJ, Shaw M, Andersen V, Pedersen H. Dose-response of resistance training for neck-and shoulder pain relief: a workplace intervention study. BMC Sports Sci Med Rehabil 2020; 12:8. [PMID: 32266072 PMCID: PMC7110779 DOI: 10.1186/s13102-020-0158-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 01/13/2020] [Indexed: 11/30/2022]
Abstract
Background Musculoskeletal disorders are highly prevalent among office workers, with strong evidence suggesting that workplace-based resistance training programs can prevent several upper extremity musculoskeletal disorders. The aim of the present study was to examine the dose-response relationship between resistance training frequency and pain relief among office workers with neck- and shoulder pain. Methods Thirty participants with mild to moderate neck- and shoulder pain attended a 16-week intervention starting with an eight-week control period followed by an eight-week training period. After the control period, the participants were randomized into either a 10 min (TG10) or 2 × 10 min (TG2) workplace-based, high-intensity neck- and shoulder specific resistance training program that was executed 5 days per week and consisting of four exercises. The participants were tested pre and post each period for mean and worst pain using the 0-100 mm visual analog scale (VAS), 0-100 mm health-related quality of life and isometric strength of the neck-and shoulder region. The analysis of variance (ANOVA) and Friedman with Bonferroni post hoc corrections were used to assess differences in between and within groups for the three testing times pre, mid and post intervention. Results No differences were observed between the groups in any of the variables in the control period (p = 0.27–0.97) or training period (p = 0.37–0.68). When merging the two groups, the mean and worst pain was reduced by 25 and 43% (p = 0.05 and < 0.01, ES = 0.41 and 0.55) in the training period in addition to 10.6% increase in health-related quality of life (p = 0.01, ES = 0.52). No difference in strength was observed (p = 0.29–0.85). Conclusion Daily bouts of specific high-intensity resistance training of the shoulder and neck region at the workplace reduced neck- and shoulder pain and improved quality of life of office workers. However, 10 min bouts were equally effective as 2 × 10 min bouts per day. The authors recommend office workers to perform daily neck- and shoulder resistance training to possibly prevent and/or decrease pain in the neck- and shoulder area. Trial registration ISRCTN69968888, retrospectively registered (24/09/2019).
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Affiliation(s)
- Atle Hole Saeterbakken
- Faculty of Education, Arts and Sports, Western Norway University of Applied Sciences, Sogndal, Norway
| | - Paula Makrygiannis
- Faculty of Education, Arts and Sports, Western Norway University of Applied Sciences, Sogndal, Norway
| | - Nicolay Stien
- Faculty of Education, Arts and Sports, Western Norway University of Applied Sciences, Sogndal, Norway
| | - Tom Erik Jorung Solstad
- Faculty of Education, Arts and Sports, Western Norway University of Applied Sciences, Sogndal, Norway
| | - Matthew Shaw
- Faculty of Education, Arts and Sports, Western Norway University of Applied Sciences, Sogndal, Norway
| | - Vidar Andersen
- Faculty of Education, Arts and Sports, Western Norway University of Applied Sciences, Sogndal, Norway
| | - Helene Pedersen
- Faculty of Education, Arts and Sports, Western Norway University of Applied Sciences, Sogndal, Norway
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17
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Welch A, Healy G, Straker L, Comans T, O'Leary S, Melloh M, Sjøgaard G, Pereira M, Chen X, Johnston V. Process evaluation of a workplace-based health promotion and exercise cluster-randomised trial to increase productivity and reduce neck pain in office workers: a RE-AIM approach. BMC Public Health 2020; 20:180. [PMID: 32019559 PMCID: PMC7001341 DOI: 10.1186/s12889-020-8208-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 01/13/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study uses the RE-AIM framework to provide a process evaluation of a workplace-based cluster randomised trial comparing an ergonomic plus exercise intervention to an ergonomic plus health promotion intervention; and to highlight variations across organisations; and consider the implications of the findings for intervention translation. METHOD This study applied the RE-AIM (reach, effectiveness, adoption, implementation, maintenance) methodology to examine the interventions' implementation and to explore the extent to which differences between participating organisations contributed to the variations in findings. Qualitative and quantitative data collected from individual participants, research team observations and organisations were interrogated to report on the five RE-AIM domains. RESULTS Overall reach was 22.7% but varied across organisations (range 9 to 83%). Participants were generally representative of the recruitment pool though more females (n = 452 or 59%) were recruited than were in the pool (49%). Effectiveness measures (health-related productivity loss and neck pain) varied across all organisations, with no clear pattern emerging to indicate the source of the variation. Organisation-level adoption (66%) and staffing level adoption (91%) were high. The interventions were implemented with minimal protocol variations and high staffing consistency, but organisations varied in their provision of resources (e.g. training space, seniority of liaisons). Mean adherence of participants to the EET intervention was 56% during the intervention period, but varied from 41 to 71% across organisations. At 12 months, 15% of participants reported regular EET adherence. Overall mean (SD) adherence to EHP was 56% (29%) across organisations during the intervention period (range 28 to 77%), with 62% of participants reporting regular adherence at 12 months. No organisations continued the interventions after the follow-up period. CONCLUSION Although the study protocol was implemented with high consistency and fidelity, variations in four domains (reach, effectiveness, adoption and implementation) arose between the 14 participating organisations. These variations may be the source of mixed effectiveness across organisations. Factors known to increase the success of workplace interventions, such as strong management support, a visible commitment to employee wellbeing and participant engagement in intervention design should be considered and adequately measured for future interventions. TRIAL REGISTRATION ACTRN12612001154897; 29 October 2012.
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Affiliation(s)
- Alyssa Welch
- School of Public Health, The University of Queensland, Brisbane, 4072, Australia. .,Centre for Health Services Research, The University of Queensland, Brisbane, 4072, Australia.
| | - Genevieve Healy
- School of Public Health, The University of Queensland, Brisbane, 4072, Australia.,School of Physiotherapy and Exercise Science, Curtin University, Perth, 6845, Australia.,Baker Heart & Diabetes Institute, Melbourne, Victoria, Australia
| | - Leon Straker
- School of Physiotherapy and Exercise Science, Curtin University, Perth, 6845, Australia
| | - Tracy Comans
- Centre for Health Services Research, The University of Queensland, Brisbane, 4072, Australia
| | - Shaun O'Leary
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, 4072, Australia.,Department of Physiotherapy, Royal Brisbane and Women's Hospital, Queensland Health, Brisbane, 4029, Australia
| | - Markus Melloh
- Institute of Health Sciences, Zurich University of Applied Sciences, 8401, Winterthur, Switzerland.,UWA Medical School, The University of Western Australia, Perth, 6009, Australia.,Curtin Medical School, Curtin University, Perth, 6845, Australia
| | - Gisela Sjøgaard
- Department of Sport Sciences and Clinical Biomechanics, Faculty of Health Sciences, University of Southern Denmark, 5230, Odense, Denmark
| | - Michelle Pereira
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, 4072, Australia.,Health Services and Outcomes Research, National Healthcare Group, Singapore, 138543, Singapore
| | - Xiaoqi Chen
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, 4072, Australia
| | - Venerina Johnston
- RECOVER Injury Research Centre, The University of Queensland, Brisbane, 4072, Australia
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18
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Sitthipornvorakul E, Sihawong R, Waongenngarm P, Janwantanakul P. The effects of walking intervention on preventing neck pain in office workers: A randomized controlled trial. J Occup Health 2020; 62:e12106. [PMID: 31849170 PMCID: PMC6970409 DOI: 10.1002/1348-9585.12106] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 11/24/2019] [Accepted: 12/02/2019] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE This study aimed to evaluate the efficacy of increased daily walking steps on the 6-month incidence of neck pain among office workers. METHODS Healthy office workers with high risk of neck pain were recruited into a 6-month prospective cluster-randomized controlled trial. Participants were randomly assigned at the cluster level, into either intervention (n = 50) or control (n = 41) groups. Participants in the intervention group were instructed to increase their daily walking steps to a designated level for a duration of 6 months. Participants in the control group received no intervention. The outcome measures included the 6-month incidence of neck pain as well as its pain intensity and disability level. Analyses were performed using multivariable logistic regression model. RESULTS Of the participants in the intervention and control groups, 22% and 34% reported a 6-month incidence of neck pain, respectively. After adjusting for confounders, a significant preventive effect of walking intervention was found (adjusted odd ratio 0.22, 95% confidence interval 0.06-0.75). No significant difference in pain intensity and disability level was found between those in the intervention and control groups. CONCLUSION An intervention to increase daily walking steps reduced onset neck pain in high-risk office workers. However, the walking interventions did not decrease pain intensity and disability in those increasing the number of daily walking steps compared to the control group.
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Affiliation(s)
- Ekalak Sitthipornvorakul
- Department of Physical TherapyFaculty of Allied Health SciencesChulalongkorn UniversityBangkokThailand
| | - Rattaporn Sihawong
- Department of Physical TherapyFaculty of Allied Health SciencesChulalongkorn UniversityBangkokThailand
| | - Pooriput Waongenngarm
- Department of Physical TherapyFaculty of Allied Health SciencesChulalongkorn UniversityBangkokThailand
| | - Prawit Janwantanakul
- Department of Physical TherapyFaculty of Allied Health SciencesChulalongkorn UniversityBangkokThailand
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19
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Cabral AM, Moreira RDFC, de Barros FC, Sato TDO. Is physical capacity associated with the occurrence of musculoskeletal symptoms among office workers? A cross-sectional study. Int Arch Occup Environ Health 2019; 92:1159-1172. [DOI: 10.1007/s00420-019-01455-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Accepted: 06/30/2019] [Indexed: 12/11/2022]
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20
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Price J, Rushton A, Tyros I, Heneghan NR. Effectiveness and optimal dosage of resistance training for chronic non-specific neck pain: a protocol for a systematic review with a qualitative synthesis and meta-analysis. BMJ Open 2019; 9:e025158. [PMID: 30782926 PMCID: PMC6398773 DOI: 10.1136/bmjopen-2018-025158] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION The prevalence of neck pain is increasing rapidly with a high percentage of patients going on to experience recurrent or chronic symptoms. The resulting pain and disability are commonly managed using a variety of treatments including exercise. Resistance training exercise aimed at the neck and shoulders is advocated to treat chronic non-specific neck pain (CNSNP), however the dosage of prescribed exercise varies considerably between studies. The aim of this study is to evaluate the effectiveness of resistance training in CNSNP and to determine an optimal dosage that should be prescribed in clinical practice. METHODS AND ANALYSIS A systematic review with qualitative synthesis and meta-analysis will be conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols. Cumulative Index to Nursing and Allied Health Literature, Excerpta Medica Database, Medical Literature Analysis and Retrieval System Online, PEDro, Zetoc, Index to Chiropractic Literature ChiroAcces, PubMed, grey literature sources and key journals will be searched. Randomised clinical trials investigating resistance training exercise in adults with CNSNP using outcome measures of pain and/or disability will be eligible for inclusion. Two reviewers will independently screen for eligibility, extract data and assess risk of bias (Cochrane risk of bias tool) with a third reviewer mediating in cases of disagreement. Data will be synthesised qualitatively to investigate intervention effectiveness and to determine the effect of exercise dosage on pain and disability. Meta-analysis using a random-effects model will be conducted where sufficient clinical homogeneity exists. The strength of the overall body of evidence will be assessed and reported using Grading of Recommendations Assessment, Development and Evaluation. ETHICS AND DISSEMINATION This study raises no ethical issues. Results will inform exercise prescription to improve management of CNSNP. Results will be published in a peer-reviewed journal and presented at conferences. PROSPERO REGISTRATION NUMBER CRD42018096187.
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Affiliation(s)
- Jonathan Price
- Musculoskeletal Physiotherapy Services, Birmingham Community Healthcare NHS Foundation Trust, Birmingham, UK
| | - Alison Rushton
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, UK
| | - Isaak Tyros
- Edgbaston Physiotherapy Clinic, Birmingham, UK
| | - Nicola R Heneghan
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, UK
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Clinical Outcomes and Central Pain Mechanisms are Improved After Upper Trapezius Eccentric Training in Female Computer Users With Chronic Neck/Shoulder Pain. Clin J Pain 2019; 35:65-76. [DOI: 10.1097/ajp.0000000000000656] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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22
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Exploring the musculoskeletal problems and associated risk-factors among brick kiln workers. INTERNATIONAL JOURNAL OF WORKPLACE HEALTH MANAGEMENT 2018. [DOI: 10.1108/ijwhm-05-2018-0061] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
Prolonged working in repetitive and awkward postures can result in musculoskeletal disorders among workers involved in labour-intensive jobs like those of brick kiln workers. Unlike other labour-intensive sectors, workers in this particular sector have a lack of awareness about musculoskeletal problems. Therefore, the purpose of this paper is to explore musculoskeletal issues and associated risk-factors among brick kiln workers.
Design/methodology/approach
A questionnaire survey was conducted among 217 male and 111 female workers aged between 17 and 53 years. They were employed in traditional brick kiln units situated in Rajasthan, India. Postures were analysed by Rapid Upper Limb Assessment and Rapid Entire Body Assessment methods. Binary logistic regression was used to find the association between musculoskeletal problems and risk-factors.
Findings
For the mould evacuating task, wrist (76.2 per cent) and lower back (56 per cent) issues were the most frequently reported musculoskeletal problems, while in spading task, lower back (62.4 per cent) and shoulder (57.7 per cent) problems were prominent. Musculoskeletal symptoms in one or more body regions were associated with personal and work-related factors including the type of task and experience.
Research limitations/implications
Kiln workers are exposed to high musculoskeletal and postural risks, particularly in spading and mould filling tasks. To reduce these risks, ergonomic interventions are needed.
Originality/value
It is recognised that the musculoskeletal health of brick kiln workers is a cause for concern. The present study provides the evidence of the prevalence of musculoskeletal symptoms experienced by brick kiln workers and the association of symptoms with various risk-factors, which has not been addressed in previous studies.
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Barros FC, Cabral AM, Moreira RDFC, Sato TDO. Does adherence to workplace-based exercises alter physical capacity, pain intensity and productivity? EUROPEAN JOURNAL OF PHYSIOTHERAPY 2018. [DOI: 10.1080/21679169.2018.1485736] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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24
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Kelly D, Shorthouse F, Roffi V, Tack C. Exercise therapy and work-related musculoskeletal disorders in sedentary workers. Occup Med (Lond) 2018; 68:262-272. [DOI: 10.1093/occmed/kqy054] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- D Kelly
- Occupational Health Physiotherapy, Guy’s and St Thomas’ NHS Foundation Trust, London, UK
| | - F Shorthouse
- Occupational Health Physiotherapy, Guy’s and St Thomas’ NHS Foundation Trust, London, UK
| | - V Roffi
- Occupational Health Physiotherapy, Guy’s and St Thomas’ NHS Foundation Trust, London, UK
| | - C Tack
- Occupational Health Physiotherapy, Guy’s and St Thomas’ NHS Foundation Trust, London, UK
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25
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Wei C, Wu AY. Surgical loupe usage among oculoplastic surgeons in North America. Can J Ophthalmol 2018; 53:139-144. [PMID: 29631825 DOI: 10.1016/j.jcjo.2017.08.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Revised: 08/02/2017] [Accepted: 08/14/2017] [Indexed: 01/09/2023]
Abstract
OBJECTIVE To study the patterns of usage and perception among U.S. oculoplastic surgeons regarding surgical loupes. METHODS An anonymous 20-question survey was emailed out to the American Society of Ophthalmic Plastic and Reconstructive Surgery listserv. Data were compiled in Google Forms. SPSS was used for statistical analyses. This study was approved by the institutional review board. RESULTS Of the 609 members contacted, 239 (39%) completed the survey; 95% of respondents owned loupes and 78% regularly used them. No association was observed between frequency of loupe usage and sex or years in practice. The most common magnification and brand were 2.5× and Designs for Vision, respectively. The most common problems associated with loupes were limited vision (33%) and lack of comfort (24%), with 11% citing neck and cervical spinal disorders. The most common benefits were magnification (93%) and increased visual accuracy (68%). Of the respondents, 56% believed improved patient care to be a benefit and 76% believed that loupes enhance surgical outcome. With regard to training, 67% supported incorporating loupes into residency, 35% believed in mandating loupe purchase, and 25% wanted residencies to provide loupes at no cost. Respondent support for the use of loupes in practice and training was directly correlated with how frequently they used loupes. CONCLUSIONS The vast majority of respondents owned loupes. Although most loupe owners used loupes regularly, a sizable proportion operated with limited vision and lack of comfort. Overall, just over half of respondents believed that loupes improve patient care and should be integrated into residency.
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Affiliation(s)
- Chen Wei
- Department of Ophthalmology, Stanford University School of Medicine, Palo Alto, CA
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26
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Chen X, Coombes BK, Sjøgaard G, Jun D, O'Leary S, Johnston V. Workplace-Based Interventions for Neck Pain in Office Workers: Systematic Review and Meta-Analysis. Phys Ther 2018; 98:40-62. [PMID: 29088401 DOI: 10.1093/ptj/pzx101] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Accepted: 10/01/2017] [Indexed: 02/09/2023]
Abstract
Abstract
Background
At present, there is no consolidated evidence for workplace-based interventions for the prevention and reduction of neck pain in office workers.
Purpose
The purpose of this review was to investigate the effectiveness of workplace-based interventions for neck pain in office workers.
Data Sources
MEDLINE, PEDro, CINAHL, and CENTRAL were searched for trials published since inception and before May 31, 2016.
Study Selection
Randomized controlled trials (RCTs) were considered when they met the following criteria: population consisted of office workers, intervention(s) was performed at the workplace, outcome measures included neck and/or neck/shoulder pain intensity and incidence/prevalence, and comparator groups included no/other intervention.
Data Extraction
Data were extracted by 1 reviewer using predefined data fields and checked by a second reviewer. Risk of bias was assessed by 2 independent reviewers using the 2015 Cochrane Back and Neck Group guidelines. Evidence quality was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation system.
Data Synthesis
Twenty-seven RCTs were included. There was moderate-quality evidence that neck/shoulder strengthening exercises and general fitness training were effective in reducing neck pain in office workers who were symptomatic, although the effect size was larger for strengthening exercises. Greater effects were observed with greater participation in exercise. Ergonomic interventions were supported by low-quality evidence.
Limitations
Data could not be obtained from some studies for meta-analysis and assessment of risk of bias. Reporting bias might have been present because only studies in the English language were included.
Conclusions
Workplace-based strengthening exercises were effective in reducing neck pain in office workers who were symptomatic, and the effect size was larger when the exercises were targeted to the neck/shoulder. Future RCTs of ergonomic interventions targeted at office workers who are symptomatic are required. More research on neck pain prevention is warranted.
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Affiliation(s)
- Xiaoqi Chen
- Division of Physiotherapy, School of Health and Rehabilitation Sciences, University of Queensland, Brisbane St Lucia, Queensland 4072, Australia
| | | | - Gisela Sjøgaard
- Department of Sport Science and Clinical Biomechanics, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Deokhoon Jun
- School of Health and Rehabilitation Sciences, University of Queensland
| | - Shaun O'Leary
- School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, and Department of Physiotherapy, Royal Brisbane and Women's Hospital, Queensland Health, Brisbane St. Lucia, Queensland
| | - Venerina Johnston
- School of Health and Rehabilitation Sciences, University of Queensland
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Louw S, Makwela S, Manas L, Meyer L, Terblanche D, Brink Y. Effectiveness of exercise in office workers with neck pain: A systematic review and meta-analysis. SOUTH AFRICAN JOURNAL OF PHYSIOTHERAPY 2017; 73:392. [PMID: 30135909 PMCID: PMC6093121 DOI: 10.4102/sajp.v73i1.392] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Accepted: 10/21/2017] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Non-specific neck pain is a common health problem of global concern for office workers. This systematic review ascertained the latest evidence for the effectiveness of therapeutic exercise versus no therapeutic exercise on reducing neck pain and improving quality of life (QoL) in office workers with non-specific neck pain. METHOD Seven electronic databases using keywords, that is, 'office workers', 'non-specific neck pain', 'exercise' and/or 'exercise therapy', 'QoL', 'strengthening', 'stretching', 'endurance', 'physiotherapy' and/or 'physical therapy', were searched from inception until March 2017. Heterogeneous data were reported in narrative format and comparable homogenous data were pooled using Revman. RESULTS Eight randomised control trials were reviewed and scored on average 6.63/10 on the Physiotherapy Evidence Database (PEDro) scale. Five studies performed strengthening exercise, one study had a strengthening and an endurance exercise group, one study performed stretching exercise and one study had an endurance intervention group and a stretching intervention group. Five and four studies reported significant improvement in neck pain and QoL, respectively, when conducting strengthening exercise. When performing endurance exercises, one and two studies reported significant changes in neck pain and QoL, respectively. The one study incorporating stretching exercise reported significant improvement in neck pain. The meta-analysis revealed that there is a clinically significant difference favouring strengthening exercise over no exercise in pain reduction but not for QoL. CONCLUSION There is level II evidence recommending that clinicians include strengthening exercise to improve neck pain and QoL. However, the effect of endurance and stretching exercise needs to be explored further.
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Affiliation(s)
- Shereen Louw
- Department of Health and Rehabilitation Sciences, Stellenbosch University, South Africa
| | - Shale Makwela
- Department of Health and Rehabilitation Sciences, Stellenbosch University, South Africa
| | - Lorisha Manas
- Department of Health and Rehabilitation Sciences, Stellenbosch University, South Africa
| | - Lyle Meyer
- Department of Health and Rehabilitation Sciences, Stellenbosch University, South Africa
| | - Daniele Terblanche
- Department of Health and Rehabilitation Sciences, Stellenbosch University, South Africa
| | - Yolandi Brink
- Department of Health and Rehabilitation Sciences, Stellenbosch University, South Africa
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Intelligent Physical Exercise Training in a Workplace Setting Improves Muscle Strength and Musculoskeletal Pain: A Randomized Controlled Trial. BIOMED RESEARCH INTERNATIONAL 2017; 2017:7914134. [PMID: 28848766 PMCID: PMC5564061 DOI: 10.1155/2017/7914134] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Revised: 05/12/2017] [Accepted: 06/20/2017] [Indexed: 12/30/2022]
Abstract
Purpose To assess effects of 1-year Intelligent Physical Exercise Training (IPET) on musculoskeletal health. Methods Office workers were randomized 1 : 1 to a training group, TG (N = 193), or a control group, CG (N = 194). TG received 1 h supervised high intensity IPET every week within working hours for 1 year and was recommended to perform 30 min of moderate intensity physical activity for 6 days a week during leisure. The IPET program was based on baseline health measures. Results No baseline differences were present. An intention-to-treat analysis showed significant between-group effect for muscle strength but not for musculoskeletal pain. However, a per-protocol analysis of those with an adherence of ≥70% demonstrated a significant between-group effect for neck pain during the past three months. Several significant within-group changes were present, where TG and TG ≥ 70% demonstrated clinically relevant pain reductions whereas minimal reductions were seen for CG. Conclusion IPET and recommendations of moderate intensity physical activity demonstrated significant between-group effect on muscle strength. Interestingly, significant within-group reductions in musculoskeletal pain were seen not only in TG but also in CG. This may underlie the lack of such between-group effect and shows that a possible positive side effect of merely drawing attention can improve musculoskeletal health.
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Søgaard K, Sjøgaard G. Physical Activity as Cause and Cure of Muscular Pain: Evidence of Underlying Mechanisms. Exerc Sport Sci Rev 2017; 45:136-145. [PMID: 28418998 PMCID: PMC5473374 DOI: 10.1249/jes.0000000000000112] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/08/2017] [Indexed: 01/18/2023]
Abstract
Work-related physical activity (PA), in terms of peak loads and sustained and/or repetitive contractions, presents risk factors for the development of muscular pain and disorders. However, PA as a training tailored to the employee's work exposure, health, and physical capacity offers prevention and rehabilitation. We suggest the concept of "Intelligent Physical Exercise Training" relying on evidence-based sports science training principles.
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Affiliation(s)
- Karen Søgaard
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense M, Denmark
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Marik TL, Roll SC. Effectiveness of Occupational Therapy Interventions for Musculoskeletal Shoulder Conditions: A Systematic Review. Am J Occup Ther 2017; 71:7101180020p1-7101180020p11. [PMID: 28027039 PMCID: PMC5182015 DOI: 10.5014/ajot.2017.023127] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
People with musculoskeletal disorders of the shoulder commonly experience pain, decreased strength, and restricted range of motion (ROM) that limit participation in meaningful occupational activities. The purpose of this systematic review was to evaluate the current evidence for interventions within the occupational therapy scope of practice that address pain reduction and increase participation in functional activities. Seventy-six studies were reviewed for this study-67 of Level I evidence, 7 of Level II evidence, and 2 of Level III evidence. Strong evidence was found that ROM, strengthening exercises, and joint mobilizations can improve function and decrease pain. The evidence to support physical modalities is moderate to mixed, depending on the shoulder disorder. Occupational therapy practitioners can use this evidence to guide daily clinical decision making.
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Affiliation(s)
- Tambra L Marik
- Tambra L. Marik, OTD, OTR/L, CHT, is Hand Therapy Elective Track Director, Rocky Mountain University for Health Professions, Provo, UT, and Staff Therapist, ATI Physical Therapy, Tacoma, WA;
| | - Shawn C Roll
- Shawn C. Roll, PhD, OTR/L, RMSKS, FAOTA, is Assistant Professor, Mrs. T. H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles
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Murray M, Lange B, Nørnberg BR, Søgaard K, Sjøgaard G. Self-administered physical exercise training as treatment of neck and shoulder pain among military helicopter pilots and crew: a randomized controlled trial. BMC Musculoskelet Disord 2017; 18:147. [PMID: 28388892 PMCID: PMC5383986 DOI: 10.1186/s12891-017-1507-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2016] [Accepted: 03/29/2017] [Indexed: 11/22/2022] Open
Abstract
Background Neck pain is frequent among military helicopter pilots and crew-members, and pain may influence individual health and work performance. The aim of this study was to examine if an exercise intervention could reduce neck pain among helicopter pilots and crew-members. Methods Thirty-one pilots and thirty-eight crew-members were randomized to either an exercise-training-group (n = 35) or a reference-group (n = 34). The exercise-training-group received 20-weeks of specific neck/shoulder training. The reference-group received no training. Primary outcome: Intensity of neck pain previous 3-months (scale 0-10). Secondary outcomes: additional neck/shoulder pain intensity variables and pressure-pain-threshold in the trapezius muscle (TRA) and upper-neck-extensor muscles (UNE). Regular training adherence was defined as ≥1 training session a week. Statistical analyses performed were intention-to-treat and per-protocol. Students t-test was performed (p < 0.05). Results Intensity of neck pain previous 3-months at baseline was: 2.2 ± 1.8 and previous 7-days: 1.0 ± 1.5, and pressure-pain-threshold in TRA and UNE (right/left) was in kPa: 424 ± 187 / 434 ± 188 and 345 ± 157 / 371 ± 170 in the exercise-training-group, and 416 ± 177 / 405 ± 163 and 334 ± 147 / 335 ± 163 in the reference-group, with no differences between groups. Intention-to-treat-analysis revealed no significant between-group-differences in neck pain intensity and pressure-pain-threshold. Between-group-differences, including participants who trained regularly (n = 10) were also non-significant. Within-group-changes were significant among participants with regular training adherence in the exercise-training-group regarding intensity of neck pain previous 3-months (from 2.2 ± 0.6 to 1.3 ± 1.3, p = 0.019). Likewise, within the whole exercise-training-group, neck pain previous 7-days decreased (from 1.0 ± 1.4 to 0.6 ± 1.1, p = 0.024). Additional within-group-changes regarding pressure-pain-threshold in kPa were for the reference-group a reduction in TRA and UNE (right/left) to: 342 ± 143 / 332 ± 154 and 295 ± 116 / 292 ± 121 implying increased pain sensitivity, while for the exercise-training-group only a reduction in left TRA was seen: 311 ± 113. Conclusions The exercise intervention did not reduce neck pain among helicopter pilots and crew-members as no significant between-group-differences were found. However, some trends were demonstrated as some neck pain intensity and sensitivity improved more within the exercise-training-group but not within the reference-group. The lack of effect may be due to low adherence since only ~ 1/3 of subjects in the exercise-training-group engaged in regular training which may be due to the self-administration of the training. Trial registrations Ethical committee of Southern Denmark (S-20120121) 29 August, 2012. Clinical Trail Registration (NCT01926262) 16 August, 2013.
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Affiliation(s)
- Mike Murray
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.
| | - Britt Lange
- Department of Anesthesia and Intensive Care Medicine, Odense University Hospital, Odense, Denmark
| | | | - Karen Søgaard
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Gisela Sjøgaard
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
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Does structured patient education improve the recovery and clinical outcomes of patients with neck pain? A systematic review from the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration. Spine J 2016; 16:1524-1540. [PMID: 24704678 DOI: 10.1016/j.spinee.2014.03.039] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2013] [Revised: 03/07/2014] [Accepted: 03/29/2014] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT In 2008, the Bone and Joint Decade 2000 to 2010 Task Force on Neck Pain and Its Associated Disorders recommended patient education for the management of neck pain. However, the effectiveness of education interventions has recently been challenged. PURPOSE To update the findings of the Bone and Joint Decade 2000 to 2010 Task Force on Neck Pain and Its Associated Disorders and evaluate the effectiveness of structured patient education for the management of patients with whiplash-associated disorders (WAD) or neck pain and associated disorders (NAD). STUDY DESIGN/SETTING Systematic review of the literature and best-evidence synthesis. PATIENT SAMPLE Randomized controlled trials that compared structured patient education with other conservative interventions. OUTCOME MEASURES Self-rated recovery, functional recovery (eg, disability, return to activities, work, or school), pain intensity, health-related quality of life, psychological outcomes such as depression or fear, or adverse effects. METHODS We systematically searched eight electronic databases (MEDLINE, EMBASE, CINAHL, PsycINFO, the Cochrane Central Register of Controlled Trials, DARE, PubMed, and ICL) from 2000 to 2012. Randomized controlled trials, cohort studies, and case-control studies meeting our selection criteria were eligible for critical appraisal. Random pairs of independent reviewers critically appraised eligible studies using the Scottish Intercollegiate Guidelines Network criteria. Scientifically admissible studies were summarized in evidence tables and synthesized following best-evidence synthesis principles. RESULTS We retrieved 4,477 articles. Of those, nine were eligible for critical appraisal and six were scientifically admissible. Four admissible articles investigated patients with WAD and two targeted patients with NAD. All structured patient education interventions included advice on activation or exercises delivered orally combined with written information or as written information alone. Overall, as a therapeutic intervention, structured patient education was equal or less effective than other conservative treatments including massage, supervised exercise, and physiotherapy. However, structured patient education may provide small benefits when combined with physiotherapy. Either mode of delivery (ie, oral or written education) provides similar results in patients with recent WAD. CONCLUSIONS This review adds to the Bone and Joint Decade 2000 to 2010 Task Force on Neck Pain and Its Associated Disorders by defining more specifically the role of structured patient education in the management of WAD and NAD. Results suggest that structured patient education alone cannot be expected to yield large benefits in clinical effectiveness compared with other conservative interventions for patients with WAD or NAD. Moreover, structured patient education may be of benefit during the recovery of patients with WAD when used as an adjunct therapy to physiotherapy or emergency room care. These benefits are small and short lived.
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Southerst D, Nordin MC, Côté P, Shearer HM, Varatharajan S, Yu H, Wong JJ, Sutton DA, Randhawa KA, van der Velde GM, Mior SA, Carroll LJ, Jacobs CL, Taylor-Vaisey AL. Is exercise effective for the management of neck pain and associated disorders or whiplash-associated disorders? A systematic review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration. Spine J 2016; 16:1503-1523. [PMID: 24534390 DOI: 10.1016/j.spinee.2014.02.014] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2013] [Revised: 01/20/2014] [Accepted: 02/03/2014] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT In 2008, the Neck Pain Task Force (NPTF) recommended exercise for the management of neck pain and whiplash-associated disorders (WAD). However, no evidence was available on the effectiveness of exercise for Grade III neck pain or WAD. Moreover, limited evidence was available to contrast the effectiveness of various types of exercises. PURPOSE To update the findings of the NPTF on the effectiveness of exercise for the management of neck pain and WAD grades I to III. STUDY DESIGN/SETTING Systematic review and best evidence synthesis. SAMPLE Studies comparing the effectiveness of exercise to other conservative interventions or no intervention. OUTCOME MEASURES Outcomes of interest included self-rated recovery, functional recovery, pain intensity, health-related quality of life, psychological outcomes, and/or adverse events. METHODS We searched eight electronic databases from 2000 to 2013. Eligible studies were critically appraised using the Scottish Intercollegiate Guidelines Network criteria. The results of scientifically admissible studies were synthesized following best-evidence synthesis principles. RESULTS We retrieved 4,761 articles, and 21 randomized controlled trials (RCTs) were critically appraised. Ten RCTs were scientifically admissible: nine investigated neck pain and one addressed WAD. For the management of recent neck pain Grade I/II, unsupervised range-of-motion exercises, nonsteroidal anti-inflammatory drugs and acetaminophen, or manual therapy lead to similar outcomes. For recent neck pain Grade III, supervised graded strengthening is more effective than advice but leads to similar short-term outcomes as a cervical collar. For persistent neck pain and WAD Grade I/II, supervised qigong and combined strengthening, range-of-motion, and flexibility exercises are more effective than wait list. Additionally, supervised Iyengar yoga is more effective than home exercise. Finally, supervised high-dose strengthening is not superior to home exercises or advice. CONCLUSIONS We found evidence that supervised qigong, Iyengar yoga, and combined programs including strengthening, range of motion, and flexibility are effective for the management of persistent neck pain. We did not find evidence that one supervised exercise program is superior to another. Overall, most studies reported small effect sizes suggesting that a small clinical effect can be expected with the use of exercise alone.
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Affiliation(s)
- Danielle Southerst
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and Canadian Memorial Chiropractic College (CMCC), 6100 Leslie St, Toronto, Ontario, Canada, M2H 3J1.
| | - Margareta C Nordin
- Department of Orthopedic Surgery, Occupational and Industrial Orthopedic Center, NYU School of Medicine, New York University, 63 Downing Street, New York, New York, USA, 10014
| | - Pierre Côté
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and Canadian Memorial Chiropractic College (CMCC), 6100 Leslie St, Toronto, Ontario, Canada, M2H 3J1; Faculty of Health Sciences, University of Ontario Institute of Technology (UOIT), 2000 Simcoe Street North, Science building, Room 3000, Oshawa, Ontario, Canada, L1H 7K4
| | - Heather M Shearer
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and Canadian Memorial Chiropractic College (CMCC), 6100 Leslie St, Toronto, Ontario, Canada, M2H 3J1
| | - Sharanya Varatharajan
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and Canadian Memorial Chiropractic College (CMCC), 6100 Leslie St, Toronto, Ontario, Canada, M2H 3J1
| | - Hainan Yu
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and Canadian Memorial Chiropractic College (CMCC), 6100 Leslie St, Toronto, Ontario, Canada, M2H 3J1
| | - Jessica J Wong
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and Canadian Memorial Chiropractic College (CMCC), 6100 Leslie St, Toronto, Ontario, Canada, M2H 3J1
| | - Deborah A Sutton
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and Canadian Memorial Chiropractic College (CMCC), 6100 Leslie St, Toronto, Ontario, Canada, M2H 3J1
| | - Kristi A Randhawa
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and Canadian Memorial Chiropractic College (CMCC), 6100 Leslie St, Toronto, Ontario, Canada, M2H 3J1
| | - Gabrielle M van der Velde
- Toronto Health Economics and Technology Assessment (THETA) Collaborative, Leslie Dan Pharmacy Building, University of Toronto, 6th Floor, Room 658, 144 College Street, Toronto, Ontario, Canada, M5S 3M2; Leslie Dan Faculty of Pharmacy, University of Toronto, 144 College Street, Toronto, Ontario, Canada, M5S 3M2; Institute for Work and Health, 481 University Ave, Toronto, Ontario, Canada, M5G 2E9
| | - Silvano A Mior
- Faculty of Health Sciences, University of Ontario Institute of Technology (UOIT), 2000 Simcoe Street North, Science building, Room 3000, Oshawa, Ontario, Canada, L1H 7K4; Graduate Education and Research, Canadian Memorial Chiropractic College (CMCC), 6100 Leslie St, Toronto, Ontario, Canada, M2H 3J1
| | - Linda J Carroll
- Department of Public Health Sciences and Alberta Centre for Injury Prevention and Research, School of Public Health, University of Alberta, 4075 RTF, 8308-114 Street, Edmonton, Alberta, Canada, T6G 2E1
| | - Craig L Jacobs
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and Canadian Memorial Chiropractic College (CMCC), 6100 Leslie St, Toronto, Ontario, Canada, M2H 3J1; Division of Clinical Education, Canadian Memorial Chiropractic College (CMCC), 6100 Leslie St, Toronto, Ontario, Canada, M2H 3J1
| | - Anne L Taylor-Vaisey
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and Canadian Memorial Chiropractic College (CMCC), 6100 Leslie St, Toronto, Ontario, Canada, M2H 3J1
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Bussières AE, Stewart G, Al-Zoubi F, Decina P, Descarreaux M, Hayden J, Hendrickson B, Hincapié C, Pagé I, Passmore S, Srbely J, Stupar M, Weisberg J, Ornelas J. The Treatment of Neck Pain–Associated Disorders and Whiplash-Associated Disorders: A Clinical Practice Guideline. J Manipulative Physiol Ther 2016; 39:523-564.e27. [DOI: 10.1016/j.jmpt.2016.08.007] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Revised: 07/14/2016] [Accepted: 08/10/2016] [Indexed: 12/25/2022]
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Stratton K, Faghri PD. Electrically and Hybrid-Induced Muscle Activations: Effects of Muscle Size and Fiber Type. Eur J Transl Myol 2016; 26:6163. [PMID: 27990244 PMCID: PMC5128977 DOI: 10.4081/ejtm.2016.6163] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
The effect of three electrical stimulation (ES) frequencies (10, 35, and 50 Hz) on two muscle groups with different proportions of fast and slow twitch fibers (abductor pollicis brevis (APB) and vastus lateralis (VL)) was explored. We evaluated the acute muscles’ responses individually and during hybrid activations (ES superimposed by voluntary activations). Surface electromyography (sEMG) and force measurements were evaluated as outcomes. Ten healthy adults (mean age: 24.4 ± 2.5 years) participated after signing an informed consent form approved by the university Institutional Review Board. Protocols were developed to: 1) compare EMG activities during each frequency for each muscle when generating 25% Maximum Voluntary Contraction (MVC) force, and 2) compare EMG activities during each frequency when additional voluntary activation was superimposed over ES-induced 25% MVC to reach 50% and 75% MVC. Empirical mode decomposition (EMD) was utilized to separate ES artifacts from voluntary muscle activation. For both muscles, higher stimulation frequency (35 and 50Hz) induced higher electrical output detected at 25% of MVC, suggesting more recruitment with higher frequencies. Hybrid activation generated proportionally less electrical activity than ES alone. ES and voluntary activations appear to generate two different modes of muscle recruitment. ES may provoke muscle strength by activating more fatiguing fast acting fibers, but voluntary activation elicits more muscle coordination. Therefore, during the hybrid activation, less electrical activity may be detected due to recruitment of more fatigue-resistant deeper muscle fibers, not reachable by surface EMG.
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Affiliation(s)
- Kelly Stratton
- Biomedical Engineering Department at the University of Connecticut , Storrs, CT USA
| | - Pouran D Faghri
- Allied Health Sciences and Biomedical Engineering Departments at the University of Connecticut , Storrs, CT USA
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Andersen LL, Vinstrup J, Jakobsen MD, Sundstrup E. Validity and reliability of elastic resistance bands for measuring shoulder muscle strength. Scand J Med Sci Sports 2016; 27:887-894. [PMID: 27185407 DOI: 10.1111/sms.12695] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/30/2016] [Indexed: 11/29/2022]
Abstract
Valid and reliable measurements of muscle strength are important in sport medicine. This study assesses concurrent validity and intrarater reliability (test-retest reliability) of elastic resistance bands for measuring shoulder muscle strength. Altogether, 50 healthy adults [mean age 36.0 (SD: 11.6), 29 women and 21 men] participated in testing and retesting 1-2 weeks later. The maximal elastic resistance (TheraBand) that each participant could hold for 3 s during standing bilateral shoulder abduction to 90° was converted into torque and validated against gold standard maximal voluntary isometric contraction (MVC) (Vishay force transducer) performed unilaterally while lying supine. The intrarater reliability of both tests were high; for the MVC and elastic band test, respectively, ICC(3,1) was 0.98 (95% CI: 0.97-0.99) and 0.99 (95% CI: 0.98-1.00), and measurement error was 4.8% (95% CI: 3.7-5.9) and 4.7% (95% CI: 3.1-6.2). For concurrent validity, ICC(3,1) was 0.96 (95% CI: 0.95-0.98) and measurement error was 8.1% (95% CI: 6.6-9.6), and the elastic band test explained 93% of the variance in the MVC test. However, the elastic band test produced systematically lower torque values than the MVC [56.5 (SD: 26.8) vs 66.5 (SD: 25.5) Nm, P < 0.01]. In conclusion, the test for shoulder muscle strength using elastic resistance bands has excellent validity and reliability, but produces systematically lower torque values than MVC. The reason for the lower torque values may be that the elastic band test has an initial concentric phase and is performed bilaterally and standing upright.
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Affiliation(s)
- L L Andersen
- National Research Centre for the Working Environment, Copenhagen, Denmark.,Physical Activity and Human Performance Group, SMI, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - J Vinstrup
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - M D Jakobsen
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - E Sundstrup
- National Research Centre for the Working Environment, Copenhagen, Denmark
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Hansen ÅM, Andersen LL, Mendes de Leon CF, Bruunsgaard H, Lund R. School education, physical performance in late midlife and allostatic load: a retrospective cohort study. J Epidemiol Community Health 2016; 70:748-54. [DOI: 10.1136/jech-2015-205664] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Accepted: 12/22/2015] [Indexed: 11/04/2022]
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Van Eerd D, Munhall C, Irvin E, Rempel D, Brewer S, van der Beek AJ, Dennerlein JT, Tullar J, Skivington K, Pinion C, Amick B. Effectiveness of workplace interventions in the prevention of upper extremity musculoskeletal disorders and symptoms: an update of the evidence. Occup Environ Med 2015; 73:62-70. [PMID: 26552695 PMCID: PMC4717459 DOI: 10.1136/oemed-2015-102992] [Citation(s) in RCA: 164] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Accepted: 09/27/2015] [Indexed: 11/29/2022]
Abstract
The burden of disabling musculoskeletal pain and injuries (musculoskeletal disorders, MSDs) arising from work-related causes in many workplaces remains substantial. There is little consensus on the most appropriate interventions for MSDs. Our objective was to update a systematic review of workplace-based interventions for preventing and managing upper extremity MSD (UEMSD). We followed a systematic review process developed by the Institute for Work & Health and an adapted best evidence synthesis. 6 electronic databases were searched (January 2008 until April 2013 inclusive) yielding 9909 non-duplicate references. 26 high-quality and medium-quality studies relevant to our research question were combined with 35 from the original review to synthesise the evidence on 30 different intervention categories. There was strong evidence for one intervention category, resistance training, leading to the recommendation: Implementing a workplace-based resistance training exercise programme can help prevent and manage UEMSD and symptoms. The synthesis also revealed moderate evidence for stretching programmes, mouse use feedback and forearm supports in preventing UEMSD or symptoms. There was also moderate evidence for no benefit for EMG biofeedback, job stress management training, and office workstation adjustment for UEMSD and symptoms. Messages are proposed for both these and other intervention categories.
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Affiliation(s)
- D Van Eerd
- Institute for Work & Health, Toronto, Ontario, Canada School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | - C Munhall
- Institute for Work & Health, Toronto, Ontario, Canada
| | - E Irvin
- Institute for Work & Health, Toronto, Ontario, Canada
| | - D Rempel
- Division of Occupational and Environmental Medicine, School of Medicine, University of California, San Francisco, Richmond, California, USA
| | - S Brewer
- CB&I, Inc, The Woodlands, Texas, USA
| | - A J van der Beek
- Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - J T Dennerlein
- Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands Department of Physical Therapy, Movement & Rehabilitation Science, Northeastern University, Boston, Massachusetts, USA
| | - J Tullar
- School of Public Health, Institute for Health Policy, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - K Skivington
- Institute for Work & Health, Toronto, Ontario, Canada MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - C Pinion
- CB&I, Inc, The Woodlands, Texas, USA
| | - B Amick
- Institute for Work & Health, Toronto, Ontario, Canada Florida International University, Robert Stempel College of Public Health and Social Work, Miami, Florida, USA
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Is exercise effective for the management of subacromial impingement syndrome and other soft tissue injuries of the shoulder? A systematic review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration. ACTA ACUST UNITED AC 2015; 20:646-56. [DOI: 10.1016/j.math.2015.03.013] [Citation(s) in RCA: 66] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2014] [Revised: 03/05/2015] [Accepted: 03/18/2015] [Indexed: 11/21/2022]
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Does training frequency and supervision affect compliance, performance and muscular health? A cluster randomized controlled trial. ACTA ACUST UNITED AC 2015; 20:657-65. [DOI: 10.1016/j.math.2015.01.016] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2014] [Revised: 12/30/2014] [Accepted: 01/22/2015] [Indexed: 11/21/2022]
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Bredahl TVG, Særvoll CA, Kirkelund L, Sjøgaard G, Andersen LL. When Intervention Meets Organisation, a Qualitative Study of Motivation and Barriers to Physical Exercise at the Workplace. ScientificWorldJournal 2015; 2015:518561. [PMID: 26380361 PMCID: PMC4563103 DOI: 10.1155/2015/518561] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2014] [Revised: 09/05/2014] [Accepted: 09/25/2014] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE To provide a comprehensive understanding of the motivational factors and barriers that are important for compliance with high-intensity workplace physical exercise that is aimed at reducing musculoskeletal disorders. METHOD The present study, which used semideductive, thematic, and structured in-depth interviews, was nested in a 20-week cluster randomised controlled trial among office workers. Interviews were conducted with 18 informants with diverse fields of sedentary office work who participated in strength training at the workplace for 20 minutes, three times per week. Organisational, implementational, and individual motives and barriers were explored. RESULTS & DISCUSSION The results show that attention should be given to the interaction between the management, the employees, and the intervention, as the main barrier to compliance was the internal working culture. The results emphasised the need for a clear connection between the management's implementational intentions and the actual implementation. The results emphasise the importance of ensuring the legitimacy of the intervention among managers, participants, and colleagues. Moreover, it is important to centrally organise, structure, and ensure flexibility in the working day to free time for participants to attend the intervention. Recommendations from this study suggest that a thorough intervention mapping process should be performed to analyse organisational and implementational factors before initiating workplace physical exercise training.
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Affiliation(s)
| | | | - Lasse Kirkelund
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100 København Ø, Denmark
| | - Gisela Sjøgaard
- Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark
| | - Lars Louis Andersen
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100 København Ø, Denmark
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Sivak-Callcott JA, Mancinelli CA, Nimbarte AD. Cervical occupational hazards in ophthalmic plastic surgery. Curr Opin Ophthalmol 2015; 26:392-8. [DOI: 10.1097/icu.0000000000000182] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Monticone M, Cedraschi C, Ambrosini E, Rocca B, Fiorentini R, Restelli M, Gianola S, Ferrante S, Zanoli G, Moja L. Cognitive-behavioural treatment for subacute and chronic neck pain. Cochrane Database Syst Rev 2015; 2015:CD010664. [PMID: 26006174 PMCID: PMC8922276 DOI: 10.1002/14651858.cd010664.pub2] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
EDITORIAL NOTE EXPRESSION OF CONCERN - Professor Marco Monticone has acted as the first author of this Cochrane review. Readers should be informed that multiple randomized controlled trials authored by Professor Monticone have been scrutinized because of potential research integrity issues, including irregularities in the data (doi:10.1097/j.pain.0000000000002659). One of the trials suspected of research integrity issues is included in this Cochrane review (doi:10.1007/s00586-012-2287-y). The Cochrane editorial team has concerns about the trustworthiness of the trial data and is applying Cochrane's policy on managing potentially problematic studies (https://www.cochranelibrary.com/cdsr/editorial-policies#problematic-studies). No major differences to the conclusions of this review were found after performing a sensitivity analysis on the main outcomes, whether the potentially problematic trial was included or excluded. Cochrane will take further action as needed on this review once additional investigations into the potentially problematic trial are concluded. In the meantime, a new version of this review topic is underway with a new author team. The new review will supersede this review. BACKGROUND Although research on non-surgical treatments for neck pain (NP) is progressing, there remains uncertainty about the efficacy of cognitive-behavioural therapy (CBT) for this population. Addressing cognitive and behavioural factors might reduce the clinical burden and the costs of NP in society. OBJECTIVES To assess the effects of CBT among individuals with subacute and chronic NP. Specifically, the following comparisons were investigated: (1) cognitive-behavioural therapy versus placebo, no treatment, or waiting list controls; (2) cognitive-behavioural therapy versus other types of interventions; (3) cognitive-behavioural therapy in addition to another intervention (e.g. physiotherapy) versus the other intervention alone. SEARCH METHODS We searched CENTRAL, MEDLINE, EMBASE, CINAHL, PsycINFO, SCOPUS, Web of Science, and PubMed, as well as ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform up to November 2014. Reference lists and citations of identified trials and relevant systematic reviews were screened. SELECTION CRITERIA We included randomised controlled trials that assessed the use of CBT in adults with subacute and chronic NP. DATA COLLECTION AND ANALYSIS Two review authors independently assessed the risk of bias in each study and extracted the data. If sufficient homogeneity existed among studies in the pre-defined comparisons, a meta-analysis was performed. We determined the quality of the evidence for each comparison with the GRADE approach. MAIN RESULTS We included 10 randomised trials (836 participants) in this review. Four trials (40%) had low risk of bias, the remaining 60% of trials had a high risk of bias.The quality of the evidence for the effects of CBT on patients with chronic NP was from very low to moderate. There was low quality evidence that CBT was better than no treatment for improving pain (standard mean difference (SMD) -0.58, 95% confidence interval (CI) -1.01 to -0.16), disability (SMD -0.61, 95% CI -1.21 to -0.01), and quality of life (SMD -0.93, 95% CI -1.54 to -0.31) at short-term follow-up, while there was from very low to low quality evidence of no effect on various psychological indicators at short-term follow-up. Both at short- and intermediate-term follow-up, CBT did not affect pain (SMD -0.06, 95% CI -0.33 to 0.21, low quality, at short-term follow-up; MD -0.89, 95% CI -2.73 to 0.94, low quality, at intermediate-term follow-up) or disability (SMD -0.10, 95% CI -0.40 to 0.20, moderate quality, at short-term follow-up; SMD -0.24, 95% CI-0.54 to 0.07, moderate quality, at intermediate-term follow-up) compared to other types of interventions. There was moderate quality evidence that CBT was better than other interventions for improving kinesiophobia at intermediate-term follow-up (SMD -0.39, 95% CI -0.69 to -0.08, I(2) = 0%). Finally, there was very low quality evidence that CBT in addition to another intervention did not differ from the other intervention alone in terms of effect on pain (SMD -0.36, 95% CI -0.73 to 0.02) and disability (SMD -0.10, 95% CI -0.56 to 0.36) at short-term follow-up.For patients with subacute NP, there was low quality evidence that CBT was better than other interventions at reducing pain at short-term follow-up (SMD -0.24, 95% CI -0.48 to 0.00), while no difference was found in terms of effect on disability (SMD -0.12, 95% CI -0.36 to 0.12) and kinesiophobia.None of the included studies reported on adverse effects. AUTHORS' CONCLUSIONS With regard to chronic neck pain, CBT was found to be statistically significantly more effective for short-term pain reduction only when compared to no treatment, but these effects could not be considered clinically meaningful. When comparing both CBT to other types of interventions and CBT in addition to another intervention to the other intervention alone, no differences were found. For patients with subacute NP, CBT was significantly better than other types of interventions at reducing pain at short-term follow-up, while no difference was found for disability and kinesiophobia. Further research is recommended to investigate the long-term benefits and risks of CBT including for the different subgroups of subjects with NP.
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Affiliation(s)
- Marco Monticone
- Physical Medicine and Rehabilitation Unit, Scientific Institute of Lissone (Milan), Institute of Care and Research, Salvatore Maugeri Foundation, IRCCS, Milan, Italy
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Tunwattanapong P, Kongkasuwan R, Kuptniratsaikul V. The effectiveness of a neck and shoulder stretching exercise program among office workers with neck pain: a randomized controlled trial. Clin Rehabil 2015; 30:64-72. [PMID: 25780258 DOI: 10.1177/0269215515575747] [Citation(s) in RCA: 74] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2014] [Accepted: 02/08/2015] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To determine the effectiveness of neck and shoulder stretching exercises for relief neck pain among office workers. DESIGN Randomized controlled trial. SETTING An outpatient setting. PARTICIPANTS A total of 96 subjects with moderate-to-severe neck pain (visual analogue score ⩾5/10) for ⩾3 months. INTERVENTIONS All participants received an informative brochure indicating the proper position and ergonomics to be applied during daily work. The treatment group received the additional instruction to perform neck and around shoulder stretching exercises two times/day, five days/week during four weeks. MAIN OUTCOMES Pain, neck functions, and quality of life were evaluated at baseline and week 4 using pain visual analogue scale, Northwick Park Neck Pain Questionnaire, and Short Form-36, respectively. RESULTS Both groups had comparable baseline data. All outcomes were improved significantly from baseline. When compared between groups, the magnitude of improvement was significantly greater in the treatment group than in the control group (-1.4; 95% CI: -2.2, -0.7 for visual analogue scale; -4.8; 95% CI: -9.3, -0.4 for Northwick Park Neck Pain Questionnaire; and 14.0; 95% CI: 7.1, 20.9 for physical dimension of the Short Form-36). Compared with the patients who performed exercises <3 times/week, those who exercised ⩾3 times/week yielded significantly greater improvement in neck function and physical dimension of quality of life scores (p = 0.005 and p = 0.018, respectively). CONCLUSION A regular stretching exercise program performed for four weeks can decrease neck and shoulder pain and improve neck function and quality of life for office workers who have chronic moderate-to-severe neck or shoulder pain.
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Affiliation(s)
- Punjama Tunwattanapong
- Division of Rehabilitation Medicine, Sunprasitthiprasong Hospital, Ubonratchatani, Thailand
| | - Ratcharin Kongkasuwan
- Department of Rehabilitation Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Vilai Kuptniratsaikul
- Department of Rehabilitation Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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Lowe BD, Dick RB. Workplace exercise for control of occupational neck/shoulder disorders: a review of prospective studies. ENVIRONMENTAL HEALTH INSIGHTS 2015; 8:75-95. [PMID: 25780338 PMCID: PMC4346313 DOI: 10.4137/ehi.s15256] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/03/2014] [Revised: 12/30/2014] [Accepted: 01/03/2015] [Indexed: 06/04/2023]
Abstract
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.
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Gross A, Kay TM, Paquin J, Blanchette S, Lalonde P, Christie T, Dupont G, Graham N, Burnie SJ, Gelley G, Goldsmith CH, Forget M, Hoving JL, Brønfort G, Santaguida PL. Exercises for mechanical neck disorders. Cochrane Database Syst Rev 2015; 1:CD004250. [PMID: 25629215 PMCID: PMC9508492 DOI: 10.1002/14651858.cd004250.pub5] [Citation(s) in RCA: 84] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Neck pain is common, disabling and costly. Exercise is one treatment approach. OBJECTIVES To assess the effectiveness of exercises to improve pain, disability, function, patient satisfaction, quality of life and global perceived effect in adults with neck pain. SEARCH METHODS We searched MEDLINE, MANTIS, ClinicalTrials.gov and three other computerized databases up to between January and May 2014 plus additional sources (reference checking, citation searching, contact with authors). SELECTION CRITERIA We included randomized controlled trials (RCTs) comparing single therapeutic exercise with a control for adults suffering from neck pain with or without cervicogenic headache or radiculopathy. DATA COLLECTION AND ANALYSIS Two review authors independently conducted trial selection, data extraction, 'Risk of bias' assessment and clinical relevance. The quality of the evidence was assessed using GRADE. Meta-analyses were performed for relative risk and standardized mean differences (SMD) with 95% confidence intervals (CIs) after judging clinical and statistical heterogeneity. MAIN RESULTS Twenty-seven trials (2485 analyzed /3005 randomized participants) met our inclusion criteria.For acute neck pain only, no evidence was found.For chronic neck pain, moderate quality evidence supports 1) cervico-scapulothoracic and upper extremity strength training to improve pain of a moderate to large amount immediately post treatment [pooled SMD (SMDp) -0.71 (95% CI: -1.33 to -0.10)] and at short-term follow-up; 2) scapulothoracic and upper extremity endurance training for slight beneficial effect on pain at immediate post treatment and short-term follow-up; 3) combined cervical, shoulder and scapulothoracic strengthening and stretching exercises varied from a small to large magnitude of beneficial effect on pain at immediate post treatment [SMDp -0.33 (95% CI: -0.55 to -0.10)] and up to long-term follow-up and a medium magnitude of effect improving function at both immediate post treatment and at short-term follow-up [SMDp -0.45 (95%CI: -0.72 to -0.18)]; 4) cervico-scapulothoracic strengthening/stabilization exercises to improve pain and function at intermediate term [SMDp -14.90 (95% CI:-22.40 to -7.39)]; 5) Mindfulness exercises (Qigong) minimally improved function but not global perceived effect at short term. Low evidence suggests 1) breathing exercises; 2) general fitness training; 3) stretching alone; and 4) feedback exercises combined with pattern synchronization may not change pain or function at immediate post treatment to short-term follow-up. Very low evidence suggests neuromuscular eye-neck co-ordination/proprioceptive exercises may improve pain and function at short-term follow-up.For chronic cervicogenic headache, moderate quality evidence supports static-dynamic cervico-scapulothoracic strengthening/endurance exercises including pressure biofeedback immediate post treatment and probably improves pain, function and global perceived effect at long-term follow-up. Low grade evidence supports sustained natural apophyseal glides (SNAG) exercises.For acute radiculopathy, low quality evidence suggests a small benefit for pain reduction at immediate post treatment with cervical stretch/strengthening/stabilization exercises. AUTHORS' CONCLUSIONS No high quality evidence was found, indicating that there is still uncertainty about the effectiveness of exercise for neck pain. Using specific strengthening exercises as a part of routine practice for chronic neck pain, cervicogenic headache and radiculopathy may be beneficial. Research showed the use of strengthening and endurance exercises for the cervico-scapulothoracic and shoulder may be beneficial in reducing pain and improving function. However, when only stretching exercises were used no beneficial effects may be expected. Future research should explore optimal dosage.
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Affiliation(s)
- Anita Gross
- McMaster UniversitySchool of Rehabilitation Science & Department of Clinical Epidemiology and Biostatistics1400 Main Street WestHamiltonONCanadaL8S 1C7
| | - Theresa M Kay
- Women's College HospitalTorontoONCanada
- University of TorontoDepartment of Physical TherapyTorontoCanada
| | | | | | | | | | | | - Nadine Graham
- McMaster UniversitySchool of Rehabilitation Science1200 Main Street WestHamiltonONCanada
| | - Stephen J Burnie
- Canadian Memorial Chiropractic CollegeDepartment of Clinical Education6100 Leslie StreetTorontoONCanadaM2H 3J1
| | - Geoff Gelley
- University of ManitobaApplied Health Sciences500 University CentreWinnipegMBCanadaR3T 2N2
| | - Charles H Goldsmith
- Simon Fraser UniversityFaculty of Health SciencesBlossom Hall, Room 95108888 University DriveBurnabyBCCanadaV5A 1S6
| | - Mario Forget
- National Defence | Défense Nationale, Government of Canada | Gouvernement du CanadaCanadian Forces Health Services Group | Groupe de services de santé des Forces Canadiennes33 Canadian Forces Health Services Centre | 33ième Centre de services de santé des Forces CanadiennesKingstonONCanadaK7K 7B4
| | - Jan L Hoving
- Academic Medical Center, University of AmsterdamCoronel Institute of Occupational Health and Research Center for Insurance MedicinePO Box 22700AmsterdamNetherlands1100 DE
| | - Gert Brønfort
- University of MinnesotaIntegrative Health & Wellbeing Research Program, Center for Spirituality & Healing420 Delaware Street SE, MMC505MinneapolisMNUSA55455
| | - Pasqualina L Santaguida
- McMaster UniversityDepartment of Clinical Epidemiology and Biostatistics1280 Main Street WestCourthouse T‐27 Building, Room 309HamiltonONCanadaL8S 4L8
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National survey of back & neck pain amongst consultant ophthalmologists in the United Kingdom. Int Ophthalmol 2015; 35:769-75. [PMID: 25609503 DOI: 10.1007/s10792-015-0036-z] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2014] [Accepted: 01/04/2015] [Indexed: 01/09/2023]
Abstract
Repetitive tasks, awkward or prolonged working postures, and high cognitive load are risk factors for occupational musculoskeletal disorders. Ophthalmologists may be vulnerable given that they are exposed to a combination of these factors. This national study assesses the prevalence, severity and associations of back and neck pain amongst UK consultant ophthalmologists. A postal survey was conducted using addresses supplied by the Royal College of Ophthalmologists. Statistical analysis was performed using Pearson correlation coefficient, two-tailed probability testing, analysis of variance (ANOVA) and Dunn's multiple comparison test. 518 responses were received (50.3 % response rate). Back and neck pain were reported by 50.6 % (262/518) and 31.8 % (165/518) of respondents, respectively, with 62.4 % (323/518) reporting one or both. 33.6 % (174/518) reported pain whilst operating, of whom 78.7 % (137/174) found operating exacerbated their pain. 31.7 % (164/518) reported pain when using the slit lamp, of whom 71.3 % (117/164) found it exacerbated their pain. Individual subspecialties showed a significant relative risk of back or neck pain in some circumstances, when compared to ophthalmologists as a whole. Occupational back and neck pain remains a problem amongst ophthalmologists. Recommendations are made for modifications to the working environment, and consideration should be given to improving education for trainees.
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Rodrigues EV, Gomes ARS, Tanhoffer AIP, Leite N. Effects of exercise on pain of musculoskeletal disorders: a systematic review. ACTA ORTOPEDICA BRASILEIRA 2014; 22:334-8. [PMID: 25538482 PMCID: PMC4273961 DOI: 10.1590/1413-78522014220601004] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/14/2014] [Accepted: 09/04/2014] [Indexed: 11/26/2022]
Abstract
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).
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Process evaluation of workplace interventions with physical exercise to reduce musculoskeletal disorders. Int J Rheumatol 2014; 2014:761363. [PMID: 25574172 PMCID: PMC4276703 DOI: 10.1155/2014/761363] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2014] [Accepted: 11/19/2014] [Indexed: 11/23/2022] Open
Abstract
Process evaluation is important to explain success or failure of workplace interventions. This study performs a summative process evaluation of workplace interventions with physical exercise. As part of a randomized controlled trial 132 office workers with neck and shoulder pain were to participate in 10 weeks of elastic resistance training five times a week at the workplace; the 2 min group performed a single set of lateral raise to failure, and the 12 min group performed 5-6 sets with 8–12 repetitions. Participants received a single instructional session together with a training diary and manual at baseline (100% dose delivered and 100% dose received), and 59 and 57 participants, respectively, replied to the process evaluation questionnaire at 10-week follow-up. Results showed that in the 2 and 12 min groups, respectively, 82% and 81% of the participants completed more than 30 training sessions. However, two-thirds of the participants would have preferred more than a single exercise to vary between. In the 12 versus 2 min group more participants experienced the training sessions as too long (30% versus 5%). Most participants (67–92%) found the training diary and manual helpful, adequacy in a single instructional session, and satisfaction with the type of training. Among those with low adherence, lack of time (51%) and difficulties in starting exercising after illness (26%) were common barriers for regular training. Among those with low adherence, 52% felt that five training sessions per week were too much, and 29% would rather have trained a completely different kind of exercise. In conclusion, resistance training at the workplace is generally well received among office workers with neck-shoulder pain, but a one-size-fits-all approach is not feasible for all employees.
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Varatharajan S, Côté P, Shearer HM, Loisel P, Wong JJ, Southerst D, Yu H, Randhawa K, Sutton D, van der Velde G, Mior S, Carroll LJ, Jacobs C, Taylor-Vaisey A. Are work disability prevention interventions effective for the management of neck pain or upper extremity disorders? A systematic review by the Ontario Protocol for Traffic Injury Management (OPTIMa) collaboration. JOURNAL OF OCCUPATIONAL REHABILITATION 2014; 24:692-708. [PMID: 24522460 DOI: 10.1007/s10926-014-9501-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
PURPOSE We conducted a systematic review to critically appraise and synthesize literature on the effectiveness of work disability prevention (WDP) interventions in workers with neck pain, whiplash-associated disorders (WAD), or upper extremity disorders. METHODS We searched electronic databases from 1990 to 2012. Random pairs of independent reviewers critically appraised eligible studies using the Scottish Intercollegiate Guidelines Network criteria. Scientifically admissible studies were summarized and synthesized following best-evidence synthesis methodology. RESULTS Of the 6,359 articles retrieved, 16 randomized controlled trials were eligible for critical appraisal and five were admissible. We found that a return-to-work coordination program (including workplace-based work hardening) was superior to clinic-based work hardening for persistent rotator cuff tendinitis. Workplace high-intensity strength training and workplace advice had similar outcomes for neck and shoulder pain. Mensendieck/Cesar postural exercises and strength and fitness exercises had similar outcomes for non-specific work-related upper limb complaints. Adding a brief job stress education program to a workplace ergonomic intervention was not beneficial for persistent upper extremity symptoms. Adding computer-prompted work breaks to ergonomic adjustments and workplace education benefited workers' recovery from recent work-related neck and upper extremity complaints. CONCLUSIONS At present, no firm conclusions can be drawn regarding the effectiveness of WDP interventions for managing neck pain, WAD, and upper extremity disorders. Our review suggests a return-to-work coordination program is more effective than clinic-based work hardening. Also, adding computer-prompted breaks to ergonomic and workplace interventions benefits workers' recovery. The current quality of evidence does not allow for a definitive evaluation of the effectiveness of ergonomic interventions.
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Affiliation(s)
- Sharanya Varatharajan
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT), 6100 Leslie Street, Toronto, ON, M2H 3J1, Canada,
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