The influence of working conditions and individual factors on the incidence of neck and upper limb symptoms among professional computer users Incidence of musculoskeletal disorders among newly employed manufacturing workers. Job task and psychosocial risk factors for work-related musculoskeletal disorders among newspaper employees. The effects of neck–shoulder pain development on sensory–motor interactions among female workers in the poultry and fish industries. A prospective study Differential effects of mental load on proximal and distal arm muscle activity Work Related Risk Factors for Neck, Shoulder and Arms Complaints: A Cohort Study Among Dutch Computer Office Workers A randomised controlled trial evaluating the effects of two workstation interventions on upper body pain and incident musculoskeletal disorders among computer operators A Tailored Workplace Exercise Program for Women at Risk for Neck and Upper Limb Musculoskeletal Disorders: A Randomized Controlled Trial The effectiveness of a work style intervention and a lifestyle physical activity intervention on the recovery from neck and upper limb symptoms in computer workers Effectiveness of a questionnaire based intervention programme on the prevalence of arm, shoulder and neck symptoms, risk factors and sick leave in computer workers: A cluster randomised controlled trial in an occupational setting Protocol for Shoulder function training reducing musculoskeletal pain in shoulder and neck: a randomized controlled trial The (cost-)effectiveness of a lifestyle physical activity intervention in addition to a work style intervention on the recovery from neck and upper limb symptoms in computer workers Upper trapezius muscle activation patterns in neck–shoulder pain patients and healthy controls Shoulder muscle co-ordination during chronic and acute experimental neck-shoulder pain. An occupational pain study Prognostic Factors for Intervention Effect on Neck/Shoulder Symptom Intensity and Disability among Female Computer Workers Social and psychological factors influenced the course of arm, neck and shoulder complaints. 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
Objectives To assess the influence of working conditions and individual factors on the incidence of neck and upper limb symptoms among professional computer users . Methods The study is a prospect i ve cohort study with an observation period of 10 months . A baseline question naire about symptoms in the neck , shoulder and arm/h and during previous month , individual factors , work content , physical and psychosocial work-related exposures was answered by 1,283 computer operators ( response rate 84 % ) . Incidence data were collected by ten monthly question naires regarding the occurrence of symptoms categorized into three gross body regions : neck , shoulders and arms/h and s. A case , in the specific gross body region , was defined as a subject who was classified as non-symptomatic in that region at baseline or during minimum one follow-up period and later reported symptoms ( ≥3 days ) . Univariable and multivariable incidence rate ratios with 95 % confidence intervals for first occurrence of neck , shoulder and arm/h and cases , respectively , were calculated with Cox regression analysis . Results The incidence rate was 67 , 41 and 47 cases per 100 person years for neck , shoulder and arm/h and symptoms , respectively . In the multivariable analyses , comfort of the computer work environment and gender were related to the incidence of symptoms in all body regions ( RR = 1.5–1.9 for low comfort and 1.8–2.1 for females , respectively ) . Duration of mouse use predicted arm/h and symptoms ( RR = 1.7 for ≥3 h/day ) and job strain ( high dem and s and low decision latitude ) predicted neck symptoms ( RR = 1.6 and 2.2 for medium and high strain , respectively ) . Additionally , age was related to neck and shoulder symptoms . Conclusion Preventive strategies to reduce neck and upper limb symptoms among computer users should include measures to reduce mouse use  , to increase the comfort of the work environment and to reduce job strain . Although the effect estimates were relatively weak to moderate , preventive measures may have a marked impact on the incidence of neck and upper limb symptoms in the general population because of the widespread use of computers in working life as well as at home OBJECTIVES The incidence of upper-limb , neck-shoulder , and low-back disorders and their induction times were investigated among new workers in tasks with various physical workloads . METHODS New trailer assemblers ( N=364 ) were followed prospect ively for 45 months -- the workers ' health status via medical records and exposure to physical workload factors via job titles , walk-throughs , task descriptions , and some direct measurements . The incidence rate of first sick leave due to such disorders was calculated for different workload groups . The proportion of workers surviving without musculoskeletal disorders was estimated by the Kaplan-Maier product-limit estimator , and the effect of the exposure on the risk of incident disorders was estimated with the Cox proportional hazards model . RESULTS The highest annual incidences were observed for strenuous tasks , the incidence rate for men being 16.8 per 100 person-years [ 95 % confidence interval ( 95 % CI ) 8.0 - 30.9 ] for upper-limb disorders in strenuous tasks and 6.1 ( 95 % CI 2.0 - 14.1 ) in nonstrenuous tasks and that for women being 32.0 ( 95 % CI 11.7 - 69.7 ) and 9.9 ( 95 % CI 0.2 - 54.9 ) , respectively . The men 's risk of contracting an upper-limb or neck-shoulder disorder in strenuous tasks was about threefold [ hazard ratio ( HR ) 3.2 ( 95 % CI 1.1 - 9.4 ) for upper-limb disorders and 2.7 ( 95 % CI 0.9 - 8.1 ) for neck-shoulder disorders ] that of nonstrenuous tasks , whereas workload seemed not to affect low-back disorders . The workers first sought medical advice for their disorders typically some months after employment began . CONCLUSIONS Newly employed workers in h and -intensive tasks have a high risk of upper-limb and neck-shoulder disorders . An etiologic role for activities involving high force dem and s in upper-limb and neck-shoulder disorders is possible OBJECTIVES A cross-sectional study was conducted to assess the association of upper extremity musculoskeletal disorders and work-related factors among employees using video display terminals at a large metropolitan newspaper . METHODS The study included 1050 r and omly selected workers from four departments . The workers were asked to complete question naires on symptoms , job tasks , and psychosocial and work organization conditions . Musculoskeletal disorders of the upper extremities were defined by frequency , duration , and intensity of symptoms not attributable to acute injury . Data were analyzed with the use of logistic regression . RESULTS A total of 973 workers completed the survey . The one-year period prevalence rate for any musculoskeletal disorder of the upper extremities was 41 % . Neck symptoms ( 26 % ) were the most frequently reported , followed by h and or wrist ( 22 % ) , shoulder ( 17 % ) , and elbow ( 10 % ) symptoms . Greater time working at the video display station was associated with increased h and or wrist symptoms in a dose-response relationship . In addition , variables corresponding to increased work-load dem and s ( eg , increased time working under deadline and increased job pressure ) were associated with increased neck , shoulder , and h and or wrist disorders . Women were more likely to report symptoms in several areas , but this finding may reflect the concentration of women in jobs involving more risk factors . CONCLUSIONS The results suggest a high prevalence of musculoskeletal disorders of the upper extremities among newspaper employees , and they provide additional evidence that increased work load , time pressure , and greater hours of computer use are related to the occurrence of work-related musculoskeletal disorders among these workers , particularly for disorders in the h and or wrist area Abstract Objectives . The purpose of this prospect i ve laboratory study was to follow newly employed workers in the fish or poultry industry for 6 months and investigate possible changes in sensory manifestations and motor performance during low load , repetitive work simulation . It was investigated whether the changes were an effect of employment duration and of development of neck – shoulder complaints . Methods . Twelve newly employed female filleting employees without any sign of neck – shoulder tenderness/pain at the time of employment of 0 months took part in two laboratory recording sessions planned within 1 month of employment and after 6 months of employment at the plant . After 6 months , six workers out of 12 had developed pain and /or tenderness in the neck – shoulder region . The recording sessions evaluated sensory-motor aspects by measuring pressure pain threshold , work-task timing , cutting forces , surface electromyographic activity of four shoulder muscles , displacement of the centre of pressure , and 3D movements of the arm and trunk during simulation of low load , repetitive filleting . Results . Effects due to the duration of employment were observed in both groups , i.e. decreased sensibility to pressure , decrease in the duration of the work cycle , increased arm starting position with respect to the upright position , and decreased range of motion of the arm and trunk ( P<0.05 ) after 6 months . Among the workers with neck – shoulder complaints , increased sensibility to pressure , lower force level , higher electromyographic activity , decreased amplitude of arm movement , and increased trunk posture and movement amplitude ( P<0.05 ) were observed , compared with workers without complaints . Conclusions . Differences in terms of sensory manifestations and motor control strategy were seen after 6 months of employment with or without neck – shoulder complaints . In general , changes in sensory manifestations and motor control strategy after 6 months work were most likely of importance , as they underlined a learning process as employment duration increased . Moreover , the present sensory – motor changes observed among workers with neck – shoulder complaints highlighted the potential physical risk factors associated with low load , repetitive work Work-related upper extremity disorders ( WRUEDs ) that result from keyboarding  tasks are prevalent and costly . Although the precise mechanisms causing the disorder are not yet fully understood , several risk factors have been proposed . These include the repetitive nature of the motor task and the associated sustained static working postures , but also more psychological factors such as mental load . Epidemiological surveys have shown that WRUEDs are more prone to develop in the postural muscles of the neck/shoulder area than in the executive muscles controlling the h and . The present study investigated whether the activation patterns of these two muscle types are differentially affected by an additional mental load during the performance of a repetitive tapping task .  Participants tapped various keying patterns with their dominant index finger at two prescribed tempi . Mental load was manipulated by means of an auditory short-term memory task . We recorded the  EMG activity of two neck/shoulder muscles ( trapezius and deltoid ) , two upper arm muscles ( biceps and triceps ) , and four forearm muscles ( flexor digitorum superficialis , extensor digitorum , extensor carpi radialis longus and extensor carpi ulnaris ) and analyzed the kinematics and impact forces of the index finger . The results confirmed that the upper limb has two functions . Specifically , activity of the executive distal musculature was increased during tapping at the higher pace , while the activity of the postural upper limb musculature was elevated due to the memory task . We argue that continuously increased muscular activity can lead to fatigue and thus eventually cause musculoskeletal complaints . The results are discussed with respect to biomechanical adaptation strategies that deal with the consequences of increased noise in the neuromotor system due to enhanced mental processing Introduction This study aims to investigate the relationship between work-related physical and psychosocial characteristics and complaints of the neck , shoulder and forearm/h and s. Methods Data were used from a prospect i ve Dutch cohort study among computer office workers with a follow-up period of 2 years . The study was conducted among 264 computer users . Physical and psychosocial risk factors were tested to predict the occurrence of neck , shoulder and forearm/h and s complaints . Bivariate and multivariable logistic regression was used to identify the association between risk factors and outcome variables . Results The 2 year follow-up prevalence rates with 95 % CI for neck complaints were 0.31 ( 0.28–0.37 ) , for shoulder complaints 0.33 ( 0.27–0.39 ) and for forearm/h and s complaints 0.21 ( 0.14–0.28 ) . Four main predictors for the occurrence of neck and shoulder complaints were identified : ( 1 ) Irregular head and body posture [ OR : 1.1 ( 1.0–1.2 ) P = 0.04 ] ; ( 2 ) task difficulty ( job dem and s ) [ OR : 1.2 ( 1.0–1.5 ) P = 0.01 ] ; ( 3 ) number of working hours/day with the computer [ OR : 1.20 ( 1.0–1.4 ) P = 0.03 ] ; and ( 4 ) having had a previous history of complaints [ OR : 7.2 ( 3.8–13.2 ) P = 0.01 ] . Two predictors were identified for forearm/h and s complaints : time pressure ( job dem and s ) [ OR : 1.20 ( 1.0–1.4 ) P = 0.03 ] and having had a previous history of complaints [ OR : 7.1 ( 3.5–14.1 ) P = 0.06 ] . Conclusion This longitudinal study suggests that risk factors of upper musculoskeletal complaints in computer workers consist of a mixture of physical and psychosocial characteristics Background : Call centre work with computers is associated with increased rates of upper body pain and musculoskeletal disorders . Methods : This one year , r and omised controlled intervention trial evaluated the effects of a wide forearm support surface and a trackball on upper body pain severity and incident musculoskeletal disorders among 182 call centre operators at a large healthcare company . Participants were r and omised to receive ( 1  ) ergonomics training only , ( 2 ) training plus a trackball , ( 3 ) training plus a forearm support , or ( 4 ) training plus a trackball and forearm support . Outcome measures were weekly pain severity scores and diagnosis of incident musculoskeletal disorder in the upper extremities or the neck/shoulder region based on physical examination performed by a physician blinded to intervention . Analyses using Cox proportional hazard models and linear regression models adjusted for demographic factors , baseline pain levels , and psychosocial job factors . Results : Post-intervention , 63 participants were diagnosed with one or more incident musculoskeletal disorders  . Hazard rate ratios showed a protective effect of the armboard for neck/shoulder disorders ( HR = 0.49 , 95 % CI 0.24 to 0.97 ) after adjusting for baseline pain levels and demographic and psychosocial factors . The armboard also significantly reduced neck/shoulder pain ( p = 0.01 ) and right upper extremity pain ( p = 0.002 ) in comparison to the control group . A return-on-investment model predicted a full return of armboard and installation costs within 10.6 months . Conclusion : Providing a large forearm support combined with ergonomic training is an effective intervention to prevent upper body musculoskeletal disorders and reduce upper body pain associated with computer work among call centre employees Objective : The aim of this study was to evaluate a tailored physical activity protocol performed in a work environment with a group of female workers employed in manual precision tasks to reduce upper limb pain . Methods : Sixty female subjects were r and omly assigned to an intervention group or a control group . The IG was administered of a 6-month , twice-a-week , tailored exercise program , whereas the CG received no intervention . Results : The IG showed a reduction on shoulder pain accompanied by increases on the range of motion measures . In addition , reductions in upper limb pain and neck disability were detected with concomitant increases in grip strength . Conclusions : This study indicated positive effects of a tailored workplace exercise protocol in female workers exposed to moderate risk for work-related musculoskeletal disorders , showing clinical ly meaningful reductions of pain symptoms and disability on upper limb and neck regions Abstract This study assessed the effectiveness of a single intervention targeting work style and a combined intervention targeting work style and physical activity on the recovery from neck and upper limb symptoms . Computer workers with frequent or long‐term neck and upper limb symptoms were r and omised into the work style group ( WS , n = 152 ) , work style and physical activity group ( WSPA , n = 156 ) , or usual care group ( n = 158 ) . The WS and WSPA group attended six group meetings . All meetings focused on behavioural change with regard to body posture , workplace adjustment , breaks and coping with high work dem and s ( WS and WSPA group ) and physical activity ( WSPA group ) . Pain , disability at work , days with symptoms and months without symptoms were measured at baseline and after 6 ( T1 ) and 12 months ( T2 ) . Self‐reported recovery was assessed at T1/T2 . Both interventions were ineffective in improving recovery . The work style intervention but not the combined intervention was effective in reducing all pain measures . These effects were present in the neck/shoulder , not in the arm/wrist/h and . For the neck/shoulder , the work style intervention group also showed an increased recovery‐rate . Total physical activity increased in all study groups but no differences between groups were observed . To conclude , a group‐based work style intervention focused on behavioural change was effective in improving recovery from neck/shoulder symptoms and reducing pain on the long‐term . The combined intervention was ineffective in increasing total physical activity . Therefore we can not draw conclusions on the effect of increasing physical activity on the recovery from neck and upper limb symptoms Background Arm , shoulder and neck symptoms are very prevalent among computer workers . In an attempt to reduce these symptoms , a large occupational health service in the Netherl and s developed a preventive programme on exposure to risk factors , prevalence of arm , shoulder and neck symptoms , and sick leave in computer workers . The purpose of this study was to assess the effectiveness of this intervention programme . Methods The study was a r and omised controlled trial . The participants were assigned to either the intervention group or the usual care group by means of cluster r and omisation . At baseline and after 12 months of follow-up , the participants completed the RSI QuickScan question naire on exposure to the risk factors and on the prevalence of arm , shoulder and neck symptoms . A tailor-made intervention programme was proposed to participants with a high risk profile at baseline . Examples of implemented interventions are an individual workstation check , a visit to the occupational health physician and an education programme on the prevention of arm , shoulder and neck symptoms . The primary outcome measure was the prevalence of arm , shoulder and neck symptoms . Secondary outcome measures were the scores on risk factors for arm , shoulder and neck symptoms and the number of days of sick leave . Sick leave data was obtained from the companies . Multilevel analyses were used to test the effectiveness . Results Of the 1,673 persons invited to participate in the study , 1,183 persons ( 71 % ) completed the baseline question naire and 741 persons participated at baseline as well as at 12-month follow-up . At 12-month follow-up , the intervention group showed a significant positive change ( OR = 0.48 ) in receiving information on healthy computer use , as well as a significant positive change regarding risk indicators for work posture and movement , compared to the usual care group . There were no significant differences in changes in the prevalence of arm , shoulder and neck symptoms or sick leave between the intervention and usual care group . Conclusions The effects of the RSI QuickScan intervention programme were small , possibly as a result of difficulties with the implementation process of the proposed interventions . However , some significant positive effects were found as to an increase in receiving education and a decrease in exposure to adverse postures and movements . With regard to symptoms and sick leave , only small and non-significant effects were found . Trial registration Netherl and s National Trial Register Background Neck and shoulder complaints are common among employees in sedentary occupations characterized by intensive computer use . Such musculoskeletal pain - which is often associated with restricted range of motion and loss of muscle strength - is one of the most common conditions treated by physical therapists . The exact mechanism of neck pain is rarely revealed by clinical examination and the treatment has varied from passive rest to active treatments . Active treatments have often been divided into either training of the painful area or the surrounding musculature avoiding direct training of the painful area . Our study investigates the effect of the latter approach . Methods / Design A r and omized controlled trial of 10 weeks duration is currently being conducted . Employed office workers with severe neck-shoulder pain are r and omized to  3 × 20 min shoulder function training with training supervision or to a reference group receiving advice to stay physically active . Shoulder function training primarily focuses on the serratus anterior and lower trapezius muscle with only minimal activation the upper trapezius . An announcement was sent to the administrative section of the university including jobs characterized by intensive computer work . The first 100 positive replies entered the study . Among these inclusion criteria were pain intensity in the neck/shoulder of at least 3 on a 0 - 9 scale . Exclusion criteria were cardiovascular disease , trauma , hypertension , or serious chronic disease . Before and after the intervention period the participants replied to a question naire about musculoskeletal disorders and work disability , and underwent a st and ardized clinical examination of the neck and shoulder girdle . Further , on a weekly basis the participants log pain intensity of the neck and shoulder during the previous week . The primary outcome measure is pain in the neck and shoulders at week 10 based on the weekly pain registration and results from the clinical examination . Secondary outcomes are strength and work disability . Trial Registration Clinical Trials ( NCT ) : Background Neck and upper limb symptoms are frequently reported by computer workers .  Work style interventions are most commonly used to reduce work-related neck and upper limb symptoms but lifestyle physical activity interventions are becoming more popular to enhance workers health and reduce work-related symptoms . A combined approach targeting work style and lifestyle physical activity seems promising , but little is known on the effectiveness of such combined interventions . Methods / design The RSI@Work study is a r and omised controlled trial that aims to assess the added value of a lifestyle physical activity intervention in addition to a work style intervention to reduce neck and upper limb symptoms in computer workers . Computer workers from seven Dutch companies with frequent or long-term neck and upper limb symptoms in the preceding six months and /or the last two weeks are r and omised into three groups : ( 1 ) work style group , ( 2 ) work style and physical activity group , or ( 3 ) control group . The work style intervention consists of six group meetings in a six month period that take place at the workplace , during work time , and under the supervision of a specially trained counsellor . The goal of this intervention is to stimulate workplace adjustment and to improve body posture , the number and quality of breaks and coping behaviour with regard to high work dem and s. In the combined ( work style and physical activity ) intervention the additional goal is to increase moderate to heavy physical activity . The control group receives usual care . Primary outcome measures are degree of recovery , pain intensity , disability , number of days with neck and upper limb symptoms , and number of months without neck and upper limb symptoms . Outcome measures will be assessed at baseline and six and 12 months after r and omisation . Cost-effectiveness of the group meetings will be assessed using an employer 's perspective . Discussion This study will be one of the first to assess the added value of a lifestyle physical activity intervention in addition to a work style intervention in reducing neck and upper limb symptoms of computer workers . The results of the study are expected in 2007 This study aim ed at investigating whether patients with neck – shoulder complaints from different aetiologies ( work-related musculo-skeletal disorders , WMSD ; whiplash associated disorders , WAD ) show comparable muscle activation patterns , characterised by higher activation and lower relaxation levels of the trapezius muscles compared to healthy controls . Twenty healthy controls , 21 WMSD and 20 WAD patients with non-acute neck-shoulder pain were recruited for this cross-sectional study .  Surface electromyography ( sEMG ) recordings were performed at the upper trapezius muscles during reference contractions , st and ardised computer tasks ( typing and unilateral stress task ) , and rest measurements . sEMG was continuously recorded during these measurements .  Outcome measures were root mean square ( RMS ) to study muscle activity , and relative rest time ( RRT ) to study muscle relaxation . Statistical analysis comprised the bootstrap technique and Kruskall – Wallis tests . Results showed no clear evidence for abnormal muscle activation patterns in WMSD and WAD patients compared to healthy controls . However , a tendency was observed for higher RMS levels during the reference contractions and computer tasks in both patient groups compared to healthy controls , and lower RRT levels at the non-dominant side during stress . Both patient groups also showed larger variability in RMS and RRT values . This variability has more often been reported in literature and may suggest the existence of subgroups of pain patients with corresponding different muscle activation patterns not related to aetiology . Future research may focus on identifying these subgroups of patients with neck-shoulder pain Abstract Little is known about the mechanisms leading to chronic neck-shoulder musculoskeletal disorders  ( MSD ) . The aim of the present study was to investigate and compare motor function during controlled , low load , repetitive work together with chronic or acute experimental neck-shoulder pain . The clinical study was performed on workers with ( n = 12 ) and without ( n = 6 ) chronic neck-shoulder pain . In the experimental study , experimental muscle pain was induced in healthy subjects by intra-muscular injection of hypertonic saline into the trapezius muscle ( n = 10 ) . The assessed parameters related to motor performance were : work task event duration , cutting forces , surface electromyogram ( EMG ) activity in four shoulder muscles , displacement of the centre of pressure , and arm and trunk 3D movements . For controlled cutting force levels , chronic and acute experimental pain provoked a series of changes : a decreased working rhythm and a protective reorganisation of muscle synergy ( experimental study ) , higher EMG frequency contents which may indicate altered motor unit recruitment , and greater postural activity and a tendency towards increased arm and trunk movements . These pain-related changes can play a role in the development of MSD . The present clinical and experimental study demonstrated similar interactions between motor co-ordination and neck-shoulder pain in occupational setting s. We therefore suggest that this experimental model can be used to study mechanisms related to MSD . Information on such modulatory processes may help in the design of new strategies aim ed at reducing the development of MSD Introduction It has been suggested that treatments may be more effective when they are matched to patient characteristics . This study aim ed at investigating potential prognostic factors for clinical ly relevant improvement in symptom intensity and symptom-related disability among employees with symptoms in the neck/shoulder area , receiving either ergonomics counseling or such counseling in combination with myofeedback training .  Methods A r and omized controlled study was performed among female computer users aged 45 or older ( n = 36 ) . A clinical examination and a question naire survey were performed before inclusion in the study . Symptom intensity and disability was assessed using question naires before the start of the interventions ( baseline ) and at follow-ups directly after the end of the interventions ( T0 ) and after 3 ( T3 ) and 6 ( T6 ) months . Logistic regression analyses were performed in order to assess prognostic factors for clinical ly relevant improvement in symptom intensity and disability . Results Improvement in symptom intensity was consistently predicted by symptom intensity at baseline . Diagnosis and stress-induced lack of muscular rest were prognostic factors for improvement in symptom intensity at short term follow-up . Baseline disability and passive coping consistently served as prognostic factors for outcome in disability . Few substantial differences were found between the interventions in terms of prognostic factors . Conclusions Myofeedback training in combination with ergonomics counseling seem to be an especially beneficial tool for secondary prevention among employees with moderate levels of symptom intensity and symptom-related disability , who respond to work-related stress by increased/sustained muscle activation , and who tend to employ passive coping to deal with their neck/shoulder symptoms OBJECTIVE To investigate the clinical course and prognostic factors of complaints of arm , neck , and shoulder . STUDY DESIGN AND SETTING A prospect i ve cohort study in physical therapy practice . Participating physiotherapists recruited new consulters with musculoskeletal complaints of the neck and /or upper extremities . Participants filled in question naires at baseline , 3 months , and 6 months . The main outcome measure was the persistence of complaints over 6-month follow-up . Possible predictors like social and psychological factors , physical factors , and complaint specific factors were tested in univariate and multivariate logistic regression analyses for repeated measurements . RESULTS Of the 624 participants at baseline 543 ( 87 % ) returned at least one follow-up question naire . At 6-month follow-up , 40 % had persisting pain and discomfort . Somatization , kinesiophobia , catastrophizing , and a long duration of complaints at baseline were significantly related to the persistence of complaints over 6 months in the total population . In those with paid work ( 77 % ) , catastrophizing , low decision authority at work , and a long duration of complaints at baseline were significantly related to the persistence of complaints over 6 months . CONCLUSION 40 % of the participants had persisting pain and discomfort after 6 months and mainly social and psychological factors played a role in this course 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 search ed electronic data bases from 1990 to 2012 . R and om pairs of independent review ers 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 r and omized 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
None of the ergonomic interventions was more beneficial for any outcome measures when compared with another treatment or with no treatment or with placebo .
Behavioural interventions had inconsistent effects on pain and disability , with some subgroups showing benefit and others showing no significant improvement when compared with no treatment , minor intervention controls or other behavioural interventions .In the eight studies that evaluated various other interventions , there was no evidence of a clear beneficial effect of any of the interventions provided .
We found very low- quality evidence indicating that pain , recovery , disability and sick leave are similar after exercises when compared with no treatment , with minor intervention controls or with exercises provided as additional treatment to people with work-related complaints of the arm , neck or shoulder .
Low- quality evidence also showed that ergonomic interventions did not decrease pain at short-term follow-up but did decrease pain at long-term follow-up .
There was no evidence of an effect on other outcomes .
For behavioural and other interventions , there was no evidence of a consistent effect on any of the outcomes .
BACKGROUND Work-related upper limb disorder ( WRULD ) , repetitive strain injury ( RSI ) , occupational overuse syndrome ( OOS ) and work-related complaints of the arm , neck or shoulder ( CANS ) are the most frequently used umbrella terms for disorders that develop as a result of repetitive movements , awkward postures and impact of external forces such as those associated with operating vibrating tools .
Work-related CANS , which is the term we use in this review , severely hampers the working population .
OBJECTIVES To assess the effects of conservative interventions for work-related complaints of the arm , neck or shoulder ( CANS ) in adults on pain , function and work-related outcomes .