PMCC PMCC

Search tips
Search criteria

Advanced
Results 1-12 (12)
 

Clipboard (0)
None

Select a Filter Below

Journals
Year of Publication
Document Types
1.  Effect of individually tailored biopsychosocial workplace interventions on chronic musculoskeletal pain, stress and work ability among laboratory technicians: randomized controlled trial protocol 
Background
Among laboratory technicians, the prevalence of neck and shoulder pain is widespread possibly due to typical daily work tasks such as pipetting, preparing vial samples for analysis, and data processing on a computer including mouse work - all tasks that require precision in motor control and may result in extended periods of time spent in static positions.
In populations characterized by intense chronic musculoskeletal pain and diagnosed conditions in conjunction with psycho-physiological symptoms such as stress-related pain and soreness and other disabling conditions, multifactorial approaches applying a combination of individually tailored physical and cognitive strategies targeting the areas most needed, may be an effective solution to the physical and mental health challenges.
The aim of this study is therefore to investigate the effect of an individually tailored biopsychosocial intervention strategy on musculoskeletal pain, stress and work disability in lab technicians with a history of musculoskeletal pain at a single worksite in Denmark.
Methods/design
In this single-blind two-armed parallel-group randomized controlled trial with allocation concealment, participants receive either an individualized multifactorial intervention or “usual care” for 10 weeks at the worksite. Inclusion criteria: 1) female laboratory technician (18-67 years of age) and 2) Pain intensity ≥ 3 (0-10 Visual Analogue Scale) lasting ≥3 months with a frequency of ≥ 3 days per week in one or more of the following regions: i) upper back i) low back iii) neck, iv) shoulder, v) elbow and/or vi) hand. Exclusion criteria: 1) life-threatening disease and 2) pregnancy. Stress, as measured by Cohen´s perceived stress questionnaire is not an inclusion criteria, thus participants can participate regardless of their stress level.
We will implement an individualized intervention addressing biopsychosocial elements of musculoskeletal pain with the following components; i) increasing physical capacity through strength- and motor control training; ii) lowering or preventing development of stress through mindfulness practice and learning de-catastrophizing pain management strategies through cognitive training.
The primary outcome at 10-week follow-up is the between-group difference in intensity of perceived musculoskeletal pain during the last week (average value of back, neck, shoulder, elbow and hand) assessed by questionnaire (modified visual analogue scale 0-10).
Discussion
This study will provide experimental evidence to guide workplace initiatives designed towards reducing chronic musculoskeletal pain and stress.
Trial registration number
ClinicalTrials.gov NCT02047669.
doi:10.1186/1471-2474-15-444
PMCID: PMC4325961  PMID: 25519844
Musculoskeletal disorders; Occupational health and performance; Neck pain; Shoulder pain; Elbow pain; Hand pain; Wrist pain; Repetitive work; Stress; Work ability
2.  Acute Effect of Topical Menthol on Chronic Pain in Slaughterhouse Workers with Carpal Tunnel Syndrome: Triple-Blind, Randomized Placebo-Controlled Trial 
Topical menthol gels are classified “topical analgesics” and are claimed to relieve minor aches and pains of the musculoskeletal system. In this study we investigate the acute effect of topical menthol on carpal tunnel syndrome (CTS). We screened 645 slaughterhouse workers and recruited 10 participants with CTS and chronic pain of the arm/hand who were randomly distributed into two groups to receive topical menthol (Biofreeze) or placebo (gel with a menthol scent) during the working day and 48 hours later the other treatment (crossover design). Participants rated arm/hand pain intensity during the last hour of work (scale 0–10) immediately before 1, 2, and 3 hours after application. Furthermore, global rating of change (GROC) in arm/hand pain was assessed 3 hours after application. Compared with placebo, pain intensity and GROC improved more following application of topical menthol (P = 0.026 and P = 0.044, resp.). Pain intensity of the arm/hand decreased by −1.2 (CI 95%: −1.7 to −0.6) following topical menthol compared with placebo, corresponding to a moderate effect size of 0.63. In conclusion, topical menthol acutely reduces pain intensity during the working day in slaughterhouse workers with CTS and should be considered as an effective nonsystemic alternative to regular analgesics in the workplace management of chronic and neuropathic pain.
doi:10.1155/2014/310913
PMCID: PMC4178917  PMID: 25298894
3.  Effect of workplace- versus home-based physical exercise on pain in healthcare workers: study protocol for a single blinded cluster randomized controlled trial 
Background
The prevalence and consequences of musculoskeletal pain is considerable among healthcare workers, allegedly due to high physical work demands of healthcare work. Previous investigations have shown promising results of physical exercise for relieving pain among different occupational groups, but the question remains whether such physical exercise should be performed at the workplace or conducted as home-based exercise. Performing physical exercise at the workplace together with colleagues may be more motivating for some employees and thus increase adherence. On the other hand, physical exercise performed during working hours at the workplace may be costly for the employers in terms of time spend. Thus, it seems relevant to compare the efficacy of workplace- versus home-based training on musculoskeletal pain. This study is intended to investigate the effect of workplace-based versus home-based physical exercise on musculoskeletal pain among healthcare workers.
Methods/Design
This study was designed as a cluster randomized controlled trial performed at 3 hospitals in Copenhagen, Denmark. Clusters are hospital departments and hospital units. Cluster randomization was chosen to increase adherence and avoid contamination between interventions. Two hundred healthcare workers from 18 departments located at three different hospitals is allocated to 10 weeks of 1) workplace based physical exercise performed during working hours (using kettlebells, elastic bands and exercise balls) for 5 × 10 minutes per week and up to 5 group-based coaching sessions, or 2) home based physical exercise performed during leisure time (using elastic bands and body weight exercises) for 5 × 10 minutes per week. Both intervention groups will also receive ergonomic instructions on patient handling and use of lifting aides etc. Inclusion criteria are female healthcare workers working at a hospital. Average pain intensity (VAS scale 0-10) of the back, neck and shoulder (primary outcome) and physical exertion during work, social capital and work ability (secondary outcomes) is assessed at baseline and 10-week follow-up. Further, postural balance and mechanical muscle function is assessed during clinical examination at baseline and follow-up.
Discussion
This cluster randomized trial will investigate the change in self-rated average pain intensity in the back, neck and shoulder after either 10 weeks of physical exercise at the workplace or at home.
Trial registration
ClinicalTrials.gov (NCT01921764).
doi:10.1186/1471-2474-15-119
PMCID: PMC3991922  PMID: 24708570
Musculoskeletal disorders; Occupational health; Health care; Strength training; Back pain; Neck pain; Shoulder pain
4.  Association between Neck/Shoulder Pain and Trapezius Muscle Tenderness in Office Workers 
Pain Research and Treatment  2014;2014:352735.
Background. Neck/shoulder pain is a common musculoskeletal disorder among adults. The pain is often assumed to be related to muscular tenderness rather than serious chronic disease. Aim. To determine the association between neck/shoulder pain intensity and trapezius muscle tenderness in office workers. Methods. 653 employees from two large office workplaces in Copenhagen, Denmark, replied to a questionnaire on health and working conditions (mean: age 43 years, body mass index 24 kg·m−2, computer use 90% of work time, 73% women). Respondents rated intensity of neck/shoulder pain during the previous three months on a scale of 0–10 and palpable tenderness of the upper trapezius muscle on a scale of “no tenderness,” “some tenderness,” or “severe tenderness.” Odds ratios for tenderness as a function of neck/shoulder pain intensity were determined using cumulative logistic regression controlled for age, gender, and chronic disease. Results. The prevalence of “no,” “some,” and “severe” tenderness of the trapezius muscle was 18%, 59%, and 23% in women and 51%, 42%, and 7% in men, respectively (chi-square, P < 0.0001). Participants with “no,” “some,” and “severe” tenderness of the trapezius muscle, respectively, rated their neck/shoulder pain intensity to 1.5 (SD 1.6), 3.8 (SD 2.0), and 5.7 (SD 1.9) for women and 1.4 (SD 1.4), 3.1 (SD 2.2), and 5.1 (SD 1.7) for men. For every unit increase in neck/shoulder pain intensity, the OR for one unit increase in trapezius tenderness was 1.86 (95% confidence interval 1.70 to 2.04). Conclusion. In office workers, a strong association between perceived neck/shoulder pain intensity and trapezius muscle tenderness exists. The present study provides reference values of pain intensity among office workers with no, some, and severe tenderness of the trapezius muscle.
doi:10.1155/2014/352735
PMCID: PMC3985383  PMID: 24800070
5.  Reliability of a Simple Physical Therapist Screening Tool to Assess Errors during Resistance Exercises for Musculoskeletal Pain 
BioMed Research International  2014;2014:961748.
The main objective was to investigate the intra- and intertester reliability of a simple screening tool assessing errors in exercise execution by visual observation. 38 participants with no previous resistance exercise experience practiced for two weeks four typical upper limb exercises using elastic tubing. At 2-week follow-up, the participants were invited for a test-retest assessment on errors in technical execution. The assessment was based on ordinal deviation of joint position from neutral of the shoulder, elbow, and wrist in a single plane by visual observation. Moderate intratester reliability weighted kappa (wΚ) score ranging from 0.50 (0.21–0.71) to 0.57 (0.24–0.82) for observer 1 and a fair to moderate intratester reliability wΚ score ranging from 0.27 (0.09–0.43) to 0.52 (0.15–0.86) for observer 2 across the four exercises was observed. For intertester reliability moderate to substantial mean wΚ scores were found between the two observers, slightly improving from round one to round two ranging from 0.40 (0.20–0.59) to 0.68 (0.45–0.91) in round one to 0.52 (0.20–0.80) to 0.69 (0.39–0.86) in round two. The exercise error assessment demonstrated fair to substantial intratester and intertester reliability, which is congruent with previously published studies. Hence the simplicity of defining a neutral joint position for each of the involved joints in the exercise and categorizing the deviation in “some deviation” and “substantial deviation” to either side in a single plane is a viable and inexpensive solution when assessing for errors during exercise.
doi:10.1155/2014/961748
PMCID: PMC3971509  PMID: 24738079
6.  Effect of Video-Based versus Personalized Instruction on Errors during Elastic Tubing Exercises for Musculoskeletal Pain: A Randomized Controlled Trial 
BioMed Research International  2014;2014:790937.
Workplace interventions have shown beneficial results of resistance training for chronic pain in the neck, shoulder, and arm. However, studies have relied on experienced exercise instructors, which may not be an available resource at most workplaces. The objective of this study is to evaluate the technical performance level of upper limb rehabilitation exercises following video-based versus personalized exercise instruction. We recruited 38 laboratory technicians and office workers with neck/shoulder pain for a two-week exercise training period receiving either (1) personal and video or (2) video only instruction in four typical neck/shoulder/arm rehabilitation exercises using elastic tubing. At a 2-week follow-up, the participants' technical execution was assessed by two blinded physical therapists using a reliable error assessment tool. The error assessment was based on ordinal deviation of joint position from the ideal position of the shoulder, elbow, and wrist in a single plane by visual observation. Of the four exercises only unilateral shoulder external rotation had a higher normalized error score in the V group of 22.19 (9.30) to 12.64 (6.94) in the P group (P = 0.002). For the remaining three exercises the normalized error score did not differ. In conclusion, when instructing simple exercises to reduce musculoskeletal pain the use of video material is a cost-effective solution that can be implemented easily in corporations with challenging work schedules not allowing for a fixed time of day to go see a personal trainer.
doi:10.1155/2014/790937
PMCID: PMC3966350  PMID: 24734244
7.  SPECIFIC AND CROSS OVER EFFECTS OF MASSAGE FOR MUSCLE SORENESS: RANDOMIZED CONTROLLED TRIAL 
Purpose/Background:
Muscle soreness can negatively interfere with the activities of daily living as well as sports performance. In the working environment, a common problem is muscle tenderness, soreness and pain, especially for workers frequently exposed to unilateral high repetitive movements tasks. The aim of the study is therefore to investigate the acute effect of massage applied using a simple device Thera‐band roller Massager on laboratory induced hamstring muscle soreness, and the potential cross over effect to the non‐massaged limb.
Methods:
22 healthy untrained men (Mean age 34 +/− 7 years; mean height 181.7 +/− 6.9 cm; mean weight 80.6 +/− 6.4 kg; BMI: 24.5 +/− 1.3) with no prior history of knee, low back or neck injury or other adverse health issues were recruited. Participants visited the researchers on two separate occasions, separated by 48 hours, each time providing a soreness rating (modified visual analog scale 0‐10), and being tested for pressure pain threshold (PPT) and active range of motion (ROM) of the hamstring muscles. During the first visit, delayed onset muscular soreness of the hamstring muscles was induced by 10 x 10 repetitions of the stiff‐legged dead‐lift. On the second visit participants received either 1) 10 minutes of roller massage on one leg, while the contralateral leg served as a cross over control, or 2) Resting for 10 minutes with no massage at all. Measurement of soreness, PPT and ROM were taken immediately before and at 0, 10, 30 and 60 min. after treatment.
Results:
There was a significant group by time interaction for soreness (p < 0.0001) and PPT (p = 0.0007), with the massage group experiencing reduced soreness and increasing PPT compared with the control group. There was no group by time interaction for ROM (p = 0.18). At 10 min. post massage there was a significant reduction in soreness of the non‐massaged limb in the cross over control group compared to controls but this effect was lost 30 minutes post massage.
Conclusion:
Massage with a roller device reduces muscle soreness and is accompanied by a higher PPT of the affected muscle.
Level of Evidence:
2c; outcomes research
PMCID: PMC3924612  PMID: 24567859
Cross over effect; delayed onset muscle soreness hyperalgesia; pain
8.  High Intensity Physical Exercise and Pain in the Neck and Upper Limb among Slaughterhouse Workers: Cross-Sectional Study 
BioMed Research International  2014;2014:218546.
Slaughterhouse work involves a high degree of repetitive and forceful upper limb movements and thus implies an elevated risk of work-related musculoskeletal disorders. High intensity strength training effectively rehabilitates musculoskeletal disorders among sedentary employees, but less is known about the effect among workers with repetitive and forceful work demands. Before performing randomized controlled trials it may be beneficial to assess the cross-sectional connection between exercise and musculoskeletal pain. We investigated the association between high intensity physical exercise and pain among 595 slaughterhouse workers in Denmark, Europe. Using logistic regression analyses, odds ratios for pain and work disability as a function of physical exercise, gender, age, BMI, smoking, and job position were estimated. The prevalence of pain in the neck, shoulder, elbow, and hand/wrist was 48%, 60%, 40%, and 52%, respectively. The odds for experiencing neck pain were significantly lower among slaughterhouse workers performing physical exercise (OR = 0.70, CI: 0.49–0.997), whereas the odds for pain in the shoulders, elbow, or hand/wrist were not associated with exercise. The present study can be used as general reference of pain in the neck and upper extremity among slaughterhouse workers. Future studies should investigate the effect of high intensity physical exercise on neck and upper limb pain in slaughterhouse workers.
doi:10.1155/2014/218546
PMCID: PMC3910536  PMID: 24527440
9.  PERCEIVED LOADING AND MUSCLE ACTIVITY DURING HIP STRENGTHENING EXERCISES: COMPARISON OF ELASTIC RESISTANCE AND MACHINE EXERCISES 
Objective:
Decreased hip muscle strength is frequently reported in patients with hip injury or pathology. Furthermore, soccer players suffering from groin injury show decreased strength of hip muscles. Estimating 10‐repetition maximum can be time‐consuming and difficult, thus, using the Borg category rating 10 scale (Borg CR10 scale) can be a useful tool for estimating the intensity of exercise. The aims of this study were 1) to investigate the feasibility of the use of the Borg CR10 scale for rating strength training intensity of the hip abductor and hip adductor muscles, and 2) to compare hip muscle activity during hip abduction and hip adduction exercises using elastic resistance and isotonic machines, using electromyography (EMG).
Methods:
EMG activity was recorded from 11 muscles at the hip, thigh and trunk during hip adduction and hip abduction exercises in 16 untrained women, using elastic resistance and isotonic exercise machines. These recordings were normalized to maximal voluntary contraction (MVC) EMG (nEMG). The exercises were performed at four levels of perceived loading reported using the Borg CR10: light (Borg ≤2), moderate (Borg >2–<5), heavy (Borg ≥5–<7) and near maximum (Borg ≥7).
Results:
Moderate to strong associations were observed between perceived loading and nEMG obtained during the adduction exercise with elastic resistance (r=0.8±0.3) as well as in machine (r=0.69±0.55) and the abduction exercise with elastic resistance (r=0.66±0.29) as well as in machine (r =0.62±0.54). The abduction exercise performed with elastic resistance displayed significantly higher gluteus medius nEMG recruitment than the in machine exercise.
Conclusions:
The results of this study show that the Borg CR10 scale can be a useful tool for estimating intensity levels during resistance training of the hip adductor and hip abductor muscles. Although elastic resistance and exercise machine seem equally effective for recruiting muscle activity of the hip adductors, the elastic resistance condition was able to demonstrate greater muscle recruitment than the exercise machine during hip abduction.
PMCID: PMC3867074  PMID: 24377067
Elastic resistance; hip adduction; hip abduction; strength training
10.  Participatory ergonomic intervention versus strength training on chronic pain and work disability in slaughterhouse workers: study protocol for a single-blind, randomized controlled trial 
Background
The prevalence of musculoskeletal pain in the shoulder, arm and hand is high among slaughterhouse workers, allegedly due to the highly repetitive and forceful exposure of these body regions during work. Work disability is a common consequence of these pains. Lowering the physical exposure through ergonomics intervention is the traditional strategy to reduce the workload. An alternative strategy could be to increase physical capacity of the worker through strength training. This study investigates the effect of two contrasting interventions, participatory ergonomics versus strength training on pain and work disability in slaughterhouse workers with chronic pain.
Methods/design
66 slaughterhouse workers were allocated to 10 weeks of (1) strength training of the shoulder, arm and hand muscles for 3 x 10 minutes per week, or (2) participatory ergonomics involving counseling on workstation adjustment and optimal use of work tools (~usual care control group). Inclusion criteria were (1) working at a slaughterhouse for at least 30 hours per week, (2) pain intensity in the shoulder, elbow/forearm, or hand/wrist of at least 3 on a 0–10 VAS scale during the last three months, (3) pain lasting for more than 3 months, (4) frequent pain (at least 3 days per week) (5) at least moderate work disability, (6) no strength training during the last year, (7) no ergonomics instruction during the last year.
Perceived pain intensity (VAS scale 0–10) of the shoulder, elbow/forearm and hand/wrist (primary outcome) and Disability of the Arm, Shoulder and Hand (Work module, DASH questionnaire) were measured at baseline and 10-week follow-up. Further, total muscle tenderness score and muscle function were assessed during clinical examination at baseline and follow-up.
Discussion
This RCT study will provide experimental evidence of the effectiveness of contrasting work-site interventions aiming at reducing chronic pain and work disability among employees engaged in repetitive and forceful work.
Trial registration
ClinicalTrials.gov:NCT01671267
doi:10.1186/1471-2474-14-67
PMCID: PMC3606231  PMID: 23433448
Musculoskeletal disorders; Occupational health; Shoulder pain; Tennis elbow; Repetitive and forceful movements
11.  SWISS BALL ABDOMINAL CRUNCH WITH ADDED ELASTIC RESISTANCE IS AN EFFECTIVE ALTERNATIVE TO TRAINING MACHINES 
Background:
Swiss ball training is recommended as a low intensity modality to improve joint position, posture, balance, and neural feedback. However, proper training intensity is difficult to obtain during Swiss ball exercises whereas strengthening exercises on machines usually are performed to induce high level of muscle activation.
Purpose:
To compare muscle activation as measured by electromyography (EMG) of global core and thigh muscles during abdominal crunches performed on Swiss ball with elastic resistance or on an isotonic training machine when normalized for training intensity.
Methods:
42 untrained individuals (18 men and 24 women) aged 28–67 years participated in the study. EMG activity was measured in 13 muscles during 3 repetitions with a 10 RM load during both abdominal crunches on training ball with elastic resistance and in the same movement utilizing a training machine (seated crunch, Technogym, Cesena, Italy). The order of performance of the exercises was randomized, and EMG amplitude was normalized to maximum voluntary isometric contraction (MVIC) EMG.
Results:
When comparing between muscles, normalized EMG was highest in the rectus abdominis (P<0.01) and the external obliques (P<0.01). However, crunches on Swiss ball with elastic resistance showed higher activity of the rectus abdominis than crunches performed on the machine (104±3.8 vs 84±3.8% nEMG respectively, P<0.0001). By contrast, crunches performed on Swiss ball induced lower activity of the rectus femoris than crunches in training machine (27±3.7 vs 65±3.8% nEMG respectively, P<0.0001) Further, gender, age and musculoskeletal pain did not significantly influence the findings.
Conclusion:
Crunches on a Swiss ball with added elastic resistance induces high rectus abdominis activity accompanied by low hip flexor activity which could be beneficial for individuals with low back pain. In opposition, the lower rectus abdominis activity and higher rectus femoris activity observed in machine warrant caution for individuals with lumbar pain. Importantly, both men and women, younger and elderly, and individuals with and without pain benefitted equally from the exercises.
PMCID: PMC3414069  PMID: 22893857
abdominal crunch; elastic resistance; electromyographic activity; exercise ball
12.  Effect of brief daily resistance training on rapid force development in painful neck and shoulder muscles: randomized controlled trial 
Objective: To determine the effect of small daily amounts of progressive resistance training on rapid force development of painful neck/shoulder muscles.
Methods: 198 generally healthy adults with frequent neck/shoulder muscle pain (mean: age 43·1 years, computer use 93% of work time, 88% women, duration of pain 186 day during the previous year) were randomly allocated to 2- or 12 min of daily progressive resistance training with elastic tubing or to a control group receiving weekly information on general health. A blinded assessor took measures at baseline and at 10-week follow-up; participants performed maximal voluntary contractions at a static 90-degree shoulder joint angle. Rapid force development was determined as the rate of torque development and maximal muscle strength was determined as the peak torque.
Results: Compared with the control group, rate of torque development increased 31·0 Nm s−1 [95% confidence interval: (1·33–11·80)] in the 2-min group and 33·2 Nm s−1 (1·66–12·33) in the 12-min group from baseline to 10-week follow-up, corresponding to an increase of 16·0% and 18·2% for the two groups, respectively. The increase was significantly different compared to controls (P<0·05) for both training groups. Maximal muscle strength increased only ∼5–6% [mean and 95% confidence interval for 2- and 12-min groups to control, respectively: 2·5 Nm (0·05–0·73) and 2·2 Nm (0·01–0·70)]. No significant differences between the 2- and 12-min groups were evident. A weak but significant relationship existed between changes in rapid force development and pain (r = 0·27, P<0·01), but not between changes in maximal muscle strength and pain.
Conclusion: Small daily amounts of progressive resistance training in adults with frequent neck/shoulder pain increases rapid force development and, to a less extent, maximal force capacity.
doi:10.1111/cpf.12041
PMCID: PMC3799013  PMID: 23758661
fear; gate control; neck and shoulder pain; rehabilitation; resistance training; threat

Results 1-12 (12)