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1.  Reproducibility and Validity of the Myotest for Measuring Step Frequency and Ground Contact Time in Recreational Runners 
Journal of Human Kinetics  2015;45:19-26.
The purpose of this study was to assess the reproducibility (test-retest reliability and agreement) and concurrent validity of the Myotest for measuring step frequency (SF) and ground contact time (GCT) in recreational runners. Based on a within-subjects design (test and retest), SF and GCT of 14 participants (11 males, 3 females) were measured at three different running speeds with the Myotest during two test sessions. SF and GCT were also assessed with a foot-mounted accelerometer (Gold Standard, previously validated by comparing to force plate data) during the first test session. Levels of test-retest reliability and concurrent validity were expressed with intraclass correlation coefficients (ICC), agreement with standard errors of measurement (SEM). For SF, test-retest reliability (ICC’s > 0.75) and agreement of the Myotest were considered as good at all running speeds. For GCT, test-retest reliability was found to be moderate at a running speed of 14 km/h and poor at speeds of 10 and 12 km/h (ICC < 0.50). Agreement of the Myotest for GCT at all three running speeds was considered not acceptable given the SEM’s calculated. Concurrent validity of the Myotest with the foot-mounted accelerometer (Gold Standard) at all three running speeds was found to be good for SF (ICC’s > 0.75) and moderate for GCT (0.50 < ICC’s < 0.75). The conclusion of our study is that estimates obtained with the Myotest are reproducible and valid for SF but not for GCT.
doi:10.1515/hukin-2015-0003
PMCID: PMC4415832  PMID: 25964806
agreement; concurrent validity; step frequency; ground contact time
2.  Use of Ergonomic Measures Related to Musculoskeletal Complaints among Construction Workers: A 2-year Follow-up Study 
Safety and Health at Work  2015;6(2):90-96.
Background
The physical work demands of construction work can be reduced using ergonomic measures. The aim of this study was to evaluate the use of ergonomic measures related to musculoskeletal disorders (MSDs) among construction workers.
Methods
A questionnaire was sent at baseline and 2 years later to 1,130 construction workers. We established (1) the proportion of workers reporting an increase in their use of ergonomic measures, (2) the proportion of workers reporting a decrease in MSDs, (3) the relative risk for an increase in the use of ergonomic measures and a decrease in MSDs, and (4) workers' knowledge and opinions about the use of ergonomic measures.
Results
At follow-up, response rate was 63% (713/1,130). The proportion of workers using ergonomic measures for vertical transport increased (34%, 144/419, p < 0.01); for measures regarding horizontal transport and the positioning of materials, no change was reported. The proportion of workers reporting shoulder complaints decreased (28%, 176/638, p = 0.02). A relationship between the use of ergonomic measures and MSDs was not found; 83% (581/704) of the workers indicated having sufficient knowledge about ergonomic measures. Lightening the physical load was reported to be the main reason for using them.
Conclusion
Only the use of ergonomic measures for vertical transport increased over a 2-year period. No relationship between the use of ergonomic measures and MSDs was found. Strategies aimed at improving the availability of ergonomic equipment complemented with individualized advice and training in using them might be the required next steps to increase the use of ergonomic measures.
doi:10.1016/j.shaw.2014.12.003
PMCID: PMC4476186  PMID: 26106507
construction industry; ergonomics; longitudinal study; musculoskeletal pain
3.  Improving occupational health care for construction workers: a process evaluation 
BMC Public Health  2013;13:218.
Background
To evaluate the process of a job-specific workers’ health surveillance (WHS) in improving occupational health care for construction workers.
Methods
From January to July 2012 were 899 bricklayers and supervisors invited for the job-specific WHS at three locations of one occupational health service throughout the Netherlands. The intervention aimed at detecting signs of work-related health problems, reduced work capacity and/or reduced work functioning. Measurements were obtained using a recruitment record and questionnaires at baseline and follow-up. The process evaluation included the following: reach (attendance rate), intervention dose delivered (provision of written recommendations and follow-up appointments), intervention dose received (intention to follow-up on advice directly after WHS and remembrance of advice three months later), and fidelity (protocol adherence). The workers scored their increase in knowledge from 0–10 with regard to health status and work ability, their satisfaction with the intervention and the perceived (future) effect of such an intervention. Program implementation was defined as the mean score of reach, fidelity, and intervention dose delivered and received.
Results
Reach was 9% (77 workers participated), fidelity was 67%, the intervention dose delivered was 92 and 63%, and the intervention dose received was 68 and 49%. The total programme implementation was 58%. The increases in knowledge regarding the health status and work ability of the workers after the WHS were graded as 7.0 and 5.9, respectively. The satisfaction of the workers with the entire intervention was graded as 7.5. The perceived (future) effects on health status were graded as 6.3, and the effects on work ability were graded with a 5.2. The economic recession affected the workers as well as the occupational health service that enacted the implementation.
Conclusions
Programme implementation was acceptable. Low reach, limited protocol adherence and modest engagement of the workers with respect to the intervention were the most prominent aspects that influenced the intervention process. The increase in the workers’ knowledge about their health status and work ability was substantial, and the workers’ satisfaction with the intervention was good. The perceived effect of the advised preventive actions on health status was sufficient.
Trial registration
Netherlands Trial Register: http://NTR3012
doi:10.1186/1471-2458-13-218
PMCID: PMC3599882  PMID: 23497119
4.  Musculoskeletal disorders among construction workers: a one-year follow-up study 
Background
Work-related musculoskeletal disorders (MSDs) are an important cause of functional impairments and disability among construction workers. An improved understanding of MSDs in different construction occupations is likely to be of value for selecting preventive measures. This study aimed to survey the prevalence of symptoms of MSDs, the work-relatedness of the symptoms and the problems experienced during work among two construction occupations: bricklayers and supervisors.
Methods
We randomly selected 750 bricklayers and 750 supervisors resident in the Netherlands in December 2009. This sample was surveyed by means of a baseline questionnaire and a follow-up questionnaire one year later. The participants were asked about complaints of the musculoskeletal system during the last six months, the perceived work-relatedness of the symptoms, the problems that occurred during work and the occupational tasks that were perceived as causes or aggravating factors of the MSD.
Results
Baseline response rate was 37%, follow-up response was 80%. The prevalence of MSDs among 267 bricklayers and 232 supervisors was 67% and 57%, respectively. Complaints of the back, knee and shoulder/upper arm were the most prevalent among both occupations. Irrespective of the body region, most of the bricklayers and supervisors reported that their complaints were work-related. Complaints of the back and elbow were the most often reported among the bricklayers during work, whereas lower arm/wrist and upper leg complaints were the most often reported among the supervisors. In both occupations, a majority of the participants perceived several occupational physical tasks and activities as causes or aggravating factors for their MSD. Recurrent complaints at follow-up were reported by both bricklayers (47% of the complaints) and supervisors (31% of the complaints). Participants in both occupations report that mainly back and knee complaints result in additional problems during work, at the time of follow-up.
Conclusions
A substantial number of the bricklayers and the supervisors report musculoskeletal disorders, mainly back, knee and shoulder/upper arm complaints. The majority of the bricklayers and half of the supervisors believe that their complaints are work-related. Irrespective of occupation, participants with MSDs report substantial problems during work. Workplace intervention measures aimed at occupational physical tasks and activities seem justified for both occupations.
doi:10.1186/1471-2474-13-196
PMCID: PMC3489781  PMID: 23061990
Construction industry; Longitudinal study; Work-related musculoskeletal disorders
5.  A trial of a job-specific workers' health surveillance program for construction workers: study protocol 
BMC Public Health  2011;11:743.
Background
Dutch construction workers are offered periodic health examinations. This care can be improved by tailoring this workers health surveillance (WHS) to the demands of the job and adjust the preventive actions to the specific health risks of a worker in a particular job. To improve the quality of the WHS for construction workers and stimulate relevant job-specific preventive actions by the occupational physician, we have developed a job-specific WHS. The job-specific WHS consists of modules assessing both physical and psychological requirements. The selected measurement instruments chosen, are based on their appropriateness to measure the workers' capacity and health requirements. They include a questionnaire and biometrical tests, and physical performance tests that measure physical functional capabilities. Furthermore, our job-specific WHS provides occupational physicians with a protocol to increase the worker-behavioural effectiveness of their counselling and to stimulate job-specific preventive actions. The objective of this paper is to describe and clarify our study to evaluate the behavioural effects of this job-specific WHS on workers and occupational physicians.
Methods/Design
The ongoing study of bricklayers and supervisors is a nonrandomised trial to compare the outcome of an intervention (job-specific WHS) group (n = 206) with that of a control (WHS) group (n = 206). The study includes a three-month follow-up. The primary outcome measure is the proportion of participants who have undertaken one or more of the preventive actions advised by their occupational physician in the three months after attending the WHS. A process evaluation will be carried out to determine context, reach, dose delivered, dose received, fidelity, and satisfaction. The present study is in accordance with the TREND Statement.
Discussion
This study will allow an evaluation of the behaviour of both the workers and occupational physician regarding the preventive actions undertaken by them within the scope of a job-specific WHS.
Trial registration
NTR3012
doi:10.1186/1471-2458-11-743
PMCID: PMC3192691  PMID: 21958019

Results 1-5 (5)