Forest plot for improvement in pain incidence with an alternative mouse intervention versus a conventional mouse in a general population of office workers (with or without neck pain) on the basis of a pooled analysis of 2 trials (in order of increasing relative risk [RR] and where weight = weighted average21). , Bertozzi L, Gardenghi I, Turoni F, Guccione AA, Pillastrini P. Andersen It can have an impact on the individual's physical, social, and psychological well-being, contributing to increasing costs to society and businesses. ), and examples of the search terms used included neck pain AND workplace AND office work (Appendix). Building the Science of Physical Therapy: Conundrums and a Wicked Problem, First Provider Seen for an Acute Episode of Low Back Pain Influences Subsequent Health Care Utilization, Learning Health Systems Are Well Suited to Define and Deliver the Physical Therapy Value Proposition, News From the Foundation for Physical Therapy Research, June 2023, Coproduction and Usability of a Smartphone App for Falls Reporting in Parkinson Disease, |${\bigoplus \! Moreover, analysis was performed separately for a general population of office workers (ie, with or without neck pain), as well as a subpopulation of office workers who were symptomatic. Neck pain is a prevalent and burdensome condition particularly in office workers compared to other occupations.13 The annual prevalence of neck pain in office workers varies from 42% to 63%,1,4,5 and office workers have the highest incidence of neck disorders among all other occupations, at 17% to 21%.6,7 Approximately 34% to 49% of workers report a new onset of neck pain during a 1-year follow-up.1,2,5,8 The impact of neck pain is significant not just for the individual, but also for industry and society.3 Workers who do not return to work within 1 to 2 months are at high risk of developing disability and may cease work altogether.3 Costs associated with neck pain place a burden on employers, society, and the individual through care-seeking behavior, reduced productivity, and workers compensation claims.3,9,10, Workplace-based interventions are becoming important to reduce the burden of neck pain. Methods The PubMed . Most RCTs addressing exercise interventions (67%), education, breaks, and myofeedback interventions (71%) focused on office workers who were symptomatic; whereas only 13% of trials of ergonomic interventions were undertaken in the symptomatic population. \bigoplus \! H Background Neck pain is one of the most common musculoskeletal disorders, having an age-standardised prevalence rate of 27.0 per 1000 population in 2019. Studies were excluded if participants had neck pain due to complex or severe pathological conditions such as radiculopathy, whiplash-associated disorders, headache/dizziness related to neck pain, fracture, tumor, infections, and systemic diseases. Risk of bias was assessed by 2 independent reviewers using the 2015 Cochrane Back and Neck Group guidelines. LL P , Saervoll CA, Mortensen OS, Poulsen OM, Hannerz H, Zebis MK. Prevalence of Neck Pain in Sedentary Workers - ijtsrd.com The aim of the current study was to estimate the one-year prevalence of neck pain among office workers and to determine which physical, psychological and . Type: Group strengthening at workplace, 30 min, 3 times/wk Description: Strengthening exercises consisted of 4 arm exercises (shoulder abduction, flexion, and extension and modified push-ups), Individual physical therapy (1 h, twice/wk), 86% of planned training sessions attended, Combined neck/shoulder endurance training and stretching vs no intervention, Job: 567 office workers Condition: Lower than normal neck flexion range (<54.1, Type: Stretching twice/workday and neck muscle endurance training twice/wk at home Description: Stretching exercises for upper trapezius, levator scapulae, pectoralis, and rectus capitis posterior muscles were performed for 30 s each; endurance training for long muscles (ie, longus capitis, longus colli, and rectus capitis anterior and lateralis) was performed 10 times; exercises were prompted by a text message Provider: Not reported Mode: Individually at work (endurance training) and at home (stretching) Duration: 52 wk, Pain incidence: pain for >24 h in last month; pain intensity: >30 mm on 0- to 100-mm VAS, Stretching: 30% of planned training sessions attended Endurance training: 57% of planned training sessions attended, Neck/shoulder stretching exercise vs no stretching, Type: Stretching during work breaks Description: Stretches were targeted at the neck, shoulders, back, and upper body and required no more than 2 min to perform Provider: Principal investigator Mode: Individually Duration: 8 wk, Feeling State Questionnaire on 15 scale, Stretching not more effective than no stretching (, Breaks in which participants stretched/total no. Furthermore, 30% of the RCTs had unclear randomization methodologies. Of the exercise trials that reported participation, 73% scored low risk of bias. Background Persisting neck pain is common in society. Recent reviews conducted on workplace-based interventions found very low to low quality, or mixed evidence for the beneficial effects of exercise and ergonomic interventions on neck pain severity. , Kay TM, Paquin J-Pet al. , Chalova K, Gerson Let al. Prevalence and occupational associations of neck pain in the British Most interventions were for 20 minutes per session, 3 sessions per week, and the intervention periods were at least 10 weeks. 2017 American Physical Therapy Association. The 3 main categories were then combined using a Boolean AND operator. Ever wonder why your back hurts at the end of the day. RW K LL , Helfand M, Schnemann HJet al. This review followed the PRISMA guidelines for reporting systematic reviews and meta-analyses.16 The Prospero registration number of this review is 42014006905. , Sitthipornvorakul E, Paksaichol A, Janwantanakul P. Korhonen , Linton SJ. , Tuntland H, Holte KAet al. Three trials studied the impact of other exercise types, including stretching,52 light whole-body resistance exercise,53 and Qigong (Chinese martial arts).54 A single trial (n = 90) of very low-quality evidence (downgraded for risk of bias and imprecision) found that 8 weeks of neck/shoulder stretching exercise alone was ineffective in reducing neck pain intensity compared to no stretching in a general population of office workers.52 In another single trial (n = 126) of moderate-quality evidence (downgraded for imprecision), 15 weeks of whole-body resistance exercise was found to be effective in reducing neck pain in office workers who were symptomatic compared to no intervention.53 A further single trial of moderate-quality evidence (downgraded for imprecision) found 6 weeks of daily Qigong ineffective in reducing neck pain in a general population of office workers compared to no intervention.54, The effect of multiple adjustments to the workstation (eg, combined keyboard, monitor, and mouse changes) was studied in 4 trials.35,40,45,55 Of these, 3 trials (n = 571) found low-quality evidence (downgraded for inconsistency and imprecision) of conflicting results for the effectiveness of multiple workstation adjustments on neck pain incidence in a general population of office workers compared to no intervention.35,40,55 Only one 26-week trial (n = 80) studied the impact of multiple workstation adjustments on office workers who were symptomatic and found it efficacious compared to no intervention (P<.0001).45 This trial was, however, of very low quality (downgraded for risk of bias and imprecision), and participation was not reported.45, Three RCTs studied the impact of an alternative mouse43,56 and arm support41,43,56 on neck pain incidence/prevalence in a general population of office workers. Evidence was generally not in favor of the other workplace-based interventions such as group education, CBT, and myofeedback in office workers who were symptomatic. Studies reporting only a combined assessment of neck, shoulder, and arm/hand pain were also excluded. 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. R \bigcirc }$|, |${\bigoplus \! Single study representing duplicate articles (with same randomized controlled trial numbers). |${\bigoplus \! , Amick BCIII, Dennerlein JTet al. TL The prevalence and incidence of work absenteeism involving neck pain: a , Bisset L, Vicenzino B. Balshem \bigoplus \! The Prevalence and Associated Factors of Neck Pain among Ministry of DM Most evidence focused on exercise interventions, with less attention directed toward ergonomic interventions. The purpose of this review was to investigate the effectiveness of workplace-based interventions for neck pain in office workers. P (2) Methods: A cross-sectional study was conducted, and the participants completed an online questionnaire based on the Standardized Nordic questionnaire and Quality of Life Scale Brief Version to evaluate their . , Bierma-Zeinstra SM, Burdorf A, Stynes SM, de Vet HC, Koes BW. 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, The cost-effectiveness of a lifestyle physical activity intervention in addition to a work style intervention on recovery from neck and upper limb symptoms and pain reduction in computer workers, Effects of ambulant myofeedback training and ergonomic counselling in female computer workers with work-related neck-shoulder complaints: a randomized controlled trial, Changes in cognitive-behavioral factors and muscle activation patterns after interventions for work-related neck-shoulder complaints: relations with discomfort and disability, The effects of office ergonomic training on musculoskeletal complaints, sickness absence, and psychological well-being: a cluster randomized control trial, The effect of forearm support on musculoskeletal discomfort during call centre work, A controlled study of the effect of neck school in medical secretaries, A randomised controlled trial evaluating an alternative mouse and forearm support on upper body discomfort and musculoskeletal disorders among engineers, Improved health and coping by physical exercise or cognitive behavioural stress management training in a work environment, The effect of ergonomic intervention on discomfort in computer users with tension neck syndrome, The effect of pain reduction on perceived tension and EMG-recorded trapezius muscle activity in workers with shoulder and neck pain, Effectiveness of small daily amounts of progressive resistance training for frequent neck/shoulder pain: randomised controlled trial, Effect of scapular function training on chronic pain in the neck/shoulder region: a randomized controlled trial, Effect of two contrasting types of physical exercise on chronic neck muscle pain, Effects of at-work exercises on computer operators, Effectiveness of dynamic muscle training, relaxation training, or ordinary activity for chronic neck pain: randomised controlled trial, Supplementary breaks and stretching exercises for data entry operators: a follow-up field study, Effects of a workplace physical exercise intervention on the intensity of headache and neck and shoulder symptoms and upper extremity muscular strength of office workers: a cluster randomized controlled cross-over trial, Qigong training and effects on stress, neck-shoulder pain and life quality in a computerised office environment, A randomised controlled trial of postural interventions for prevention of musculoskeletal symptoms among computer users, A randomised controlled trial evaluating the effects of two workstation interventions on upper body pain and incident musculoskeletal disorders among computer operators, Work with visual display units: longterm health effects of high and downward line-of-sight in ordinary office environments, A field study of supplementary rest breaks for data-entry operators, Effects of software programs stimulating regular breaks and exercises on work-related neck and upper-limb disorders, Clinical evaluation of a myofeedback-based teletreatment service applied in the workplace: a randomized controlled trial, Dose-response of strengthening exercise for treatment of severe neck pain in women, Effect of specific resistance training on musculoskeletal pain symptoms: dose-response relationship, Treatment compliance and effectiveness of a cognitive behavioural intervention for low back pain: a complier average causal effect approach to the BeST data set, Officewise: a guide to health and safety in the office, Canberra, Australian Capital Territory, Australia, Current issues in case definitions for common musculoskeletal disorders in workers for clinical practice and research, Impacts of differences in epidemiological case definitions on prevalence for upper-extremity musculoskeletal disorders, Effects of aerobic and resistance training on hemoglobin A1C levels in patients with type 2 diabetes: a randomized controlled trial, Beneficial exercise programme for office workers with shoulder and neck complaints. The burden and determinants of neck pain in workers: results of the Bone and Joint Decade 20002010 Task Force on Neck Pain and Its Associated Disorders. Cook Introduction: Many of the injury mechanisms that cause mild traumatic brain injury (mTBI) also create forces commonly associated with whiplash, resulting in cervical pain injury. DM BK Previous research has identified that office workers are a specific population at high risk of developing neck pain, with one year prevalence rates much higher than in the general population [6-8]. The present review also explored factors that may influence the effectiveness of exercise training regimens on pain outcomes. Updated method guidelines for systematic reviews in the Cochrane Collaboration Back Review Group. Prevalence of neck pain and body areas with pain. Conlon (C) Forest plot for improvement in pain intensity after general fitness exercises versus no training in office workers who were symptomatic (with neck pain) on the basis of a pooled analysis of 2 trials. The authors completed the ICJME Form for Disclosure of Potential Conflicts of Interest and reported no conflicts of interest. checked the accuracy of extracted data.17 The predefined data fields were customized on the basis of the PICO (Population, Intervention, Control, and Outcomes) process and a modified Template for Intervention Description and Replication (TIDieR) checklist.18 Data were subgrouped based on the type of intervention (eg, exercise, ergonomic intervention) and study population (eg, general population of office workers who were symptomatic). Higgins All RCTs did not meet the patient and care provider blinding criteria, as it is not possible for the type of interventions performed in this review. , Bredahl TG, Pedersen MT, Boyle E, Andersen LL, Sjgaard G. Andersen Prevalence of myofascial trigger points in spinal disorders: a systematic review and meta-analysis. T 3B). Neck pain is a major cause of morbidity and disability in everyday life and at work in many countries. The SMD was used, as it standardizes the results of studies to a uniform scale before they are combined.21 A positive SMD (>0) indicated an effect in favor of the intervention, and a negative SMD (<0) favored the comparator.22 When the CI did not cross 0, effects were deemed statistically significant.22 An SMD of less than 0.5 indicated a small effect, SMDs of 0.5 to 0.8 indicated a medium effect, and an SMD of greater than 0.8 indicated a large effect.22,23, For dichotomous data, relative risk (RR) with corresponding 95% CI were calculated using postintervention neck pain incidence/prevalence values with a random-effects model.21 The intervention was favored when RR was greater than 1, and the comparator was favored when RR was less than 1. , Sandsjo L, Vollenbroek-Hutten MMR, Larsman P, Kadefors R, Hermans HJ. of breaks: 25%39%, Whole-body light resistance exercise vs no intervention, Job: 126 office workers from admin companies Condition: Neck/shoulder pain or headache restricting normal daily activities for last 12 mo, Type: Whole-body light resistance exercise once/d for first 5 wk and then 1 or 2 times/d for next 10 wk Description: Whole-body progressive light resistance exercise consisted of dynamic symmetrical movements: upper body extension/flexion, trunk rotation to right/left, knee extension/flexion, 20 repetitions Provider: Physical therapist Mode: Individually except for 3 group sessions that were supervised face-to-face at 5-wk intervals Duration: 15 wk, Pain in last week on 010 Borg CR10 Scale, Whole-body light resistance exercise more effective than no intervention (, 75% of planned training sessions attended, Type: All-around physical activity, 1 h/wk Description: Participants were motivated to increase their daily physical activities at their worksite and during leisure time via pep talks and contract setting; activities such as Nordic walking and running were started, and exercise instruments such as steppers were placed next to copy machines to encourage activity Providers: Experienced exercise instructors Mode: Face-to-face in a group Duration: 52 wk, 30% of participants participated at least 20 min/wk (mean of 31% the first half and 28% the second half of the intervention), Job: 79 office workers from an insurance company, Type: Aerobic exercise, 55 min, 3 d/wk Description: Aerobic exercises were dynamic and rhythmical, at moderate intensity, and aimed at improving physical capacity, muscle strength, flexibility, and relaxation of neck, back, and shoulder muscles Providers: Instructors with university-level sport education and aerobic dance certification Mode: Face-to-face in a group Duration: 10 wk, Pain in last month on 4-point scale using Health Questionnaire Pain Index, Aerobic physical exercise more effective than no intervention (, Job: 113/549 office workers (subset from Blangsted etal, 2008, Type: General fitness training, 20 min, 3 times/wk Description: Participants performed high-intensity general fitness training with legs only (without holding onto handlebars) on a Monark bicycle ergometer (Monark Exercise AB, Vansbro, Sweden) Provider: Exercises were supervised Mode: Face-to-face in a group Duration: 10 wk, 83% of planned training sessions attended, Job: 37 office workers from the electronic and electrotechnical sectors, Type: Qigong (Chinese martial arts) Description: Participants performed Qigong as a group activity while watching a video daily for 1725 min; the training involved movements, breathing, and verbal instructions Provider: Video of Qigong program Mode: Video activity in a group Duration: 6 wk, Current/average/worst pain in last week on 010 scale, Qigong not more effective than no intervention (, Multiple ergonomic adjustments (eg, keyboard, monitor, mouse) vs no intervention, Job: 376 office workers from insurance, financial, and food product companies and universities, Type: 2 intervention arms, consisting of alternative ergonomics (from protective factors identified for neck and upper body in a pilot study) and conventional ergonomics (from industry recommendations) Description: Both alternative and conventional ergonomics involved ergonomic adjustments, such as keyboard, monitor, and mouse angles at various degrees Provider: Study staff member Mode: Face-to-face individually Duration: 26 wk, Pain incidence: pain severity of 6 on any day of the week using 010 VAS, Alternate ergonomics: RR = 0.93 (0.63 to 1.37) Conventional ergonomics: RR = 0.99 (0.67 to 1.47), Alternate ergonomics: 25% fully compliant to all preset ergonomic adjustments Conventional ergonomics: 38% fully compliant to all preset ergonomic adjustments, Job: 16 female clerical and office workers from a college, Type/Description: Work injury prevention program consisting of education (on posture, stretching, and proper use and positioning of office supplies), workstation redesign (chairs, monitors, and keyboards were readjusted on the basis of a worksite analysis and worker input), and individually tailored task modifications (eg, stretching and changing positions throughout the day) Provider: Master of Occupational Therapy students and principal investigator Mode: Face-to-face individually Duration: 4 wk, Type/Description: Lecture on office ergonomics followed by a practical one-on-one session with a trainer who provided assistance on adjustment of workstation Providers: Trainers from the National Institute of Safety and Health Mode: Face-to-face in a group and individually Duration: 26 wk, Workstation adjustments more effective than no intervention (, Job: 80 office workers Condition: Tension neck syndrome, Type/Description: Workstation adjustments were performed on the basis of recommendations from computer software (IntelAd version 1.2; for individual participants; examples of recommendations included changes to height of seat base, keyboard home row, center of monitor, and footrest height Provider: Not reported Mode: Face-to-face individually Duration: 26 wk, Pain in the morning and afternoon on 010 VAS, Ergonomic interventions (alternative mouse vs conventional mouse), Job: 206 office workers from an aerospace engineering firm, Type/Description: Alternative mouse (vertical handle, flat base for ulnar support, and roller ball for tracking) Provider: Not reported Mode: Face-to-face individually Duration: 52 wk, Conventional mouse (LED for mouse tracking, hand pronated), Pain incidence: worst pain in last week of >5 on 010 scale, Job: 182 customer service employees from a large health care company, Type/Description: Trackball (Marble Mouse; Logitech, Fremont, California) Provider: Trained research associate Mode: Face-to-face individually Duration: 52 wk, Ergonomic interventions (arm support vs no support), Type/Description: Forearm board (butterfly shaped) attached to desk at inclination upwards at 5 and padded forearm support Provider: Not reported Mode: Face-to-face individually Duration: 52 wk, Type/Description: Forearm support (using desk surface) and maintenance of neutral shoulder elevation Provider: Not reported Mode: Face-to-face individually Duration: 6 wk, Job: 182 customer service employees from a health care company, Type/Description: Arm board (wraparound padded arm support on edge of desk) Provider: Trained research associate Mode: Face-to-face individually Duration: 52 wk, Pain incidence: Worst pain in last week of >5 on 010 scale, Ergonomic interventions (low vs high monitor angle), Job: 150 employees from an insurance company, Type/Description: Low monitor line of sight (at 30 to horizontal line) Provider: Not reported Mode: Face-to-face individually Duration: 52 wk, Pain symptom questionnaire developed in-house, Low more effective than high monitor line of sight (, Job: 466 employees from insurance, science, energy, transportation, and tax offices Condition: Neck stiffness/tingling 1 time/wk for last 6 mo and/or 2 wk, Type/Description: Work style behavior education (behavioral change for posture, workplace adjustments, breaks, and coping with job demands) Provider: Specially trained counselor Mode: Face-to-face in a group Duration: 26 wk, Current, average, and worst pain in last 4 wk on 010 NRS, Work style education not more effective than no intervention (, 82% of participants who attended 3 of total of 6 group meetings, Job: 79 medical secretaries Condition: Neck/shoulder pain in previous year, Type/Description: 2 intervention arms: Traditional neck school (lectures twice weekly on prevention of work-related neck/shoulder pain [eg, anatomy, etiology, and self-care measures]); reinforced neck school (traditional neck school plus individualized workstation and psychological intervention) Provider: Physical therapist Mode: Face-to-face in a group (traditional neck school) and individually (reinforced neck school) Duration: 4 wk, Morning, noon, and afternoon pain intensity on 0100 VAS, Traditional and reinforced neck school not more effective than no intervention (, Traditional neck school: 100% of planned sessions attended Reinforced neck school: 98% of planned sessions attended, Cognitive behavioral stress management vs no intervention, Type/Description: Cognitive behavioral stress management of lifestyle and health issues (diet, smoking, common health problems) for 55 min, 3 d/wk Providers: Principal investigator, psychiatrist, medical officer, and scientist specializing in stress research Mode: Face-to-face in a group Duration: 10 wk, Cognitive behavioral stress management not more effective than no intervention (, Supplementary vs conventional work breaks, Type/Description: Supplementary work breaks (extra 5-min break/h of work shift) Provider: Not applicable Mode: Individual Duration: 8 wk, Conventional work breaks (15-min breaks during first and second halves of shift), Current discomfort: Feeling State Questionnaire on 15 scale, Supplementary more effective than conventional work breaks (, Job: 90 data entry operators processing income tax forms, Supplementary: Mean of 6 breaks/d Conventional: Mean of 3 breaks/d, Job: 268 office workers from a social security allowance company Condition: Current neck/shoulder complaints for 2 wk, Type/Description: Extra breaks (5-min break after computer use of 35 min and microbreak of 7 s after each continuous use of 5 min) Provider: Not applicable Mode: IndividualDuration: 8 wk, Job: 65 female office workers from rehabilitation centers and patient websites and medical secretaries Condition: Average neck/shoulder pain in the past month of 3 (of 10) on VAS, Type/Description: Myofeedback-based teletreatment (muscle biofeedback for relaxation of the trapezius muscle plus teleconsultations) Provider: Therapist Mode: Individual Duration: 4 wk, Myofeedback-based teletreatment not more effective than no intervention (, Job: 79 female job counselors and medical secretaries Condition: Neck/shoulder symptoms for 30 d during the last year, Type/Description: Myofeedback training (upper trapezius muscle biofeedback) and individualized ergonomic counseling Provider: Therapist Mode: Face-to-face individually (ergonomic counseling) Duration: 4 wk, Myofeedback training and ergonomic counseling not more effective than ergonomic counseling alone (, Neck/shoulder strengthening vs no training, No difference (SMD = 0.03; 95% CI = 0.39 to 0.33), Neck/shoulder strengthening vs physical therapy (individualized), No difference (SMD = 0.04; 95% CI = 0.76 to 0.84), Combined neck endurance and stretching vs no intervention, Whole-body light resistance exercise vs no training, Small effect in favor of general fitness exercise (SMD = 0.43; 95% CI = 0.08 to 0.78), Qigong (Chinese marital arts) vs no intervention, In favor of multicomponent ergonomic intervention (, No difference (RR = 1.60; 95% CI = 0.99 to 2.60) (, Cognitive behavioral stress management training vs no intervention, No difference (SMD = 0.13; 95% CI = 0.46 to 0.20), Myofeedback (muscle biofeedback intervention) vs no myofeedback, Copyright 2023 American Physical Therapy Association. AP The quality of evidence for all individual or pools of RCTs begin as high quality, and quality could be downgraded by 1 or 3 levels to very low, low, or moderate evidence.19,24 Downgrading for risk of bias was applied when the included studies (eg, Chiarotto et al25) did not meet at least 50% of the 12-item checklist by Furlan et al.19 For a set of trials, risk of bias was applied when more than 25% of total participants were from studies that did not meet the 50% cutoff of the same checklist.19,26 Downgrading for inconsistency was applied when there was high statistical heterogeneity (I275%), or when the direction of the study results was different in the majority (75%) of studies.19 Evidence was downgraded for indirectness when there was uncertainty about the generalizability of the results based on the inclusion criteria defined in this review.19 Imprecision was downgraded when a large CI was observed, when CIs were not reported in 1 or more studies, or when only 1 small study reported the outcome (total number of participants: <300).19,26 Publication bias was downgraded when the study results provided differed from the original protocol or study objectives.19 The criterion was scored as unclear if the authors could not be contacted or if the information is no longer available.19, The following definitions of quality of evidence were applied in this review: high-quality evidence means further research is very unlikely to change confidence in the estimate of effect; moderate-quality evidence means further research is likely to have an important impact on confidence in the estimate of effect and may change the estimate; low-quality evidence means further research is very likely to have an important impact on confidence in estimate of effect and is likely to change the estimate; and very low-quality evidence means very little confidence in the effect estimate.19.