Agneta Lindegård

Cardiorespiratory Fitness Protects Against Stress-Related Symptoms of Burnout and Depression

OBJECTIVE To examine how cardiorespiratory fitness and self-perceived stress are associated with burnout and depression. To determine if any relationship between stress and burnout/depression is mitigated among participants with high fitness levels. METHODS 197 participants (51% men, mean age=39.2 years) took part in the study. The Åstrand bicycle test was used to assess cardorespiratory fitness. Burnout was measured with the Shirom-Melamed Burnout Questionnaire (SMBQ), depressive symptoms with the Hospital Anxiety and Depression Scale (HAD-D). A gender-matched stratified sample was used to ensure that participants with varying stress levels were equally represented. RESULTS Participants with moderate and high fitness reported fewer symptoms of burnout and depression than participants with low fitness. Individuals with high stress who also had moderate or high fitness levels reported lower scores on the SMBQ Tension subscale and the HAD-D than individuals with high stress, but low fitness levels. CONCLUSION Better cardiovascular fitness seems to be associated with decreased symptoms of burnout and a better capacity to cope with stress. PRACTICAL IMPLICATIONS Promoting and measuring cardiorespiratory fitness can motivate employees to adopt a more physically active lifestyle and thus strengthen their ability to cope with stress exposure and stress-related disorders.

The impact of working technique on physical loads—an exposure profile among newspaper editors

About 35 % of the working population in Sweden report that computer use accounts for 50% or more of their total working hours. Among this population approximately 40% of the women and 25% of the men experienced symptoms in the neck and/or upper extremities at least once a week during the preceding 3 month. The overall aim of the studies underlying this thesis was to explore possible associations between working technique and perceived exertion, comfort, biomechanical and psychosocial strain as well as neck and upper extremity symptoms among computer users. Specific research questions addressed were a) Whether working technique was associated with muscle activity, wrist positions and forces applied to the computer mouse, respectively? b) Whether working technique was associated with psychological demands, emotional stress and perceived muscle tension, respectively? c) Whether there were associations between self-rated perceived comfort and observations of workplace layout and between self-rated perceived exertion and working postures. d) Whether working technique perceived exertion and comfort was associated with neck and upper extremity symptoms. The results showed that subjects classified as having a good working technique worked with less muscular load in the forearm (p=0.03) and in the trapezius muscle on the mouse operating side (p=0.02) compared to subjects classified as having a poor working technique. Subjects who reported high psychological demands and perceived muscular tension, respectively, used poorer working technique than subjects who did not perceive this conditions (demands, p=0.03, muscular tension, p=0.02). Moreover, the concordance between ratings of comfort and observations of workplace layout was reasonably good concerning the working chair and the keyboard and good regarding the computer screen and the input device. The concordance between ratings of perceived exertion and observations of working postures indicated good agreement for all measured body locations. This applies to the group that rated poor comfort and high exertion. Regarding the group that rated good comfort and low exertion ratings must be supplemented with observations. Furthermore, the results revealed that high perceived exertion and low comfort were related to an increased incidence of neck, and upper extremity symptoms, while poor working technique was not associated with such a risk. It is concluded that working technique is associated with both biomechanical and psychological strain while no associations could be seen between working technique and the incidence of neck and upper extremity symptoms. Furthermore, high perceived exertion and low comfort are associated with a higher incidence of neck and upper extremity symptoms.The aim of this study was to investigate the possible associations between working technique, sex, symptoms and level of physical load in VDU-work. A study group of 32 employees in the editing department of a daily newspaper answered a questionnaire, about physical working conditions and symptoms from the neck and the upper extremities. Muscular load, wrist positions and computer mouse forces were measured. Working technique was assessed from an observation protocol for computer work. In addition ratings of perceived exertion and overall comfort were collected. The results showed that subjects classified as having a good working technique worked with less muscular load in the forearm (extensor carpi ulnaris p=0.03) and in the trapezius muscle on the mouse operating side (p=0.02) compared to subjects classified as having a poor working technique. Moreover there were no differences in gap frequency (number of episodes when muscle activity is below 2.5% of a reference contraction) or muscular rest (total duration of gaps) between the two working technique groups. Women in this study used more force (mean force p=0.006, peak force p=0.02) expressed as % MVC than the men when operating the computer mouse. No major differences were shown in muscular load, wrist postures, perceived exertion or perceived comfort between men and women or between cases and symptom free subjects. In conclusion a good working technique was associated with reduced muscular load in the forearm muscles and in the trapezius muscle on the mouse operating side. Moreover women used more force (mean force and peak force) than men when operating the click button (left button) of the computer mouse.

Technique, muscle activity and kinematic differences in young adults texting on mobile phones

The aim of this study was to investigate whether there are differences in technique between young adults with and without musculoskeletal symptoms when using a mobile phone for texting and whether there are differences in muscle activity and kinematics between different texting techniques. A total of 56 young adults performed a standardised texting task on a mobile phone. Their texting techniques were registered using an observation protocol. The muscular activity in six muscles in the right forearm/hand and both shoulders were registered by surface electromyography and the thumb abduction/adduction and flexion/extension were registered using a biaxial electrogoniometer. Differences in texting techniques were found between the symptomatic and the asymptomatic group, with a higher proportion of sitting with back support and forearm support and with a neutral head position in the asymptomatic group. Differences in muscle activity and kinematics were also found between different texting techniques. The differences in texting technique between symptomatic and asymptomatic subjects cannot be explained by them having symptoms but may be a possible contribution to their symptoms. Statement of Relevance: There has been a dramatically increased use of mobile phones for texting especially among young people during the last years. A better understanding of the physical exposure associated with the intensive use is important in order to prevent the development of musculoskeletal disorders and decreased work ability related to this use.

The level of leisure time physical activity is associated with work ability-a cross sectional and prospective study of health care workers.

BackgroundWith increasing age, physical capacity decreases, while the need and time for recovery increases. At the same time, the demands of work usually do not change with age. In the near future, an aging and physically changing workforce risks reduced work ability. Therefore, the impact of different factors, such as physical activity, on work ability is of interest. Thus, the aim of this study was to evaluate the association between physical activity and work ability using both cross sectional and prospective analyses.MethodsThis study was based on an extensive questionnaire survey. The number of participants included in the analysis at baseline in 2004 was 2.783, of whom 2.597 were also included in the follow-up in 2006. The primary outcome measure was the Work Ability Index (WAI), and the level of physical activity was measured using a single-item question. In the cross-sectional analysis we calculated the level of physical activity and the prevalence of poor or moderate work ability as reported by the participants. In the prospective analysis we calculated different levels of physical activity and the prevalence of positive changes in WAI-category from baseline to follow-up. In both the cross sectional and the prospective analyses the prevalence ratio was calculated using Generalized Linear Models.ResultsThe cross-sectional analysis showed that with an increased level of physical activity, the reporting of poor or moderate work ability decreased. In the prospective analysis, participants reporting a higher level of physical activity were more likely to have made an improvement in WAI from 2004 to 2006.ConclusionsThe level of physical activity seems to be related to work ability. Assessment of physical activity may also be useful as a predictive tool, potentially making it possible to prevent poor work ability and improve future work ability. For employers, the main implications of this study are the importance of promoting and facilitating the employees’ engagement in physical activity, and the importance of the employees’ maintaining a physically active lifestyle.

Perceived exertion, comfort and working technique in professional computer users and associations with the incidence of neck and upper extremity symptoms

BackgroundThe aim of this study was to investigate whether perceived exertion, perceived comfort and working technique is associated with the incidence of neck and upper extremity symptoms among professional computer users.MethodsAt baseline a self-administered questionnaire was distributed to 853 participants from 46 different work sites (382 men and 471 women) who, at baseline, had been free from neck and upper extremity symptoms during the preceding month. Work-related exposures, individual factors, and symptoms from the neck and upper extremities were assessed. Observations of working technique were performed by ergonomists using an ergonomic checklist. Incidence data were collected by means of 10 monthly questionnaires, asking for information on the occurrence of neck, shoulder and arm/hand symptoms. Perceived exertion was rated on a modified Borg RPE scale ranging from 0 (very, very light) to 14 (very, very strenuous). Perceived comfort was rated on a 9-point scale ranging from -4 (very, very poor) to +4 (very, very good) in relation to the chair, computer screen, keyboard, and computer mouse.ResultsThe median follow up time was 10.3 months. The incidence of symptoms from the neck, shoulders and arm/hands were 50, 24 and 34 cases per 100 person years, respectively.Higher perceived exertion in the neck, shoulder or arm/hands was associated with an increased risk of developing symptoms in the corresponding body region. Moreover, a dose-response relationship between the level of exertion and the risk of developing symptoms was recorded for all three regions. There was an association between low comfort and an increased risk for neck symptoms, but not for shoulder and arm/hand symptoms, although a trend towards such an association (not statistically significant) could be seen. Working technique was, in this study, not associated with the risk of developing symptoms in any of the investigated body regions.ConclusionThere was a strong association between high perceived exertion and the development of neck, shoulder, and arm/hand symptoms. Moreover, there was an association between poor perceived comfort and neck pain. Surveillance of computer users may include perceived exertion and comfort to target individuals at risk for neck and upper extremity symptoms.

The Influence of the Environment on Directed Attention, Blood Pressure and Heart Rate—An Experimental Study Using a Relaxation Intervention

Abstract Attention is a basic cognitive function necessary in most daily activities. Beneficial effects on cognitive abilities after exposure to nature have been reported. To explore if relaxation indoors and in nature differently affect directed attention and physiological measures, 51 participants (39 women) were measured on directed attention with the Necker Cube Pattern Control Test before and after a guided progressive relaxation session indoors and outdoors in nature. Additionally, systolic and diastolic blood pressure and heart rate were measured before and after the relaxation. Participants’ environmental preference was explored. The main result showed an environmental effect on directed attention in favour of the natural environment. No similar environmental effect on physiological measures was seen. The results indicate that relaxation in natural environments had a positive effect on directed attention and hence could be an important component for preventive and rehabilitative interventions for stress-related symptoms.

Opting to wear prismatic spectacles was associated with reduced neck pain in dental personnel: a longitudinal cohort study

BackgroundThe aim of this study was to investigate effects on perceived exertion, work ability self-reported neck pain and clinically diagnosed conditions in the neck, of an intervention with prismatic spectacles among dental personnel.MethodsIn this cohort study a baseline questionnaire including questions about frequency of neck pain, perceived exertion during work and background information was distributed to dental personnel in municipal dental care units. In connection, personnel from 78 out of 110 dental care units underwent a clinical neck examination and rated their perceived work ability with the single-item question from the Work Ability Index. The study population consisted of 564 participants; 366 in the questionnaire group, 321 in the examination group, whereof 123 participated in both assessments. In total 371 belonged to the intervention group and received individually adjusted prismatic spectacles after the baseline assessments (inclusion based on self-selection) and 193 belonged to the reference group. At the 12-month follow-up the clinical examination was repeated and the same questionnaire with additional questions was completed. Fisher’s exact test or the Mann–Whitney U test was used to assess differences between the intervention group and the reference group at baseline. Differences at follow up between the two groups were assessed by means of Linear-by Linear association test for trends.ResultsA significant decrease in neck pain (p = 0.047), clinical diagnoses in the neck (p = 0.025), and perceived exertion (p = 0.003) was observed at follow up for the intervention group compared to the reference group. Moreover, for the intervention group a significantly improved self-rated work ability (p = 0.040) was reported. Finally, opting to wear prismatic spectacles during dental work appeared to have a preventive effect on neck pain.ConclusionsDental personnel opting to wear prismatic spectacles reduced their neck pain significantly more at follow up compared with the reference group. These results are worthwhile testing in a randomised design. The practical implication of this study is that recommendations regarding ergonomics for dental professionals may include the use of prismatic glasses, both as primary and secondary prevention of work-related neck pain. Such glasses should also be tested in other working situations where the work tasks include high visual demands in sustained awkward neck postures.