Kirsten Kaya Roessler

Implementation of neck/shoulder exercises for pain relief among industrial workers: a randomized controlled trial.

BackgroundAlthough leisure-time physical activity is important for health, adherence to regular exercise is challenging for many adults. The workplace may provide an optimal setting to reach a large proportion of the adult population needing regular physical exercise. This study evaluates the effect of implementing strength training at the workplace on non-specific neck and shoulder pain among industrial workers.MethodsCluster-randomized controlled trial involving 537 adults from occupations with high prevalence of neck and shoulder pain (industrial production units). Participants were randomized to 20 weeks of high-intensity strength training for the neck and shoulders three times a week (n = 282) or a control group receiving advice to stay physically active (n = 255). The strength training program followed principles of progressive overload and periodization. The primary outcome was changes in self-reported neck and shoulder pain intensity (scale 0-9).Results85% of the participants followed the strength training program on a weekly basis. In the training group compared with the control group, neck pain intensity decreased significantly (-0.6, 95% CI -1.0 to -0.1) and shoulder pain intensity tended to decrease (-0.2, 95% CI -0.5 to 0.1, P = 0.07). For pain-cases at baseline (pain intensity > = 3) the odds ratio - in the training group compared with the control group - for being a non-case at follow-up (pain intensity < 3) was 2.0 (95% CI 1.0 to 4.2) for the neck and 3.9 (95% CI 1.7 to 9.4) for the shoulders.ConclusionHigh-intensity strength training relying on principles of progressive overload can be successfully implemented at industrial workplaces, and results in significant reductions of neck and shoulder pain.Trial registrationNCT01071980.

Successful talent development in track and field: considering the role of environment

Track and field includes a number of high‐intensity disciplines with many demanding practices and represents a motivational challenge for talented athletes aiming to make a successful transition to the senior elite level. Based on a holistic ecological approach, this study presents an analysis of a particular athletic talent development environment, the IFK Växjö track and field club, and examines key factors behind its successful history of creating top‐level athletes. The research takes the form of a case study. Data were collected from multiple perspectives (in‐depth interviews with administrators, coaches and athletes), from multiple situations (observation of training, competitions and meetings) and from the analysis of documents. The environment was characterized by a high degree of cohesion, by the organization of athletes and coaches into groups and teams, and by the important role given to elite athletes. A strong organizational culture, characterized by values of open co‐operation, by a focus on performance process and by a whole‐person approach, provided an important basis for the environments success. The holistic ecological approach encourages practitioners to broaden their focus beyond the individual in their efforts to help talented junior athletes make a successful transition to the elite senior level.

Exercise treatment for drug abuse--a Danish pilot study.

Aims: The paper presents a recent Danish programme using exercise to alter the behaviour and body image of drug addicts. Methods: 38 participants (23 male and 15 female) took part in groups three times per week for a minimum of two to a maximum of six months. Self-reported data combined with the European Addiction Severity Index (EuropASI) collected at initial admission and in follow-up interviews included information on drug use, body image, self-confidence and motivation to change behaviour. Results: The completion rate of the participants during the training period was on average 52%, which is considered as a success in treatments with drug abusers, usually characterized by a low compliance and commitment. The results of the participants who completed the programme (n = 20) showed an increased oxygen uptake of an average of 10%, improved self-reported quality of life and a higher energy level for the majority of the participants. The addicts obtained a better body image, became more sensitive to physical pain and disorders and reduced their drug intake during the training period. The long-term effect showed that five of the 20 abusers interviewed reported that they still had not taken drugs, 10 had downgraded their intake, four experienced no change at all and one died through an overdose. Conclusions: The results show that physical exercise can provide important support in the treatment of drug abuse and that the main problem is maintaining change in behaviour and peer group influence to ensure long-term change.

Protocol for Work place adjusted Intelligent physical exercise reducing Musculoskeletal pain in Shoulder and neck (VIMS): a cluster randomized controlled trial

BackgroundNeck and shoulder complaints are common among employees in sedentary occupations characterized by intensive computer use. Specific strength training is a promising type of physical exercise for relieving neck and shoulder pain in office workers. However, the optimal combination of frequency and exercise duration, as well as the importance of exercise supervision, is unknown. The VIMS study investigates in a cluster randomized controlled design the effectiveness of different time wise combinations of specific strength training with identical accumulated volume, and the relevance of training supervision for safe and effective training.Methods/designA cluster randomized controlled trial of 20 weeks duration where employed office workers are randomized to 1 × 60 min, 3 × 20 min, 9 × 7 min per week of specific strength training with training supervision, to 3 × 20 min per week of specific strength training with a minimal amount of training supervision, or to a reference group without training. A questionnaire will be sent to 2000 employees in jobs characterized by intensive computer work. Employees with cardiovascular disease, trauma, hypertension, or serious chronic disease will be excluded. The main outcome measure is pain in the neck and shoulders at week 20.Trial RegistrationThe trial is registered at ClinicalTrials.gov, number NCT01027390.

Exercise on Prescription. Effect of attendance on participants' psychological factors in a Danish version of Exercise on Prescription: A Study Protocol

BackgroundIn many countries exercise prescriptions are used to facilitate physical activity in a sedentary population with or in risk of developing lifestyle diseases. Some studies show a positive effect of exercise prescription on specific lifestyle diseases. Others only show moderately positive or no effect on physical activity level. Furthermore, the challenge is adherence of participants to a physically active lifestyle on a long term basis after intervention. Therefore, it is essential for offering successful prescribed interventions aiming towards behaviour change to focus on psychological and social issues as well as physiological issues. The aim of this study is to assess the short and long term development of psychological conditions in two different Exercise on Prescription groups; The Treatment Perspective and The Preventive Perspective behaviour. Thus, the aim of this paper is to describe the design used.Methods/DesignThe Treatment Perspective involves a 16 week supervised training intervention including motivational counselling. The Preventive Perspective only involves motivational counselling. The study is an evaluation of best practice and is accomplished by the use of a combination of quantitative (collected by questionnaires) and qualitative (collected by the use of semi structured interviews) measures. Comparison of The Treatment Perspective and The Preventive Perspective are performed at baseline and after 16 months. Development within the groups is measured at 4, 10, and 16 months. Self-reported measures describe physical activity, health-related quality of life, compliance with national guidelines for physical activity, physical fitness, self-efficacy, readiness to change, decisional balance, and processes of change. To elaborate self-efficacy, readiness to change, decisional balance, and processes of change, these issues were elucidated by interviews.DiscussionThis study of best practice is designed to provide information about important psychological concepts in relation to behaviour change and physical activity. The study is part of a health technology assessment of Exercise on Prescription, which apart from the psychological concepts (the patients perspective) covers the effectiveness, the organization, and the health economy.

Exercise as Treatment for Alcohol Dependence: - A Pilot Study -

Abstract Objective The clinical management of alcohol dependence involves evidence-based knowledge on medical treatment, physical training, and psychological management. This pilot study investigates the effect of physical exercise on cardio-respiratory fitness and socio-psychological outcomes. Design: 10 alcohol patients are included to 12 times moderate intensity exercise in groups. Methods: Aerobic power, anxiety, and depression are measured at baseline and post intervention. Observations of the instructor are described. Results: No significant change of aerobic power, but decreased subjective exhaustion. A trend is shown of decreased depression and less concern. Clinical observations showed the testing environment as obstacle and found the communicative role of the instructor crucial. Conclusion: Future research with regard of adherence has to concentrate on the social and contextual aspects of physical activity as treatment.

Psychosocial aspects of everyday life with chronic musculoskeletal pain: A systematic review

Abstract Background and objective Chronic pain is a growing phenomenon worldwide. It is considered a medical problem because, besides the socio-economic issues involved, pain is often accompanied by psychosocial problems. Apart from the physical pain, living with chronic pain has many additional consequences. People living with chronic pain generally suffer from other physical and psychological consequences. The impact of chronic pain varies enormously between individuals, but the suffering is frequently pervasive and detrimental. The objective of this study was to review the evidence concerning, ways in which people living with chronic pain are affected in their everyday lives. Methods Electronic databases Scopus, Cinahl and PsycINFO were searched from 2008 to September 2012 using a ‘building blocks’ approach and reference lists were scanned. PubMed was also searched and checked for duplicates compared to Scopus, Cinahl and PsycINFO. Data were extracted from included studies and methodological quality assessed with a view to exploring quality differences. To guide the review and interpretation, individual components of methodological quality were compared against a checklist. A narrative synthesis was formulated involving three categories: (1) clinical aspects, (2) everyday life aspects and (3) interpersonal aspects. Results The search strategy identified 1140 citations; one study was found during the preliminary searching through references, and a search of reference lists provided five publications. Of these, 24 publications, representing 23 populations, met the inclusion criteria. In total, there were 22 cross-sectional studies and 2 cohort studies. Study populations ranged from 74 to 3928 participants and were heterogeneous in nature across studies with respect to age, duration and localisations of pain and outcome measures. We found a general consensus that life with chronic pain was associated with higher prevalence and higher levels of depression and diagnoses of widespread pain and nonspecific pain are more clearly associated with depression than is specific pain. The results of link between chronic pain and anxiety and stress were not obvious. Overall, there is plausible evidence to suggest a positive relationship between chronic pain and disability and the evidence is stronger for a significant positive association between nonspecific pain and disability, compared to specific pain. It can be summarized that there is a lack of evidence for a relationship between intensity of pain and quality of life. However, there is evidence that nonspecific pain is more compellingly associated with low quality of life than is specific pain. The evidence of a positive relation between pain and problems in close relations is not convincing but there is an indication to suggest that there is a pain-related issue regarding participation in many social aspects of everyday life. Conclusion Besides the pain itself, people living with chronic pain are affected in other aspects of life. In particular, it is evident that they experience challenges with respect to depressive thoughts, disability, lower quality of life and conflicts in close relationships. Implications When designing interventions for people with chronic pain, it is essential to take into consideration the fact that living with chronic pain has far-reaching consequences beyond the pain suffered.

A corrective emotional experience - or just a bit of exercise? The relevance of interpersonal learning in Exercise on prescription

The objective of the present study was to examine psychological aspects of intra- and interpersonal learning for patients with Type 2 diabetes, hypertension and dyslipidemia treated with Exercise on prescription. The research design consists of a qualitative investigation of 30 patients in Denmark undergoing a community-based exercise treatment at baseline, a post-intervention investigation after four months and a follow-up one year after the start of intervention. The results demonstrated that, for the majority of the participants, interaction under group conditions contributes to maintaining the commitment to exercise. For a corrective emotional experience- a correction of an emotional situation a person could not handle in the past - to occur requires two conditions: the group and the environment must be experienced as sufficiently safe, and there must be feedback to permit reality-testing. However, existential psychological aspects such as fear of dying or the universality of suffering triggered, but could not sustain, a change in health behavior. The article concludes that behavioral change is strengthened by interaction with health personnel and with the training group. These new insights likewise demand an increased focus on the human resources of general practitioners or physiotherapists who handle the training. They should learn about their supportive role for the participants, the regressive urges of the participants and the benefits of promoting group relations.

Hiding the Plot: Parents’ Moral Dilemmas and Strategies When Helping Their Overweight Children Lose Weight

In this study we investigated the moral dilemmas and strategies of a group of Danish parents who were trying to help their overweight children lose weight. Data were drawn from repeated semistructured interviews carried out over a period of 2 years with 12 families with overweight children. Using a narrative approach, we show the moral dilemmas parents found themselves in when trying to further the two seemingly incompatible goals of helping their children lose weight and simultaneously strengthening their self-worth. When the children were young, the parents tried to hide the fact that they needed to lose weight to protect them from feeling stigmatized. As the children grew older, the parents became more forthright about weight loss so the children would take on more responsibility. We suggest that for parents, weight loss is experienced as a risky undertaking because they perceive their children’s self-worth as being in jeopardy during the process.

Effects of exercise and group counselling on body composition and VO2max in overweight women with polycystic ovary syndrome

Polycystic ovary syndrome (PCOS) is often associated with an increased waist circumference and with lower cardio‐respiratory fitness as a consequence of obesity, which may be improved by physical activity.