Mogens Theisen Pedersen

Effect of physical exercise interventions on musculoskeletal pain in all body regions among office workers: A one-year randomized controlled trial

This study investigated effects of physical exercise on musculoskeletal pain symptoms in all regions of the body, as well as on other musculoskeletal pain in association with neck pain. A single blind randomized controlled trial testing a one-year exercise intervention was performed among 549 office workers; specific neck/shoulder resistance training, all-round physical exercise, or a reference intervention. Pain symptoms were determined by questionnaire screening of twelve selected body regions. Case individuals were identified for each body region as those reporting pain intensities at baseline of 3 or more (scale of 0-9) during the last three months. For neck cases specifically, the additional number of pain regions was counted. Intensity of pain decreased significantly more in the neck, low back, right elbow and right hand in cases of the two exercise groups compared with the reference group (P<0.0001-0.05). The additional number of pain regions in neck cases decreased in the two exercise groups only (P<0.01-0.05). In individuals with no or minor pain at baseline, development of pain was minor in all three groups. In conclusion, both specific resistance training and all-round physical exercise for office workers caused better effects than a reference intervention in relieving musculoskeletal pain symptoms in exposed regions of the upper body.

A Randomized Controlled Intervention Trial to Relieve and Prevent Neck/Shoulder Pain.

PURPOSE The objective of this study is to investigate the effect of three different workplace interventions on long-term compliance, muscle strength gains, and neck/shoulder pain in office workers. METHODS A 1-yr randomized controlled intervention trial was done with three groups: specific resistance training (SRT, n = 180), all-round physical exercise (APE, n = 187), and reference intervention (REF, n = 182) with general health counseling. Physical tests were performed and questionnaires answered at pre-, mid-, and postintervention. The main outcome measures were compliance, changes in maximal muscle strength, and changes in intensity of neck/shoulder pain (scale 0-9) in those with and without pain at baseline. RESULTS Regular participation was achieved by 54%, 31%, and 16% of those of the participants who answered the questionnaire in SRT (78%), APE (81%), and REF (80%), respectively, during the first half of the intervention period, and decreased to 35%, 28% and 9%, respectively, during the second half. Shoulder elevation strength increased 9-11% in SRT and APE (P < 0.0001). Participants with neck pain at baseline decreased the intensity of neck pain through SRT, from 5.0 +/- 0.2 to 3.4 +/- 0.2 (P < 0.0001), and through APE, from 5.0 +/- 0.2 to 3.6 +/- 0.2 (P < 0.001), whereas REF caused no change. For participants without shoulder pain at baseline, there was a significantly greater increase in pain over the 1-yr period in REF compared with SRT and APE (P < 0.01). CONCLUSION Compliance was highest in SRT but generally decreased over time. SRT and APE caused increased shoulder elevation strength, were more effective than REF to decrease neck pain among those with symptoms at baseline, and prevent development of shoulder pain in those without symptoms at baseline.

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.

The effect of worksite physical activity intervention on physical capacity, health, and productivity: a 1-year randomized controlled trial.

Objective: To investigate the effect of two contrasting physical activity worksite interventions versus a reference intervention (REF) on various health outcomes. Methods: A 1-year randomized controlled trial was conducted with specific resistance training (SRT), all-round physical exercise (APE), and REF. Results: SRT and APE compared with REF showed significant reductions in systolic blood pressure (∼6 mm Hg), body fat percentage (∼2.2 body fat%), as well as shoulder and back pain (∼30% reduction in duration). Muscle strength (APE and SRT) and maximal oxygen uptake (APE) increased approximately 10%. Conclusions: Worksite intervention with both SRT as well as APE is recommended, since these activities compared with REF resulted in clinically relevant reductions of cardiovascular and metabolic syndrome-related risk factors as well as musculoskeletal pain symptoms, in combination with minor increases in physical capacity.

Long-term musculoskeletal and cardiac health effects of recreational football and running for premenopausal women.

We examined long‐term musculoskeletal and cardiac adaptations elicited by recreational football (FG, n=9) and running (RG, n=10) in untrained premenopausal women in comparison with a control group (CG, n=9). Training was performed for 16 months (∼2 weekly 1‐h sessions). For FG, right and left ventricular end‐diastolic diameters were increased by 24% and 5% (P<0.05), respectively, after 16 months. Right ventricular systolic function measured by tricuspid annular plane systolic excursion (TAPSE) increased (P<0.05) in FG after 4 months and further (P<0.05) after 16 months (15% and 32%, respectively). In RG and CG, cardiac structure, E/A and TAPSE remained unchanged. For FG, whole‐body bone mineral density (BMD) was 2.3% and 1.3% higher (P<0.05) after 16 months, than after 4 and 0 months, respectively, with no changes for RG and CG. FG demonstrated substantial improvements (P<0.05) in fast (27% and 16%) and slow (16% and 17%) eccentric muscle strength and rapid force capacity (Imp30ms: 66% and 65%) after 16 months compared with 4 and 0 months, with RG improving Imp30ms by 64% and 46%. In conclusion, long‐term recreational football improved muscle function, postural balance and BMD in adult women with a potential favorable influence on the risk of falls and fractures. Moreover, football training induced consistent cardiac adaptations, which may have implications for long‐term cardiovascular health.

Influence of frequency and duration of strength training for effective management of neck and shoulder pain: a randomised controlled trial

Background Specific strength training can reduce neck and shoulder pain in office workers, but the optimal combination of exercise frequency and duration remains unknown. This study investigates how one weekly hour of strength training for the neck and shoulder muscles is most effectively distributed. Methods A total of 447 office workers with and without neck and/or shoulder pain were randomly allocated at the cluster-level to one of four groups; 1×60 (1WS), 3×20 (3WS) or 9×7 (9WS) min a week of supervised high-intensity strength training for 20 weeks, or to a reference group without training (REF). Primary outcome was self-reported neck and shoulder pain (scale 0–9) and secondary outcome work disability (Disability in Arms, Shoulders and Hands (DASH)). Results The intention-to-treat analysis showed reduced neck and right shoulder pain in the training groups after 20 weeks compared with REF. Among those with pain ≥3 at baseline (n=256), all three training groups achieved significant reduction in neck pain compared with REF (p<0.01). From a baseline pain rating of 3.2 (SD 2.3) in the neck among neck cases, 1WS experienced a reduction of 1.14 (95% CI 0.17 to 2.10), 3WS 1.88 (0.90 to 2.87) and 9WS 1.35 (0.24 to 2.46) which is considered clinically significant. DASH was reduced in 1WS and 3WS only. Conclusion One hour of specific strength training effectively reduced neck and shoulder pain in office workers. Although the three contrasting training groups showed no statistical differences in neck pain reduction, only 1WS and 3WS reduced DASH. This study suggests some flexibility regarding time-wise distribution when implementing specific strength training at the workplace.

Recreational soccer can improve the reflex response to sudden trunk loading among untrained women.

Pedersen, MT, Randers, MB, Skotte, JH, and Krustrup, P. Recreational soccer can improve the reflex response to sudden trunk loading among untrained women. J Strength Cond Res 23(9): 2621-2626, 2009-A slower reflex response to sudden trunk loading (SL) has been shown to increase future risk of low back injuries in healthy subjects, and specific readiness training can improve the response to SL among healthy subjects. The purpose of the study was to investigate the effect of recreational soccer training on the reaction to SL among untrained healthy women. Thirty-six healthy, untrained, Danish women (age 19-45 years) were randomly assigned to a soccer group (SO, n = 19) and a running group (RU, n = 17). In addition, an untrained control group (CON, n = 10) was recruited. Training was performed for 1 hour twice a week (mean heart rate of 165 b·min−1 in SO and 164 b·min−1 in RU) for 16 weeks. Test of reactions to sudden unexpected trunk loading was performed before and after the training period. Furthermore, time-motion analysis of the soccer training was performed for 9 subjects. Group assignment was blinded to the test personnel. Physical education students organized the training. During 1 hour of soccer training, the total number of sudden moves including sudden loading of the upper body (e.g. turns, stops, throw-ins, headers, and shoulder tackles) was 192 (63). In SO, time elapsed until stopping of the forward movement of the trunk (stopping time) decreased (p < 0.05) by 15% and distance moved after unexpected SL decreased (p < 0.05) by 24% compared with no changes in RU and CON. In conclusion, football training includes a high number of sudden loadings of the upper body and can improve the reflex response to SL. The faster reflex response indicates that soccer training can reduce the risk of low back injuries.

Effect of specific resistance training on forearm pain and work disability in industrial technicians: cluster randomised controlled trial

Objectives To determine the effect of specific resistance training on forearm pain and work disability in industrial technicians. Design and setting Two-armed cluster randomised controlled trial of 20 weeks performed at two industrial production units in Copenhagen, Denmark. Participants Working-age industrial technicians both with and without pain and disability. Interventions The training group (n=282) performed specific resistance training for the shoulder, neck and arm muscles three times a week. The control group (n=255) was advised to continue normal physical activity. Outcome All participants rated forearm pain intensity (Visual Analogue Scale, 0–100 mm) once a week (primary outcome) and replied to a questionnaire on work disability (Disability of the Arm Shoulder and Hand, 0–100) at baseline and follow-up (secondary outcome). Results Questionnaires were sent to 854 workers of which 30 (n=282) and 27 (n=255) clusters were randomised to training and control, respectively. Of these, 211 and 237 participants, respectively, responded to the follow-up questionnaire. Intention-to-treat analyses including both individuals with and without pain showed that from baseline to follow-up, pain intensity and work disability decreased more in the training group than in the control group (4–5 on a scale of 0–100, p<0.01–0.001). Among those with pain >30 mm Visual Analogue Scale at baseline (n=54), the OR for complete recovery at follow-up in the training group compared with the control group was 4.6 (95% CI 1.2 to 17.9). Among those with work disability >30 at baseline (n=113), the OR for complete recovery at follow-up in the training group compared with the control group was 6.0 (95% CI 1.8 to 19.8). Conclusion Specific resistance training of the shoulder, neck and arm reduces forearm pain and work disability among industrial technicians. Trial registration number NCT01071980.

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.

Effect of Training Supervision on Effectiveness of Strength Training for Reducing Neck/Shoulder Pain and Headache in Office Workers: Cluster Randomized Controlled Trial

Objective. To investigate the effect of workplace neck/shoulder strength training with and without regular supervision on neck/shoulder pain and headache among office workers. Method. A 20-week cluster randomized controlled trial among 351 office workers was randomized into three groups: two training groups with the same total amount of planned exercises three times per week (1) with supervision (3WS) throughout the intervention period, (2) with minimal supervision (3MS) only initially, and (3) a reference group (REF). Main outcome is self-reported pain intensity in neck and shoulder (scale 0–9) and headache (scale 0–10). Results. Intention-to-treat analyses showed a significant decrease in neck pain intensity the last 7 days in 3MS compared with REF: −0.5 ± 0.2 (P < 0.02) and a tendency for 3WS versus REF: −0.4 ± 0.2 (P < 0.07). Intensity of headache the last month decreased in both training groups: 3WS versus REF: −1.1 ± 0.2 (P < 0.001) and 3MS versus REF: −1.1 ± 0.2 (P < 0.001). Additionally, days of headache decreased 1.0 ± 0.5 in 3WS and 1.3 ± 0.5 in 3MS versus REF. There were no differences between the two training groups for any of the variables. Conclusion. Neck/shoulder training at the workplace reduced neck pain and headache among office workers independently of the extent of supervision. This finding has important practical implications for future workplace interventions.