Prawit Janwantanakul

Prevalence of self-reported musculoskeletal symptoms among office workers

BACKGROUND To date, no study has investigated the prevalence of self-reported musculoskeletal symptoms in all the body regions in the general population of office workers. AIMS To estimate the 12-month prevalence of self-reported musculoskeletal symptoms in the head/neck, shoulders, elbows, wrists/hands, upper back, low back, hips, knees and ankles/feet among office workers. METHODS We conducted a cross-sectional survey using a descriptive questionnaire distributed to 2000 office workers in 54 workplaces. RESULTS A total of 1428 subjects (71%) returned the questionnaire, of whom 1185 were eligible for the study. The annual prevalence of self-reported musculoskeletal symptoms attributed to work was 63%. Sites of symptoms, in order of prevalence, were head/neck (42%), low back (34%), upper back (28%), wrists/hands (20%), shoulders (16%), ankles/feet (13%), knees (12%), hips (6%) and elbows (5%). Female office workers were more likely to report symptoms in the head/neck, shoulder, upper back and ankle/foot regions than male counterparts (P < 0.05). Office workers younger than 30 years were more likely to have symptoms in the upper back than those older than 49 years (P < 0.05). CONCLUSION Musculoskeletal symptoms are common among office workers with a high proportion experiencing symptoms in the spine. The prevalence of musculoskeletal symptoms in some body regions is dependent on gender and age. This indicates a need to develop specific strategies to reduce the occurrence of such symptoms among office workers.

The association between physical activity and neck and low back pain: a systematic review

The effect of physical activity on neck and low back pain is still controversial. No systematic review has been conducted on the association between daily physical activity and neck and low back pain. The objective of this study was to evaluate the association between physical activity and the incidence/prevalence of neck and low back pain. Publications were systematically searched from 1980 to June 2009 in several databases. The following key words were used: neck pain, back pain, physical activity, leisure time activity, daily activity, everyday activity, lifestyle activity, sedentary, and physical inactivity. A hand search of relevant journals was also carried out. Relevant studies were retrieved and assessed for methodological quality by two independent reviewers. The strength of the evidence was based on methodological quality and consistency of the results. Seventeen studies were included in this review, of which 13 were rated as high-quality studies. Of high-quality studies, there was limited evidence for no association between physical activity and neck pain in workers and strong evidence for no association in school children. Conflicting evidence was found for the association between physical activity and low back pain in both general population and school children. Literature with respect to the effect of physical activity on neck and low back pain was too heterogeneous and more research is needed before any final conclusion can be reached.

Exercise Therapy for Office Workers With Nonspecific Neck Pain: A Systematic Review

OBJECTIVE The purpose of this study was to evaluate the effectiveness of various types of exercise for prevention and cure of nonspecific neck pain in office workers. METHODS Publications between 1980 and April 2010 were systematically searched in various databases (PubMed, CINAHL Plus with full text, The Cochrane Library, Science Direct, PEDro, ProQuest, PsycNet, and Scopus). The following key words were used: neck pain, cervical pain, exercise, strengthening, stretching, endurance, office workers, visual display unit, visual display terminal, and computer users. A hand search of relevant journals was also carried out. Relevant randomized controlled trials were retrieved and assessed for methodological quality by 2 independent reviewers. The strength of the evidence was based on methodological quality and consistency of the results. RESULTS Nine randomized controlled trials were included in this review, of which 6 were rated as high-quality studies. No exercise type was identified as being effective in the prevention of nonspecific neck pain in office workers. Strong evidence was found for the effectiveness of muscle strengthening and endurance exercises in treating neck pain. Moderate evidence supported the use of muscle endurance exercise in reducing disability attributed to neck pain. CONCLUSION Literature investigating the efficacy of exercise in office workers with nonspecific neck pain was heterogeneous. Within the limitations, for treatment of neck pain, either muscle strengthening or endurance exercise is recommended, whereas for reduction of pain-related disability, muscle endurance exercise is suggested. Further research is needed before any firm conclusions regarding the most effective exercise programs for office workers can be reached.

Office workers' risk factors for the development of non-specific neck pain: a systematic review of prospective cohort studies

The purpose of this study was to systematically review prospective cohort studies to gain insights into risk factors for the development of non-specific neck pain in office workers as well as to assess the strength of evidence. Publications were systematically searched from 1980 - March 2011 in several databases. The following key words were used: neck pain paired with risk or prognostic factors and office or computer or visual display unit or visual display terminal. Relevant studies were retrieved and assessed for methodological quality by two independent reviewers. The strength of the evidence was based on methodological quality and consistency of the results. Five high-quality and two low-quality prospective cohort studies investigating the predictive value of 47 individual, work-related physical and work-related psychosocial factors for the onset of non-specific neck pain in office workers were included in this review. Strong evidence was found for female gender and previous history of neck complaints to be predictors of the onset of neck pain. Interestingly, for a large number of factors that have been mentioned in the literature as risk factors for neck pain, such as high physical leisure activity, low social support, and high psychosocial stress, we found no predictive value for future neck pain in office workers. Literature with respect to the development of non-specific neck pain in office workers is scant. Only female gender and previous history of neck complaints have been identified as risk factors that predict the onset of neck pain.

Risk Factors for the Onset of Nonspecific Low Back Pain in Office Workers: A Systematic Review of Prospective Cohort Studies

OBJECTIVE The purpose of this study was to systematically review prospective cohort studies to identify risk factors for the onset of low back pain (LBP) in office workers. METHODS Online searches were conducted on PubMed, CINAHL Plus with full text, ScienceDirect, PEDro, ProQuest, and Scopus databases from 1980 to November 2011 using the following keywords: low back pain paired with risk or prognostic factors and office or computer or visual display unit (VDU) or visual display terminal (VDT). The methodological quality of each study was assessed using a 21-item checklist, which was divided into 2 parts: the internal validity (11 items) and descriptive quality (10 items) of studies. Strength of evidence for risk factors associated with the development of nonspecific LBP was assessed by defining 5 levels of evidence based on the number of studies and the quality score of studies. RESULTS Eighteen full-text articles were identified, and 15 were excluded. A total of 3 articles were judged to meet the selection criteria and were included in the methodological quality assessment. Risk factors were divided into 3 groups: individual, work-related physical, and work-related psychosocial risk factors. There was strong evidence that history of LBP is a predictor of the onset of LBP. Limited evidence was found that the combination of postural risk factors and job strain is associated with the onset of LBP. CONCLUSION After review of 3 high-quality prospective studies on the association between risk factors and the onset of nonspecific LBP in office workers, few risk factors were found to predict the onset of LBP in office workers.

Associations between Prevalence of Self-reported Musculoskeletal Symptoms of the Spine and Biopsychosocial Factors among Office Workers

Associations between Prevalence of Self‐reported Musculoskeletal Symptoms of the Spine and Biopsychosocial Factors among Office Workers: Prawit Janwantanakul, et al. Department of Physical Therapy, Faculty of Allied Health Sciences, Chulalongkorn University, Thailand

Development of a risk score for low back pain in office workers - a cross-sectional study

BackgroundLow back pain (LBP) is common among office workers and is the most common cause of work-related disability in people under 45 years of age. The aetiology of LBP is widely accepted to be multi-factorial. Prognostic research into office workers at risk of developing LBP has received limited attention. The aims of this study were to develop a risk score to identify office workers likely to have LBP and to evaluate its predictive power.Methods397 office workers filled out a self-administered questionnaire and underwent physical examination. The questionnaire gathered data on individual, work-related physical and psychosocial data as well as the presence of low back pain in the previous 4 weeks. The physical examination included measurement of body weight, height, waist circumference, hamstrings length, spinal scoliosis, spinal curve, Backache Index and lumbar stability. Logistic regression was used to select significant factors associated with LBP to build a risk score. The coefficients from the logistic regression model were transformed into the components of a risk score.ResultsThe model included six items: previous history of working as an office worker, years of work experience, continuous standing for >2 hrs/d, frequency of forward bending during work day, chair having lumbar support and Backache Index outcome. The risk score for LBP in office workers (The Back pain Risk score for Office Workers: The BROW) was built with a risk score ranging from 0 to 9. A cut-off score of ≥4 had a sensitivity of 80% and a specificity of 58%. The positive predictive value and negative predictive values were 70% each.ConclusionsThe BROW is easy and quick to administer. It appears to have reasonable sensitivity, specificity, positive predictive value and negative predictive values for the cut-off point of ≥4. The BROW is a promising tool for use to identify office workers in need of early interventions. Further prospective study is needed to validate the predictive performance of the BROW.

The effect of quantity of ice and size of contact area on ice pack/skin interface temperature

OBJECTIVE To determine the effect of quantity of ice and contact area on ice pack/skin interface temperature during a 20-minute cooling period. DESIGN Repeated measures. SETTING Laboratory setting in an educational institution. PARTICIPANTS Twenty healthy males aged between 18 and 22 years. INTERVENTIONS An ice pack was applied to the right thigh with compression using an elastic bandage. The effects of three packs measuring 18 cm x 23 cm containing 0.3, 0.6 and 0.8 kg of ice, and one pack measuring 20 cm x 25 m containing 0.6 kg of ice were compared. MAIN OUTCOME MEASURE The reduction in temperature at the ice pack/skin interface during 20-minute ice applications was monitored at 1-minute intervals. RESULTS The application of 0.8-kg and 0.6-kg ice packs led to a significantly greater decrease in the interface temperature compared with the 0.3-kg ice pack [0.8 kg vs. 0.3 kg: -2.35 degrees C, 95% confidence interval (CI) of the difference -3.36 to -1.34 degrees C; 0.6 kg vs. 0.3 kg: -2.95 degrees C, 95% CI -4.07 to -1.83 degrees C]. No significant difference in temperature was found between the 0.6-kg and 0.8-kg ice packs (0.8 kg vs. 0.6 kg: 0.6 degrees C, 95% CI -0.12 to 1.32 degrees C, P>0.05). The size of the contact area did not alter the degree of cooling significantly (difference between smaller and larger pack: 0.05 degrees C, 95% CI -0.93 to 1.03 degrees C, P>0.05). The lowest temperature during ice application was reached after 8-9 minutes of cooling. CONCLUSION Application of an ice pack containing at least 0.6 kg of ice leads to a greater magnitude of cooling compared with application of a 0.3-kg ice pack, regardless of the size of the contact area. Thus, clinicians should consider using ice packs weighing at least 0.6 kg for cold treatment.

Perceived body discomfort and trunk muscle activity in three prolonged sitting postures.

[Purpose] This study aimed to investigate the perceived discomfort and trunk muscle activity in three different 1-hour sitting postures. [Subjects] A repeated-measures design study was conducted on 10 healthy subjects. [Methods] Each subject sat for an hour in three sitting postures (i.e., upright, slumped, and forward leaning sitting postures). Subjects rated perceived body discomfort using Borg’s CR-10 scale at the beginning and after 1 hour sitting. The electromyographic activity of the trunk muscle activity was recorded during the 1-hour period of sitting. [Results] The forward leaning sitting posture led to higher Borg scores in the low back than those in the upright (p = 0.002) and slumped sitting postures (p < 0.001). The forward leaning posture was significantly associated with increased iliocostalis lumborum pars thoracis (ICL) and superficial lumbar multifidus (MF) muscle activity compared with the upright and slumped sitting postures. The upright sitting posture was significantly associated with increased internal oblique (IO)/transversus abdominis (TrA) and ICL muscle activity compared with the slumped sitting posture. [Conclusion] The sitting posture with the highest low back discomfort after prolonged sitting was the forward leaning posture. Sitting in an upright posture is recommended because it increases IO/TrA muscle activation and induces only relatively moderate ICL and MF muscle activation.

Prevalence of and factors associated with musculoskeletal symptoms in the spine attributed to computer use in undergraduate students.

OBJECTIVE This study aimed to investigate the 3-month prevalence of musculoskeletal symptoms at the spine attributed to computer use and to identify biopsychosocial factors associated with the prevalence in undergraduate students. PARTICIPANTS Undergraduate students who studied at a public university in Thailand. METHODS A cross-sectional survey was conducted with a self-administered questionnaire delivered to 3,545 students. RESULTS A total of 2,511 students (73.7%) returned the questionnaires. Cervical symptoms (22.3%) were the most frequently reported, followed by thoracic (11%) and lumbar symptoms (10.7%). Females, daily computer use greater than three hours and too-high keyboards position were significantly associated with a high prevalence of cervical symptoms. A significant association was found between higher undergraduate year of the study and too-high keyboards position and a high prevalence of thoracic symptoms. Higher undergraduate year of the study and daily computer use greater than three hours were significantly related to a high prevalence of lumbar symptoms. Better-than-normal mental health status was associated with a low prevalence of lumbar symptoms. CONCLUSION Spinal symptoms are common among undergraduate students. Various factors were identified to be associated with high prevalence of spinal symptoms. Further research investigating the causal relation between these factors and musculoskeletal symptoms should be conducted.