Work ability in aging office workers with musculoskeletal disorders and non-communicable diseases and its associated factors: a cross-sectional study.

Objectives. The prevalence of musculoskeletal disorders (MSDs) and non-communicable diseases (NCDs) increases with age. This study examined the impact of MSDs and NCDs on work ability, using the work ability index (WAI), among aging office workers (between 45 and 60 years old) and determined factors associated with WAI scores. Methods. A cross-sectional study was conducted in office workers from 27 government offices in Bangkok and nearby provinces using an online questionnaire. Analyses were conducted using the Mann-Whitney U test and a multivariable logistic regression model. Results. Of 689 workers (452 females and 237 males), 34, 13, 12 and 41% reported MSDs, NCDs, MSDs + NCDs and no MSDs/NCDs, respectively, in the past year. Median scores (interquartile range) of WAI were 37.0 (6) for MSDs, 37.0 (4) for NCDs, 34.5 (6) for MSDs + NCDs and 40.0 (4) for no MSDs/NCDs. Significant difference in WAI scores was found between the MSDs and MSDs + NCDs groups (p = 0.005); and between the NCDs and MSDs + NCDs groups (p < 0.001). Female, high work experience and low job control were significantly associated with reduced WAI scores (WAI ≤ 36). Conclusion. The presence of MSDs or NCDs reduced work ability among aging office workers compared to their healthy counterparts. Having MSDs + NCDs further reduced work ability.

Efficacy of risk factor education on pain intensity and disability in office workers with nonspecific neck or low back pain: A pilot cluster randomized clinical trial.

BACKGROUND: Musculoskeletal disorders are of multi-factorial origin, including individual, physical, and psychosocial factors. An effective education program for musculoskeletal disorders should include predisposing factors. OBJECTIVE: This study aimed to examine the effect of risk factor education on pain intensity and disability levels compared to a home-based exercise program in office workers with nonspecific neck or low back pain. METHODS: A pilot cluster randomized clinical trial was conducted in 46 workers with neck or low back pain. The education group received checklists of risk factors and handbooks providing information on how to manage them. The exercise group received a home-based exercise program to manage their neck or low back pain. The primary outcome measures were pain intensity and disability levels. RESULTS: There was no significant difference in pain intensity or disability level between groups at baseline and follow-ups. However, neck and low back pain intensity, but not disability level, at the 3-month and 6-month follow-ups was significantly lower than those at baseline in both groups. CONCLUSION: Risk factor education was not more effective than the home-based exercise program in terms of pain intensity or disability reduction in workers with nonspecific neck or low back pain.

The effects of walking intervention on preventing neck pain in office workers: A randomized controlled trial.

OBJECTIVE: This study aimed to evaluate the efficacy of increased daily walking steps on the 6-month incidence of neck pain among office workers. METHODS: Healthy office workers with high risk of neck pain were recruited into a 6-month prospective cluster-randomized controlled trial. Participants were randomly assigned at the cluster level, into either intervention (n = 50) or control (n = 41) groups. Participants in the intervention group were instructed to increase their daily walking steps to a designated level for a duration of 6 months. Participants in the control group received no intervention. The outcome measures included the 6-month incidence of neck pain as well as its pain intensity and disability level. Analyses were performed using multivariable logistic regression model. RESULTS: Of the participants in the intervention and control groups, 22% and 34% reported a 6-month incidence of neck pain, respectively. After adjusting for confounders, a significant preventive effect of walking intervention was found (adjusted odd ratio 0.22, 95% confidence interval 0.06-0.75). No significant difference in pain intensity and disability level was found between those in the intervention and control groups. CONCLUSION: An intervention to increase daily walking steps reduced onset neck pain in high-risk office workers. However, the walking interventions did not decrease pain intensity and disability in those increasing the number of daily walking steps compared to the control group.

A Path Analysis of the Effects of Biopsychosocial Factors on the Onset of Nonspecific Low Back Pain in Office Workers.

OBJECTIVE: The purpose of this study was to develop a conceptual model for the association between various biopsychosocial factors and nonspecific low back pain (LBP) in a sample of office workers. METHODS: A 1-year prospective cohort study of 669 healthy office workers was conducted. At baseline, a self-administered questionnaire and standardized physical examination were employed to gather biopsychosocial data. Follow-up data were collected every month for the incidence of LBP. A regression model was built to analyze factors predicting the onset of LBP. Path analysis was performed to examine direct and indirect associations between identified risk factors and LBP. RESULTS: The onset of LBP was predicted by history of LBP, frequency of rest breaks, and psychological demand, measured by the Job Content Questionnaire. All 3 factors directly related to LBP; history of LBP was the strongest effector on the onset of LBP. History of LBP and frequency of rest breaks had indirect effects on LBP that were mediated through psychological demand, and frequency of rest breaks was the most influential effector on psychological demand. CONCLUSIONS: Three risk factors were identified to predict onset LBP, including history of LBP, frequency of rest breaks, and psychological demand. Each factor had direct effects on the development of LBP. Also, history of LBP and frequency of rest breaks had indirect effects on LBP that were mediated through psychological demand.

The effects of walking intervention in patients with chronic low back pain: A meta-analysis of randomized controlled trials.

OBJECTIVE: The aim of this meta-analysis of randomized controlled trials was to gain insight into the effectiveness of walking intervention on pain, disability, and quality of life in patients with chronic low back pain (LBP) at post intervention and follow ups. METHOD: Six electronic databases (PubMed, Science Direct, Web of Science, Scopus, PEDro and The Cochrane library) were searched from 1980 to October 2017. The following keywords were used: Walk* or Pedometer* or Accelerometer* or Treadmill* paired with "Back pain", "Low back pain", "Chronic low back pain", "LBP", or "Backache". Randomized controlled trials in patients with chronic LBP were included if they compared the effects of walking intervention to non-pharmacological interventions. Pain, disability, and quality of life were the primary health outcomes. RESULTS: Nine studies were suitable for meta-analysis. Data was analyzed according to the duration of follow-up (short-term, < 3 months; intermediate-term, between 3 and 12 months; long-term, > 12 months). Low- to moderate-quality evidence suggests that walking intervention in patients with chronic LBP was as effective as other non-pharmacological interventions on pain and disability reduction in both short- and intermediate-term follow ups. CONCLUSIONS: Unless supplementary high-quality studies provide different evidence, walking, which is easy to perform and highly accessible, can be recommended in the management of chronic LBP to reduce pain and disability.

Predictors for chronic neck and low back pain in office workers: a 1-year prospective cohort study.

OBJECTIVE: All occupations expose workers to varied and unique conditions. The nature of work has been recognized as influencing the health of workers. Whether predictors for chronic neck and low back pain would be occupation-specific is unknown. This study aimed to identify predictors for chronic neck and low back pain in a cohort of office workers. METHODS: A prospective study was carried out among 669 healthy office workers. At baseline, risk factors were assessed using a questionnaire and standardized physical examination. A symptomatic case was defined as an individual who reported pain greater than 30 mm on a 100-mm VAS, and chronic pain was defined as experiencing ongoing neck or low back pain for greater than 3 months over the past 6 months. Two regression models were built to analyze the risk factors for developing chronic neck and low back pain. RESULTS: Of the sample, 17 and 27% of office workers who reported a new onset of neck or low back pain developed chronicity, respectively. Predictors for chronic neck pain were high body mass index, frequent neck extension during the work day, high initial pain intensity, and high psychological job demands. The development of chronic low back pain was associated with history of low back pain and high initial pain intensity. CONCLUSIONS: The findings suggest that predictors for chronic musculoskeletal pain in a subpopulation may be a subset of predictors identified in a general population or occupation specific. Successful management to prevent chronic musculoskeletal pain may also need to consider the patient's occupation.

A screening tool for non-specific low back pain with disability in office workers: a 1-year prospective cohort study.

BACKGROUND: Having a screening tool with reasonable predictive ability is essential in providing information about an individual's risk of developing a disease, allowing an examination to be conducted with limited personnel and time, and selecting the relevant individuals for therapeutic research. This study aimed to produce a screening tool to identify office workers at risk of developing non-specific low back pain (LBP) with disability, and to evaluate the tool's predictive power. METHODS: At baseline, 615 healthy office workers filled out a self-administered questionnaire and underwent physical examination to gather potential risk factors. The incidence of LBP was collected every month thereafter. Disability level was assessed using the Roland-Morris Disability Questionnaire (RMDQ). The minimum RMDQ score for categorization as LBP was 3. Logistic regression was used to select significant factors to build a risk score. The coefficients from the logistic regression model were used to develop the components of a screening tool. RESULTS: Over the 1-year follow-up, 8.8 % of participants reported incident LBP with disability. The screening tool for non-specific low back pain with disability in office workers comprised two items that contributed to the total score: previous history of LBP and psychological demand (assessed by the Job Content Questionnaire). The score range of the screening tool was 12 to 69. With a cut-off score of 53, the sensitivity was 65 % and the specificity was 68 %. The positive and negative predictive values were 16 and 95 %, respectively. The area under the receiver-operating characteristic curve was 0.76. CONCLUSIONS: A screening tool for non-specific low back pain with disability in office workers was developed and appears to have reasonable sensitivity, specificity, positive predictive values, and negative predictive values. Further validation and impact studies of the screening tool in a new population of office workers are suggested.

A prospective, cluster-randomized controlled trial of exercise program to prevent low back pain in office workers.

PURPOSE: The objective of this study was to evaluate the effects of an exercise program focusing on muscle stretching and endurance training on the 12-month incidence of low back pain (LBP) in office workers. METHODS: A 12-month prospective cluster-randomized controlled trial was conducted in healthy office workers with lower-than-normal trunk extension flexibility or trunk muscle endurance. Healthy office workers (n = 563) were randomly assigned at the cluster level into either intervention (n = 282) or control (n = 281) groups. Participants in the intervention group received an exercise program that included daily stretching exercise and twice-a-week muscle endurance training. Those in the control group received no intervention. The 12-month incidence of LBP was the primary outcome. Secondary outcome were pain intensity, disability level, and quality of life and health status. Analyses were performed using the Cox proportional hazard models. RESULTS: Over the 12-month follow-up, 8.8% of participants in the intervention group and 19.7% in the control group developed incidence of LBP. Hazard rate ratios showed a protective effect of the exercise program for LBP (HR = 0.37, 95% CI 0.22-0.64) after adjusting for biopsychosocial factors. There was no significant difference in pain intensity, disability, and quality of life and health status between those who reported incidence of LBP in the intervention and control groups. CONCLUSION: An exercise program consisting of muscle stretching and endurance training is an effective intervention to reduce incident LBP for office workers with lower-than-normal trunk extension flexibility or trunk muscle endurance.

Effects of an exercise programme on preventing neck pain among office workers: a 12-month cluster-randomised controlled trial.

OBJECTIVES: This study aimed to evaluate the effects of an exercise programme focusing on muscle stretching and endurance training on the 12-month incidence of neck pain in office workers. METHODS: A 12-month prospective cluster-randomised controlled trial was conducted in healthy office workers with lower-than-normal neck flexion movement or neck flexor endurance. Participants were recruited from 12 large-scale enterprises. A total of 567 healthy office workers were randomly assigned at the cluster level into either intervention (n=285) or control (n=282) groups. Participants in the intervention group received an exercise programme that included daily stretching exercise and twice-a-week muscle endurance training. Those in the control group received no intervention. The primary outcome measure was the 12-month incidence of neck pain, and the secondary outcome measures were pain intensity, disability level, and quality of life and health status. Analyses were performed using the Cox proportional hazard models. RESULTS: Over the 12-month follow-up, 12.1% of participants in the intervention group and 26.7% in the control group developed incident neck pain. Hazard rate ratios showed a protective effect of the exercise programme for neck pain (HR=0.45, 95% CI 0.28 to 0.71) after adjusting for biopsychosocial factors. There was no significant difference in pain intensity, disability and quality of life and health status between those who reported incident neck pain in the intervention and control groups. CONCLUSIONS: The exercise programme reduced incident neck pain and increased neck flexion movement for office workers with lower-than-normal neck flexion movement.

Incidence of and risk factors for musculoskeletal symptoms in the neck and low-back during severe flooding in Bangkok in 2011.

OBJECTIVE: To examine whether the incidences of neck and low-back symptoms were elevated during the severe floods that occurred in Bangkok, Thailand in 2011, and to explore flood-related risk factors for neck and low-back symptoms. DESIGN: Prospective cohort design. METHODS: Severe flooding occurred in Bangkok and surrounding neighbourhoods between October and December, 2011. After the flood had subsided (January 2012), 377 healthy office workers, who were already taking part in a study on musculoskeletal symptoms, were asked about their contact with floodwater. Data were gathered from subjects, who had reported no neck and low-back symptoms at the end of September 2011 and who were affected by the flood. Two regression models for the outcomes of 3-month incidence of neck and low-back symptoms, respectively, were performed. RESULT: Eighty-two percent of the subjects were affected by the flood. No flood-related factor was found to associate significantly with either neck or low-back symptoms. However, neck symptoms may be associated with commuting frequently through flooded areas, and low-back symptoms may be associated with the subjects' homes or workplaces being flooded. CONCLUSION: These findings indicate that more attention needs to be paid to the problem of musculoskeletal symptoms during flooding in urban areas, and that preventive measures are required.

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.