The bigger, the stronger? Insights from muscle architecture and nervous characteristics in obese adolescent girls.

BACKGROUND: Young obese youth are generally stronger than lean youth. This has been linked to the loading effect of excess body mass, acting as a training stimulus comparable to strength training. Whether this triggers specific adaptations of the muscle architecture (MA) and voluntary activation (VA) that could account for the higher strength of obese subjects remains unknown. METHODS: MA characteristics (that is, pennation angle (PA), fascicle length (FL) and muscle thickness (MT)) and muscle size (that is, anatomical cross-sectional area (ACSA)) of the knee extensor (KE) and plantar flexor (PF) muscles were evaluated in 12 obese and 12 non-obese adolescent girls (12-15 years). Maximal isometric torque and VA of the KE and PF muscles were also assessed. RESULTS: Results revealed higher PA (P<0.05), greater MT (P<0.001), ACSA (P<0.01), segmental lean mass (P<0.001) and VA (P<0.001) for KE and PF muscles in obese girls. Moreover, obese individuals produced a higher absolute torque than their lean counterparts on the KE (224.6±39.5 vs 135.7±32.7 N m, respectively; P<0.001) and PF muscles (73.3±16.5 vs 44.5±6.2 N m; P<0.001). Maximal voluntary contraction (MVC) was correlated to PA for the KE (r=0.46-0.57, P<0.05-0.01) and PF muscles (r=0.45-0.55, P<0.05-0.01). MVC was also correlated with VA (KE: r=0.44, P<0.05; PF: r=0.65, P<0.001) and segmental lean mass (KE: r=0.48, P<0.05; PF: r=0.57, P<0.01). CONCLUSIONS: This study highlighted favorable muscular and nervous adaptations to obesity that account for the higher strength of obese youth. The excess of body mass supported during daily activities could act as a chronic training stimulus responsible for these adaptations.

Efficacy of self-management program associated with a spa therapy for knee osteoarthritis patients (GETT 2): a research protocol for a randomized trial.

INTRODUCTION: Osteoarthritis is a chronic pathology that involves multidisciplinary management. Self-management for patients is an essential element, present in all international guidelines. During the time of the spa therapy, the patient is receptive to take the advantage of self-management workshops. The aim of this study is to assess the effects of 18 days spa therapy associated with a self-management intervention in patients with knee osteoarthritis in comparison with spa therapy alone on a priority objective, personalized and determined with the patient, chosen in the list of 5 objectives determined during the self-management initial assessment. METHODS AND ANALYSIS: Two hundred fifty participants with knee osteoarthritis will participate to this multicenter, prospective, randomized, controlled study. All patients will benefit 18 days of spa therapy and patients randomized in the intervention group will participate to 6 self-management workshops. Randomization will be centralized. The allocation ratio will be 1:1. Data analysts and assessor will be blinded. The primary outcome is the effectiveness of the educational workshops associated with spa therapy in comparison with spa therapy alone on a priority objective, measured by Goal Attainment Scaling (GAS). The secondary outcomes are disability, health-related quality of life, and pain intensity. ETHICS AND DISSEMINATION: Ethics were approved by the CPP Sud-Méditerranée II. The results will be disseminated in a peer-reviewed journal and disseminated at PRM, rheumatology, and orthopedics conferences. The results will also be disseminated to patients. TRIAL REGISTRATION: Trial registration number NCT03550547. Registered 8 June 2018. Date and version identifier of the protocol. Version N°6 of March 12, 2018.

Early rehabilitation management strategy for septic arthritis of the knee.

OBJECTIVES: Early rehabilitation management of septic arthritis in the native knee is not standardized. In this context, it is necessary to develop and validate an early rehabilitation strategy. MATERIEL AND METHODS: Based on the formalized HAS consensus method, a 4-phase rehabilitation strategy has been developed: recovery of joint amplitudes, muscle recovery without resistance, recovery with technical aid (crutches, canes), continuation of the rehabilitation (pursuit of muscle, articular, proprioceptive and endurance recovery). RESULTS: It was submitted to the opinion of multidisciplinary experts (PMR, general practitioner, rheumatologist, infectiologist, orthopedic surgeon, physiotherapist). Nearly 80% of the items were directly validated, with only five items scoring less than 5/10. Modifications were made in order to obtain a final version of the protocol. CONCLUSION: Use of a rigorous methodology enabled a consensual strategy for early rehabilitation management to be developed. Prospective validation of this strategy is needed to confirm its feasibility and effectiveness.

Perceived barriers to and facilitators of physical activity in people with knee osteoarthritis: Development of the Evaluation of the Perception of Physical Activity questionnaire.

BACKGROUND: The physical activity (PA) level of individuals with knee osteoarthritis is lower than in the general population. International recommendations recommend a non-pharmacological intervention including a self-management education program, weight loss and an adapted exercise program. However, we have no scale assessing the perceived barriers to and facilitators of PA in this population. OBJECTIVE: We constructed and validated a self-administered questionnaire assessing perceived barriers to and facilitators of regular practice of PA in people with knee osteoarthritis. METHODS: Semi-structured interviews identified 24 barriers and facilitators. We developed a 24-item questionnaire, Evaluation of the Perception of Physical Activity (EPPA) that was completed by 548 individuals with knee osteoarthritis, to assess acceptability, construct validity, internal consistency and convergent validity. Participants also completed the Knee Osteoarthritis Fears and Beliefs Questionnaire (KOFBeQ), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and International Physical Activity Questionnaire (IPAQ). Reliability and sensitivity to change were evaluated in a second group of 168 people with knee osteoarthritis at a 3-week spa therapy resort. RESULTS: Factorial analysis identified 17 items grouped into 4 subscales (Barriers, Facilitators, Motivation and Beliefs). The internal consistency was good for Barriers, Facilitators and Motivation subscales (Cronbach α>0.70) and intermediate for the Beliefs subscale (Cronbach α=0.64). The EPPA subscale scores were significantly correlated with KOFBeQ and WOMAC scores but not associated with IPAQ physical activity level. Reliability was good for all subscales, with intraclass correlation coefficients>0.60. A sensitivity to change was found for only the Beliefs subscale, with a moderate effect size. CONCLUSIONS: The EPPA questionnaire has good psychometric properties and can help guide the management of knee osteoarthritis. It can be used in research for evaluating the perception of physical activity.

Comparison of psychometric properties between the Labin, a new electronic dynamometer, and the Jamar: Preliminary results in healthy subjects.

Many instruments exist for measuring grip strength. The Jamar hydraulic hand dynamometer is currently the gold standard. The Labin is a prototype electronic dynamometer that can also measure maximum grip strength. The main objective was to compare the Labin dynamometer with the gold standard instrument, the Jamar, in a healthy population, and secondarily to compare discomfort during use. A single-center exploratory study was conducted. The subjects enrolled had to be aged between 20 and 60, be volunteers and give consent. The required number of subjects was 30. The subjects were positioned according to American Society of Hand Therapists recommendations. Maximum grip force was measured in kilograms using the mean of three successive trials. The first dynamometer used was chosen randomly. The handle's discomfort during use was rated on a simple verbal scale from 0 to 10. Thirty-four subjects were included. The concordance coefficient for peak torque between the Labin and Jamar dynamometers was 0.90 for the dominant hand and 0.83 for the non-dominant hand. The intraclass correlation coefficient for peak torque with the Labin was 0.81 [0.69; 0.89] for the dominant hand and 0.86 [0.76; 0.92] for the non-dominant hand. In our study, we have shown that the Labin prototype has acceptable validity and reproducibility. The Labin will need to be tested in pathological conditions next.

[What is the interest of early knee mobilization after total knee arthoplasty?]. / Intérêt d'une mobilisation très précoce après la pose d'une prothèse totale de genou? Elaboration de recommandations françaises pour la pratique clinique.

AIMS: To develop clinical practice guidelines for early mobilisation after total knee replacement (TKR). METHOD: We used the French Society of Physical and Rehabilitation Medicine (SOFMER) methodology, which associates a systematic review of the literature, collection of information regarding current clinical practice and external review by a multidisciplinary expert panel. RESULTS: A review of the literature and French clinical practice allow for recommending early mobilisation, at day 0, after TKR. This practice, with continuous passive motion, does not seem to increase the frequency of complications and seems to help with rapid recovery of the joint range of motion. Trials with good methodology must be developed to define the criteria for prescribing early mobilisation after TKR. These trials should focus mainly on joint range of motion but also on economical criteria (duration of hospitalisation, rehabilitation, physiotherapy, use of painkillers) and the satisfaction of the patient.

[What is the interest of early mobilization after total hip arthroplasty? Development of French guidelines for clinical practice]. / Intérêt d'une mobilisation très précoce après la pose d'une prothèse totale de hanche ? Elaboration de recommandations françaises pour la pratique clinique.

AIMS: To develop clinical practice guidelines for early mobilisation after total hip replacement (THR). METHOD: We used the French Society of Physical and Rehabilitation Medicine (Sofmer) methodology, which associates a systematic review of the literature, the collection of information regarding current clinical practice and external review by a multidisciplinary expert panel. RESULTS: Recommending early mobilisation after THR is not established by a review of the literature. A survey of French clinical practice allows for recommending early mobilisation in the context of complex hip issues. Trials with good methodology must be developed to evaluate the interest of early functional mobilisation corresponding to when patients first stand and take their first steps after surgery. These trials should focus mainly on the final pain, functional status, and reduction of handicap.

Establishing recommendations for physical medicine and rehabilitation: the SOFMER methodology.

OBJECTIVE: The development of a rigorous methodology based on published results of clinical trials, evaluation of daily practice in France and multidisciplinary expert opinion to elaborate recommendations for rehabilitation interventions. METHODS AND RESULTS: The following describes the methodology of SOFMER (Société Française de Médecine Physique et de Réadaptation [French Society of Physical Medicine and Rehabilitation]) for developing recommendations for rehabilitation interventions. The test case was developing recommendations for rehabilitation in hip or knee osteoarthritis (OA) and hip or knee arthroplasty. Physicians in rehabilitation, orthopedic surgery and rheumatology identified, synthesized, and analyzed data from the literature by use of the usual French system of grading trials (the French Agency for Accreditation and Evaluation in Healthcare [ANAES] scale). The data were published results of comparative controlled studies such as randomized controlled trials, controlled clinical trials, cohort studies, case control studies, reviews of clinical trials, and case series, as well as uncontrolled cohort studies. The resulting recommendations were presented to the three annual French national congresses of rehabilitation, rheumatology, and orthopedic surgery for comment and for adapting to French professional practice. Finally, a panel of multidisciplinary experts (physicians in physical medicine and rehabilitation, rheumatologists, orthopedic surgeons, general practitioners, physical therapists, social workers, podologists, occupational therapists, nurses, and patients) validated the recommendations. CONCLUSION: The SOFMER methodology could be an interesting tool for use in developing recommendations elaborated by all the concerned medical and surgical specialists in the wide domain of rehabilitation.

Could preoperative rehabilitation modify postoperative outcomes after total hip and knee arthroplasty? Elaboration of French clinical practice guidelines.

OBJECTIVE: To develop clinical practice guidelines concerning preoperative rehabilitation for hip and knee total arthroplasty. METHOD: We used the SOFMER (French Physical Medicine and Rehabilitation Society) methodology, combining systematic literature review, collection of everyday clinical practice, and external review by a multidisciplinary expert panel, to develop the guidelines. Main outcomes considered in the recommendations were impairment, disability, medico-economic implications and postoperative complications. RESULTS: A preoperative rehabilitation program, comprising at least physical therapy and education, is recommended before total hip and knee arthroplasty. Occupational therapy could be combined with patient home visits. Isolated physical therapy before total knee arthroplasty (TKA) is not recommended. Multidisciplinary rehabilitation comprising at least occupational therapy and education is desirable for the most fragile patients because of major disability, co-morbidity or social problems. Complementary studies are required to confirm the impact of pre-operative rehabilitation before total hip and knee arthroplasty, to define components of rehabilitation and the patients most likely to benefit. CONCLUSION: Rehabilitation before total hip and knee arthroplasty contributes to reduced hospital length of and modifying discharge conditions. This rehabilitation necessitates the collaboration of qualified health care professionals in the educational topic and return-home preparation. Preoperative patient assessment is important.

[Does the quality of Web sites related to low back pain meet patients expectations? A systematic review]. / La qualité de l'information disponible sur Internet concernant la lombalgie est-elle adaptée aux attentes des patients? Revue systématique.

INTRODUCTION: An assessment of 36 back-pain-related French-language Web sites, miming a patient search strategy, was previously done by use of evidence-based items. Medical information quality was poor, as already noted about English-language Web sites. Thus, patients' expectations may exceed that provided by Web sites with simple medical information. OBJECTIVES: To study whether French-language Web sites related to low back pain meet patients expectations and to valid a rating scale including patients' expectations. MATERIALS AND METHOD: First we reviewed French-language Web sites with new keywords and medical gateways. Second, we systematically double assessed back pain-related Web sites with a health care professional and patient-centered scale. RESULTS: We found 30 additional Web sites not found with the previous search, 7 focusing on patient information. The rating scale is valid, and its use on a Web site sample leads to results different from those generated by an evidence-based medicine rating scale but close to a more global assessment. DISCUSSION: French-language Web sites related to low back pain do not meet patients' expectations. Patients participation in Web site assessment or construction could help to close the gap between the expectations of people with low back pain and information delivered by doctors.

The benefits of ambulatory physiotherapy after total hip replacement. Clinical practice recommendations.

AIM: To develop clinical practice guidelines for prescribing ambulatory physiotherapy for patients able to leave the surgery department directly for home just after total knee replacement (THR). METHOD: We used the SOFMER (French Society of Physical and Rehabilitation Medicine) methodology, which associates a systematic revue of the literature, collection of information regarding current clinical practice and external review by a multidisciplinary expert panel. Main outcomes considered in the recommendations were impairment, disability, medico-economic implications and postoperative complications. RESULTS: The literature review results showed some advantage for programs of ambulatory physiotherapy for patients able to return home just after total hip replacement. The main outcomes ameliorated are muscle strength and function. However, studies were methodologically limited. When the patient can return home directly from the surgery department, we recommend ambulatory physiotherapy as suggested by French clinical practice. The program and number and objectives of the ambulatory rehabilitation must be defined in future trials with good methodology. No difference in cost was found if home therapy is used.

The benefits of ambulatory physiotherapy after total knee replacement. Clinical practice recommendations.

AIMS: To develop clinical practice guidelines for ambulatory physiotherapy for patients able to leave the surgery department directly for home just after total knee replacement (TKR). METHOD: We used the SOFMER (French Society of Physical and Rehabilitation Medicine) methodology, which associates a systematic revue of the literature, collection of information regarding current clinical practice and external review by a multidisciplinary expert panel. Main outcomes considered in the recommendations were impairment, disability, medico-economic implications and postoperative complications. RESULTS: The literature review did not allow for recommending systematic prescription of ambulatory physiotherapy for patients able to leave the surgery department directly for home just after TKR. However, this prescription could improve muscle strength and function but not mobility. When patients can return home directly after surgery, we recommend ambulatory physiotherapy as suggested by French clinical practice to increase function. CONCLUSION: Good methodological trials must be developed to define the criteria for prescribing ambulatory physiotherapy for patients able to return home just after total knee replacement (TKR) and to evaluate the content of the optimal program.

Could a simple educational intervention modify beliefs about whiplash? A preliminary study among professionals working in a rehabilitation ward.

UNLABELLED: Could a simple educational intervention modify beliefs about whiplash? A preliminary study among professionals working in a rehabilitation ward. OBJECTIVE: Whiplash and its consequences remain an alarming clinical and social problem, and psychosocial factors could play a role. We aimed to translate and assess the effects on beliefs of an evidence-based educational booklet on whiplash-associated disorders among professionals who work in a rehabilitation ward. METHODS: After translation/back-translation of the English version of The Whiplash Book, we undertook a before-and-after prospective study. The main outcome assessment was final score on the whiplash belief questionnaire (WBQ) involving nine questions assessing beliefs and attitudes about the consequences of whiplash rated on a 5-point Likert scale ranging from "completely agree" to "complete disagree." Final scores range from 9 to 45, low scores indicating positive beliefs. Demographic, educational and professional data, as well as personal medical history of neck pain, were recorded. Acceptability of the booklet was rated on a 10-point scale and by open questions. RESULTS: Among the 50 professionals included in the study, 48 completed the questionnaire. Whiplash beliefs tended to be positive at first assessment (WBQ score 23.37+/-6.45). Reading the whiplash booklet significantly improved beliefs (14.27+/-4.39; P<0.05). Global evaluation of the booklet on a 10-point scale was good (8.13+/-1.05) as was acceptability (8.13+/-1.05). CONCLUSION: After reading a booklet about whiplash translated into French, beliefs about the consequences of whiplash were changed for the better in this sample of French-speaking healthy professionals working in a rehabilitation ward. This simple educational intervention translated into French could be used for education and for ameliorating beliefs about the consequences of whiplash among health care professionals and the public.

Is there predictive criteria for transfer of patients to a rehabilitation ward after hip and knee total arthroplasty? Elaboration of French clinical practice guidelines.

OBJECTIVE: To develop clinical practice guidelines concerning predictive criteria for transfer of patients to a rehabilitation ward after hip and knee total arthroplasty. METHOD: The SOFMER (French Physical Medicine and Rehabilitation Society) methodology, associating a systematic literature review, collection of everyday clinical practice, and external review by a multidisciplinary expert panel, was used. RESULTS: From systematic literature review and collection of French professional practice, we cannot distinguish the patients undergoing THA and TKA who can transfer to a rehabilitation ward. For both types of patients, the main criteria determining transfer are demographic criteria such as older age or female sex; psychosocial and environmental criteria such as living alone, feeling unable to return home directly (pre-operative education could modify this criterion); and surgeon advice based on the pre and post-operative clinical and functional status. CONCLUSION: Studies with good methodological quality are urgently needed to evaluate the use of predictive tools such as the RAPT, separating THA and TKA, and using as parameters of assessment functional status and handicap reduction.

Qualitative evaluation of the expectations of low back pain patients with regard to information gained through semi-directed navigation on the Internet.

OBJECTIVES: To make a qualitative analysis of the expectations of chronic low back pain (LBP) sufferers with regard to information gained using semi-directed Internet navigation on a sample of French LBP-related websites, and to compare the results with those of physical medicine and rehabilitation (PMR) medical doctors (MD). MATERIAL AND METHODS: Twenty-seven hospitalised chronic LBP sufferers assessed in ecological conditions a sample of seven LBP-related websites. The sites were assessed using a simplified version of a rating scale of patients' expectations. Analysis of the relative importance of the different kinds of information delivered was done using a point sharing method. RESULTS: In a comfortable environment, patients gave high scores for medical and extra-medical information, but low scores for website design. Overall quality assessment was similar for patients and MDs. The relative importance of medical and extra-medical information, and design quality, was similar for Chronic LBP patients and MDs. CONCLUSION: PMR MD seemed able to correctly evaluate the overall expectations of chronic LBP patients with regard to information, but their opinions on the different qualities of websites were different. Doctors and patients should collaborate in order to create or validate high quality websites concerned with LBP.

The value of individual or collective group exercise programs for knee or hip osteoarthritis. Clinical practice recommendations.

OBJECTIVE: To develop clinical practice guidelines concerning individual and group exercise therapy for knee and/or hip osteoarthritis (OA). METHOD: We used the SOFMER (French Physical Medicine and Rehabilitation Society) methodology, combining systematic literature review, collection of everyday clinical practice, and external review by a multidisciplinary expert panel, to develop the guidelines. RESULTS: Physical exercises are proposed for knee and hip OA. The benefit of individual exercises is low to moderate for pain, strength and ability to walk. The effectiveness is not maintained over time if the individual exercise program is not continued. The benefit of group exercise is also low to moderate for pain, strength, balance and ability to walk. There is no evidence of the superiority of one modality over the other (individual or group). CONCLUSION: More randomised controlled trials with good methodology are needed to compare the effectiveness of individual versus group exercise therapy for knee and hip OA.

An evidence-based information booklet helps reduce fear-avoidance beliefs after first-time discectomy for disc prolapse.

OBJECTIVE: We aimed to assess the impact of a booklet integrating the biopsychosocial model of chronic pain management on reducing disability among patients undergoing lumbar discetomy. METHODS: In a prospective, controlled, time-series study with an alternate-month design, we enrolled 129 patients from a tertiary care university hospital after they underwent uncomplicated lumbar discectomy for the first time. The intervention group received the biopsychosocial evidence-based booklet and the control group a biomedical-based booklet; the booklets differed only in information content. Patients were blinded to treatment group. The main outcome was disability at 2 months (measured by the Quebec back-pain disability scale [QBPDS]). Secondary outcomes were fear and avoidance beliefs measured by the Fear-Avoidance Beliefs Questionnaire (FABQ). All data were collected by self-reporting questionnaires. RESULTS: At 2 months, disability did not differ between the 2 groups (QBPDS score 32.4±22.8 vs 36.1±18.7, P=0.36). FABQ physical activity score was lower with the evidenced-based booklet as compared with controls (8.0±7.14 vs 11.2±6.3, P=0.008). CONCLUSIONS: Providing an evidence-based booklet had no effect at 2 months after surgery on disability but reduced fear-avoidance beliefs about physical activity. This booklet could be an effective tool for health care professionals in helping with patient education. CLINICALTRIALS. GOV IDENTIFIER: NCT00761111.

[The role of an information booklet or oral information about back pain in reducing disability and fear-avoidance beliefs among patients with subacute and chronic low back pain. A randomized controlled trial in a rehabilitation unit]. / Un simple livret d'information peut contribuer à réduire l'incapacité fonctionnelle de patients lombalgiques subaigus et chroniques. Etude contrôlée randomisée en milieu de rééducation.

OBJECTIVES: To compare the efficacy of an information booklet or oral information about back pain in reducing disability and fear-avoidance beliefs among patients with subacute and chronic low back pain referred to a rehabilitation department. METHODS: An alternate-month design was used for 142 patients with subacute or chronic low back pain who were hospitalized for treatment. Seventy-two patients received written standardized information about back pain (the "back book") and usual physical therapy (intervention group), and 70 received usual physical therapy only along with nonstandardized oral information (control group). The main outcome measure was disability (measured on the Quebec back-pain disability scale), and secondary outcome measures were pain intensity (measured on a visual analog scale), fear-avoidance beliefs (measured on the Fear-Avoidance Beliefs Questionnaire [FABQ] Physical component), and knowledge of the relation of back pain to physical activity assessed at baseline, just before discharge from the hospital and 3 months after discharge. Satisfaction related to the information received was assessed on the day of discharge. RESULTS: Receiving the "back book" had a significant impact on disability at 3 months, from 48.40+/-14.55 to 34.57+/-18.42 in the intervention group and from 52.17+/-16.88 to 42.40+/-14.95 in the control group (p=0.03). Receipt of the book also had a significant impact on patients' knowledge and satisfaction about information but a nonsignificant effect on fear-avoidance beliefs. CONCLUSIONS: Providing an information booklet about back pain to patients with subacute and chronic low back pain referred to a rehabilitation unit contributes to reduced disability in these patients.

Educating patients about the benefits of physical activity and exercise for their hip and knee osteoarthritis. Systematic literature review.

OBJECTIVES: Highlight the role of patient education about physical activity and exercise in the treatment of hip and knee osteoarthritis (OA). METHODS: Systematic literature review from the Cochrane Library, PubMed and Wiley Online Library databases. A total of 125 items were identified, including 11 recommendations from learned societies interested in OA and 45 randomized controlled trials addressing treatment education and activity/exercise for the treatment of hip and knee osteoarthritis. RESULTS: In the end, 13 randomized controlled trials and 8 recommendations were reviewed (1b level of evidence). Based on the analysis, it was clear that education, exercise and weight loss are the pillars of non-pharmacological treatments. These treatments have proven to be effective but require changes in patient behaviour that are difficult to obtain. Exercise and weight loss improve function and reduce pain. Education potentiates compliance to exercise and weight loss programs, thereby improving their long-term benefits. Cost efficiency studies have found a reduction in medical visits and healthcare costs after 12 months because of self-management programs. CONCLUSION: Among non-surgical treatment options for hip and knee osteoarthritis, the most recent guidelines focus on non-pharmacological treatment. Self-management for general physical activity and exercise has a critical role. Programs must be personalized and adjusted to the patient's phenotype. This development should help every healthcare professional adapt the care they propose to each patient. Registration number for the systematic review: CRD42015032346.

Evaluation of 'I-Preventive': a digital preventive tool for musculoskeletal disorders in computer workers-a pilot cluster randomised trial.

OBJECTIVES: I-Preventive is a digital preventive tool for musculoskeletal disorders (MSDs) in computer workers. We sought to determine its impact on pain in computer workers with upper limb MSDs and visual discomfort. METHODS: We conducted a pilot cluster randomised trial in 2 different sites of a tyre factory in France. We randomised 200 employees to either an intervention group (I-Preventive) or control group, each comprising symptomatic and asymptomatic employees. The workers were followed up for 5 months. The main outcome was overall recovery from symptoms following 1 month's intervention based on Nordic-style and eyestrain questionnaires. RESULTS: We included 185/200 workers: 96 in the intervention group (mean age 41.8±1.4 years; 88.5% males) and 79 in the control group (mean age 42.9±12.0 years; 94.5% males). The most painful areas (numerical scale ≥2) were the neck (40.0%), upper back (18.8%) and shoulders (15.7%). For the most painful anatomical area, the Nordic score significantly decreased after 1 month in the intervention group (p=0.038); no change was observed in the control group (p=0.59). After 1 month's use, the intervention group reported less pain in the painful area and less visual discomfort symptoms (p=0.02). Adherence to the I-Preventive program was 60%. CONCLUSIONS: I-Preventive is effective in the short term on musculoskeletal symptoms and visual discomfort by promoting active breaks and eyestrain treatment. This easy-to-use digital tool allows each worker to focus on areas of their choice via personalised, easy exercises that can be performed in the workplace. TRIAL REGISTRATION NUMBER: NCT02350244; Pre-results.