Physical activity and relaxation in the work setting to reduce the need for recovery: what works for whom?

BACKGROUND: To recover from work stress, a worksite health program aimed at improving physical activity and relaxation may be valuable. However, not every program is effective for all participants, as would be expected within a "one size fits all" approach. The effectiveness of how the program is delivered may differ across individuals. The aim of this study was to identify subgroups for whom one intervention may be better suited than another by using a new method called QUalitative INteraction Trees (QUINT). METHODS: Data were used from the "Be Active & Relax" study, in which 329 office workers participated. Two delivery modes of a worksite health program were given, a social environmental intervention (group motivational interviewing delivered by team leaders) and a physical environmental intervention (environmental modifications). The main outcome was change in Need for Recovery (NFR) from baseline to 12 month follow-up. The QUINT method was used to identify subgroups that benefitted more from either type of delivery mode, by incorporating moderator variables concerning sociodemographic, health, home, and work-related characteristics of the participants. RESULTS: The mean improvement in NFR of younger office workers in the social environmental intervention group was significantly higher than younger office workers who did not receive the social environmental intervention (10.52; 95 % CI: 4.12, 16.92). Furthermore, the mean improvement in NFR of older office workers in the social environmental intervention group was significantly lower than older office workers who did not receive the social environmental intervention ( -10.65; 95 % CI: -19.35, -1.96). The results for the physical environmental intervention indicated that the mean improvement in NFR of office workers (regardless of age) who worked fewer hours overtime was significantly higher when they had received the physical environmental intervention than when they had not received this type of intervention (7.40; 95 % CI: 0.99, 13.81). Finally, for office workers who worked more hours overtime there was no effect of the physical environmental intervention. CONCLUSIONS: The results suggest that a social environmental intervention might be more beneficial for younger workers, and a physical environmental intervention might be more beneficial for employees with a few hours overtime to reduce the NFR. TRIAL REGISTRATION: NTR2553.

Ergonomics in gynecologists' daily practice: A nationwide survey in The Netherlands.

BACKGROUND: Gynecologists are exposed to multiple risk factors for developing physical complaints. To enhance the workplace ergonomics in gynecological practice, a more detailed insight about job content and associated demands is necessary to subsequently decrease the exposure to risk factors. OBJECTIVE: The aim of this study was to investigate the prevalence of physical complaints and the presence of ergonomic constraints in Dutch gynecological practice. METHODS: A questionnaire was distributed among the 1200 members of the Dutch Society of Obstetrics and Gynecology. It consisted of 52 Dutch questions derived from the validated Dutch Musculoskeletal Questionnaire. RESULTS: A total of 227 respondents completed the questionnaire (response rate 18.9%). Overall, 99.5% of the respondents rated their health status as reasonable or good. However, the twelve-month prevalence of physical complaints in one or more body part was 89.4%. Sustained adverse body postures were particularly reported for performing abdominal, and endoscopic surgery, and for assisting in vaginal surgery. Limited workspace, instruments, and patient size were reported by more than 60% of the respondents as constraints for adopting a neutral body posture during vaginal, endoscopic and abdominal surgery respectively. CONCLUSION: The results emphasize the necessity of enhancing ergonomics in gynecological practice. Better ergonomic circumstances will most likely benefit both the health of the gynecologists as well as the quality of surgical care.

Objective and continuous measurement of peripheral motor indicators of pain in hospitalized infants: a feasibility study.

Measurement of pain in pre-verbal infants is complex. Until now, pain behavior has mainly been assessed intermittently using observational tools. Therefore, we determined the feasibility of long-term, objective and continuous measurement of peripheral motor parameters through body-fixed sensors to discriminate between pain and no pain in hospitalized pre-verbal infants. Two pain modes were studied: for procedural pain 10 measurements were performed before, during and after routine heel lances in 9 infants (age range infants: 5-175 days), and for post-operative pain 14 infants (age range 45-400 days) were measured for prolonged periods (mean 7h) using the validated COMFORT-behavior scale as reference method. Several peripheral motor parameters were studied: three body part activity parameters derived from acceleration sensors attached to one arm and both legs, and two muscle activity parameters derived from electromyographic (EMG) sensors attached to wrist flexor and extensor muscles. Results showed that the accelerometry-based parameters legs activity and overall extremity activity (i.e. mean of arm and legs) were significantly higher during heel lance than before or after lance (p0.001), whereas arm activity accelerometry data and wrist muscle activity EMG data showed no significant change. For the post-operative pain measurements, relationships were found between accelerometry-based overall extremity activity and COMFORT-behavior (r=0.76, p<0.001), and between EMG-based wrist flexor activity and COMFORT-behavior (r=0.55, p<0.001, for a subgroup of 7 infants). We conclude that long-term, objective and continuous measurement of peripheral motor parameters is feasible, has high potential, and is promising to assess pain in pre-verbal hospitalized infants.

Effects of a thermal-insulating mouse pad on temperature of forearm and hand during computer tasks.

This laboratory experiment studied the effects of a thermal-insulating mouse pad on arm temperature and comfort during computer work. Fourteen subjects performed two 20-min computer tasks (a mouse task and a combined task alternating keyboard and mouse use), under three conditions, namely with: 1) a thermal-insulating pad; 2) a placebo pad; 3) no pad (desktop). The temperatures of the forearm, wrist, hand and fingers were measured with four thermocouples. Comfort and discomfort were determined by two visual analogue scales. No arm temperature differences were found between the experimental conditions after performing the combination task in any location. After the mouse task, however, arm temperature decreased significantly less with the thermal-insulating mouse pad than with the placebo pad. The thermal-insulating pad was rated as more comfortable and less uncomfortable than a regular desktop during mouse tasks. A large size is recommended for the thermal-insulating pad.

Automated estimation of initial and terminal contact timing using accelerometers; development and validation in transtibial amputees and controls.

The aim of this study was to develop and validate an automated accelerometry-based system for estimating initial contact (IC) and terminal contact (TC) timing information from walking patterns of healthy control subjects and transtibial amputees that can be used in daily life with minimal interference of researchers. Subjects were instrumented with two uniaxial accelerometers just below the knee while synchronized ground reaction force (GRF) recordings were used as reference measurements. An automated multiphase algorithm was developed to estimate the time of IC and TC in the acceleration signals of five healthy subjects and two transtibial amputees walking at different walking speeds. The accuracy of the detection algorithm in ten control subjects and eight transtibial amputees indicated mean errors ranging between 0.013 and 0.034 s for the TC and IC timing, with 95 % confidence interval of the individual step errors ranging between -0.062 and 0.115 s. Correlation coefficients between the estimated stance phase duration and GRF data were 0.98 and 0.97 for controls and amputees, respectively. We concluded that IC and TC can be accurately and easily measured using this system in both healthy subjects and transtibial amputees walking at different walking speeds. The system can be used in clinical situations or gait labs as well as during daily life.