Postural shifts and body perceived discomfort during 1-hour sitting when leaning and sitting on an air-filled seat cushion among healthy office workers.

This study compared the number of postural shifts and perceived discomfort while leaning and sitting on an air-filled seat cushion for 1 hour. Sixty office workers typed a standard text while leaning on a cushion placed behind the low back, sitting on a cushion placed under the buttocks, and sitting without a cushion (a control condition). The number of postural shifts was collected using a seat pressure mat device. Low back discomfort was assessed using the Borg CR-10 scale. Leaning on a seat cushion (22 shifts/h) led to a significantly higher number of postural shifts than sitting on a seat cushion (18 shifts/h) and the control condition (20 shifts/h). Leaning or sitting on a seat cushion significantly decreased low back discomfort compared to the control condition (p < 0.05). Leaning on a seat cushion placed behind the low back may be an effective means of preventing low back pain among office workers.

During prolonged sitting, using a seat cushion, whether leaning or sitting on it, may be more efficient in preventing low back pain compared to not using one. Particularly, leaning on a seat cushion led to more postural shifts during sitting compared to sitting on one or not using any.

Effects of Postural Shifting Frequency on Perceived Musculoskeletal Discomfort During 1-Hour Sitting in Office Workers.

OBJECTIVE: The purpose of this study was to evaluate the effects of postural shifting frequency on perceived musculoskeletal discomfort during 1 hour of sitting in healthy office workers. METHODS: An experimental study comparing 3 different postural shifting frequencies was conducted on 60 healthy office workers who were asked to sit for an hour. The effects of 3 postural shifts (ie, 10, 20, and 30 times/h) on discomfort, measured by Borg's CR-10 scale, were compared. A seat pressure mat was used to confirm an individual's postural shift. RESULTS: Postural shifting frequency of 10 to 30 times/h had significant effects on perceived discomfort in the neck, shoulder, and upper and lower back during 1-hour sitting. At the neck and shoulder, a postural shifting frequency of 30 times/h significantly reduced perceived discomfort compared to a postural shifting frequency of 10 times/h during 1-hour sitting. At the upper and lower back, a postural shifting frequency of 20 to 30 times/h significantly reduced perceived discomfort compared to a postural shifting frequency of 10 times/h. CONCLUSION: Postural shifts of 30 times/h provided buffering effects on perceived musculoskeletal discomfort at the neck, shoulder, and upper and lower back.

Can the Borg CR-10 scale for neck and low back discomfort predict future neck and low back pain among high-risk office workers?

PURPOSE: Perceived discomfort could indicate an early sign of pain, for example, as a result of a biomechanical load on the musculoskeletal system. Assessing discomfort can, therefore, help to identify workers at increased risk of musculoskeletal disorders for targeted intervention development. We aimed: (1) to identify the optimal cut-off value of neck and low back discomfort among office workers and (2) to evaluate its predictive validity with future neck and low back pain, respectively. METHODS: At baseline healthy participants (n = 100) completed questionnaires, including the Borg CR-10 discomfort scale (on a 0-10 scale), and were followed for six months, during which musculoskeletal pain was assessed monthly. Logistic regression analyses were performed to assess the associations of baseline discomfort with the onset of future neck or low back pain. Sensitivity, specificity, and the area under the receiver operating characteristics curve were estimated to identify the optimal discomfort cut-off value predicting future pain. RESULTS: Borg CR-10 scores ≥ 3.5 for perceived neck and low back discomfort had acceptable sensitivity and specificity to predict future neck and low back pain, respectively. Perceived discomfort at baseline as a dichotomous measure (using the ≥ 3.5 cut-off) was a statistically significant predictor of future neck pain (OR = 10.33) and low back pain (OR = 11.81). CONCLUSION: We identified the optimal cut-off value of the Borg CR-10 discomfort scale to identify office workers at increased risk of developing neck and low back pain. These findings might benefit ergonomists, primary health care providers, and occupational health researchers in developing targeted interventions.

Cross-cultural adaptation, reliability, and construct validity of the Thai version of the Patient-Reported Outcomes Measurement Information System-29 in individuals with chronic low back pain.

PURPOSE: To culturally adapt the Patient-Reported Outcomes Measurement Information System-29 into Thai (T-PROMIS-29) and evaluate the reliability and validity of the culturally adapted questionnaire. METHODS: The translation was performed using the Functional Assessment of Chronic Illness Therapy (FACIT) translation guidelines. Unidimensionality, internal consistency, and test-retest reliability at a 1-week interval for the translated measure were computed. Construct validity was evaluated by computing correlations between the T-PROMIS-29 scores and selected SF-36 scale scores. RESULTS: The study sample comprised of 241 participants with chronic low back pain. Internal consistencies were good to excellent, with Cronbach's alphas ranging from 0.84 to 0.94. The test-retest stability of all T-PROMIS-29 domains were moderate to good, with ICCs(2,1) ranging from 0.57 to 0.74. Unidimensionality, convergent validity, and divergent construct validity were satisfactory. CONCLUSIONS: The findings support the reliability and validity of the T-PROMIS-29 scale scores. The measure can be used to assess key quality of life domains in individuals from Thailand with chronic low back pain.

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 effect of daily walking steps on preventing neck and low back pain in sedentary workers: a 1-year prospective cohort study.

OBJECTIVE: This study aimed to investigate the causal relationship between daily walking steps and the 1-year incidence of neck and low back pain in workers with sedentary jobs. METHODS: A 1-year prospective study was carried out among 387 workers who reported no spinal symptoms in the previous 3 months with pain intensity greater than 30 mm on a 100-mm visual analog scale. Data were gathered using a self-administered questionnaire, physical examination, and pedometer. Follow-up data were collected every month for the incidence of musculoskeletal disorders and every 3 months for daily walking steps. Two regression models were built to analyze the effect of daily walking steps on the 1-year incidence of neck and low back pain. RESULTS: Among 367 (95 %) participants followed for 1 year, 16 and 14 % reported incident neck and low back pain, respectively. After adjusting for confounders, a negative association between daily walking steps and onset of neck pain was found. Increasing daily walking steps by 1,000 reduced the risk of neck pain by 14 %. No significant association between daily walking steps and the onset of low back pain was found. CONCLUSIONS: Increasing daily walking steps is a protective factor for onset of neck pain in those with sedentary jobs. Interventions to reduce neck pain should include attempts to increase daily walking steps.

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.

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.

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.

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.

Development of a neck pain risk score for predicting nonspecific neck pain with disability in office workers: a 1-year prospective cohort study.

OBJECTIVE: The purpose of this study was to develop a neck pain risk score for office workers (NROW) to identify office workers at risk for developing nonspecific neck pain with disability. METHODS: A 1-year prospective cohort study of 559 healthy office workers was conducted. At baseline, risk factors were assessed using questionnaires and standardized physical examination. The incidence of neck pain was collected every month thereafter. Disability level was evaluated using the neck disability index. Logistic regression was used to select significant factors to build a risk score. The coefficients from the logistic regression model were transformed into the components of a risk score. RESULTS: Among 535 (96%) participants who were followed up for 1 year, 23% reported incident neck pain with disability (≥5). After adjusting for confounders, the onset of neck pain with disability was significantly associated with history of neck pain, chair adjustability, and perceived muscular tension. Thus, the NROW comprises 3 questions about history of neck pain, chair adjustability, and perceived muscular tension. The NROW had scores ranging from 0 to 4. A cut-off score of at least 2 had a sensitivity of 82% and specificity of 48%. The positive and negative predictive values were 29% and 91%, respectively. The area under the receiver operating characteristic curve was 0.75. CONCLUSION: The risk score for nonspecific neck pain with disability in office workers was developed, and it contained 3 items with scores ranging from 0 to 4. This study shows that the score appears to have reasonable sensitivity, specificity, positive predictive value, and negative predictive values for the cut-off point of at least 2.

Effect of different types of rest-break interventions on neck and shoulder muscle activity, perceived discomfort and productivity in symptomatic VDU operators: a randomized controlled trial.

OBJECTIVE: This study evaluated the effect of different types of activities during rest-break interventions on neck and shoulder muscle activity, muscle discomfort and productivity among symptomatic video display unit (VDU) operators performing prolonged computer terminal work. STUDY DESIGN AND SETTING: Randomized controlled trial was used. Thirty symptomatic VDU operators were randomly assigned to 2 active break groups (stretching and dynamic movement) and a reference group. The subjects performed the same typing task for 60 min and received 3-min breaks after each 20 min of work. Root mean square and median frequency were calculated for neck and shoulder muscle activity. Muscle discomfort was measured with Borg's CR-10 scale. Productivity was measured by counting words. RESULTS: There were no significant differences between the types of activities during breaks on neck and shoulder muscle activity, muscle discomfort or productivity. However, there was a significant difference in the level of muscle discomfort over time. CONCLUSIONS: Three types of activity during breaks showed a favourable effect on neck and shoulder muscle activity and productivity, and a positive effect on muscle discomfort in symptomatic VDU operators.

Mediators and moderators of a walking intervention to prevent neck pain among high-risk office workers: a secondary analysis of a randomized controlled trial.

OBJECTIVES: To test hypothesized mediators and moderators of the benefits of an app-provided walking intervention for preventing neck pain in high-risk office workers. METHODS: Ninety-one office workers at risk for developing neck pain participated in the primary clinical trial. Two hypothesized mediators (the total number of steps taken and the number of days that participants exceed the number of recommended steps) were tested using a smartphone application every month during a 6-month period. Four hypothesized moderators (number of working hours, level of work psychological demands, chair height adjustability, and body mass index) were assessed at baseline. Parallel mediation and moderation analyses were conducted using the Hayes PROCESS macro, model 4 and 1, respectively, with post-hoc Johnson-Neyman techniques. RESULTS: The number of days that participants exceeded the recommended steps ‒ the specific number was tailored to each participant, but averaged 7735 steps/day ‒ mediated the benefits of the walking intervention for reducing the risk for neck pain at each of six assessment points (B's range -0.63 to -0.89, all p's < 0.05) over 6-month period. None of the hypothesized moderators evidenced statistically significant moderator effects of the walking intervention. CONCLUSION: Workers should walk at rates greater than recommended levels on as many days as possible, rather than attempt to maximize walking within a limited number of days. Given that the walking program studied appeared to be similarly effective across multiple groups of workers, the findings suggest that regular walking can reduce the risk for developing neck pain among high-risk office workers.

Responsiveness and clinically important differences of the PROMIS short form-depression 8a, anxiety 8a, and PASS-20 in individuals with chronic low back pain.

Introduction: Depression and anxiety are the most commonly reported mental health conditions. The Patient-Reported Outcomes Measurement Information System Short Form v1.0-Depression 8a (PROMIS-D-8a), Anxiety 8a (PROMIS-Anx8a), and Pain Anxiety Symptoms Scale-20 (PASS-20) measures were designed to assess depression, general anxiety, and pain-related anxiety, respectively. Objectives: To examine the responsiveness and estimate the clinically important differences (CIDs) of the Thai version of these measures in individuals with chronic low back pain (CLBP). Methods: The study sample comprised 144 participants with CLBP. Responsiveness was evaluated by calculating the change scores, effect sizes (ESs), standardized response means (SRMs), area under the curve (AUC), and correlations between the change scores and associated Global Perceived Effect (GPE). We also estimated CIDs by the difference in mean change score between improved and unchanged groups and standard error of measurement (SEM) for each measure. Results: Statistically significant differences in the mean change scores, ESs, and SRMs supported the responsiveness of all measures. The AUCs achieved acceptable discriminatory ability (0.71-0.72) for moderate improvement but not for any improvement (0.65-0.68). The correlations between GPE and change scores on all measures were low (r ranging 0.28-0.33). The estimated CIDs for the PROMIS-D-8a, PROMIS-Anx8a, and PASS-20 were 3.64, 4.20, and 8.80, respectively. Conclusion: The PROMIS-D-8a, PROMIS-Anx8a, and PASS-20 measures were sensitive for detecting clinical changes over time in individuals with CLBP. The CID values can be used as reference points for assessing meaningful improvements in the domains assessed by these scales in clinical and research practice.

The effectiveness of a dynamic seat cushion in preventing neck and low-back pain among high-risk office workers: a 6-month cluster-randomized controlled trial.

OBJECTIVE: This study evaluated the effectiveness of the promotion of postural shift intervention using a dynamic seat cushion on the 6-month incidence of neck and low-back pain among high-risk office workers. METHODS: In a cluster-randomized controlled trial (RCT), 133 office workers were randomly assigned, at cluster level, to intervention (N=67) and control (N=66) groups. The intervention group received a dynamic seat cushion to encourage postural shifts during sitting, while the control group received a placebo seat pad. Primary outcomes were 6-month incidence of neck and low-back pain. Secondary outcomes included sitting discomfort, pain intensity, disability, and trunk muscle performance. Analyses utilized Cox proportional hazard models. RESULTS: During the 6-month period, 15% of participants in the intervention group developed neck pain and 10% developed low-back pain. For the control group, this was 65% and 59%, respectively. Hazard rate (HR) ratios, after adjusting for biopsychosocial factors, indicated a protective effect of the intervention for neck pain [HRadj 0.19, 95% confidence interval (CI) 0.09-0.39, P<0.001] and low-back pain (HRadj 0.16, 95% CI 0.07-0.35, P<0.001). The intervention group demonstrated a significant reduction in sitting discomfort and improvement in trunk muscle performance compared to the control group (P<0.05). However, the intervention did not reduce pain and disability in individuals experiencing pain compared to the control group. CONCLUSIONS: The dynamic seat cushion effectively reduced the incidence of neck and low-back pain by promoting postural shifts. These findings suggest that the key factor in reducing the risk of developing neck and low-back pain is the facilitation of postural shifts during sitting, which can potentially be achieved with other dynamic interventions designed to reduce prolonged and static sitting among office workers.

Effect of two dynamic seat cushions on postural shift, trunk muscle activation and spinal discomfort in office workers.

We investigated the effect of two dynamic seat cushions on postural shift, trunk muscle activation and spinal discomfort. In this repeated-measures study, 30 healthy office workers were randomly assigned to a sequence of three conditions: sitting on a dynamic seat cushion-A, cushion-B and control (no seat cushion). The two dynamic seat cushions had different inflation levels. Participants typed a standard text for an hour and were monitored for postural shift by using a seat pressure mat, transversus abdominis/internal oblique and lumbar multifidus muscles activity by using surface EMG, spinal discomfort by using Borg's CR-10 scale. Two-way repeated ANOVAs showed no statistically significant interaction effects between condition and time on postural shift and muscle activation. Post hoc Bonferroni tests showed that postural shifts and lumbar multifidus activation during sitting on cushion-A were significantly higher (p < 0.01) than in the control and cushion-B conditions. Both cushions reduced spinal discomfort, compared to the control condition (p < 0.05).

Cross-cultural adaptation and psychometric properties of the Thai version of the patient-reported outcomes measurement information system short form- depression 8a in individuals with chronic low back pain.

BACKGROUND: The study aimed to cross-culturally adapt the Patient-Reported Outcomes Measurement Information System Short Form v1.0 - Depression 8a (PROMIS SF v1.0 - Depression 8a) into Thai and evaluate its psychometric properties in individuals with chronic low back pain (CLBP). METHODS: The PROMIS SF v1.0- Depression 8a was translated and cross-culturally adapted into Thai using the Functional Assessment of Chronic Illness Therapy translation methodology. Two hundred and sixty-nine individuals with CLBP completed the Thai version of PROMIS SF v1.0- Depression 8a (T-PROMIS-D-8a) scale and a set of measures assessing validity criterion domains. Structural validity, internal consistency, and test-retest reliability at a 7-day interval of the T-PROMIS-D-8a scale were computed and its construct validity was evaluated by computing correlations with the Thai version of Patient Health Questionnaire-9 (T-PHQ-9), Numeric Rating Scale of pain intensity (T-NRS), and Fear Avoidance Beliefs Questionnaire (T-FABQ). RESULTS: Data from 269 participants were analyzed. Most participants were women (70%), and the sample had a mean age of 42.5 (SD 16.6) years. The findings supported the unidimensionality, internal consistency (Cronbach's alpha = 0.94), and test-retest reliability (ICC [2,1] = 0.86) of the T-PROMIS-D-8a. A floor effect was observed for 16% of the sample. Associations with the T-PHQ-9, T-NRS, and T-FABQ supported the construct validity of the T-PROMIS-D-8a. CONCLUSIONS: The T-PROMIS-D-8a was successfully translated and culturally adapted. The findings indicated that the scale is reliable and valid for assessing depression in Thai individuals with CLBP.

How Low Back Pain is Managed-A Mixed-Methods Study in 32 Countries. Part 2 of Low Back Pain in Low- and Middle-Income Countries Series.

BACKGROUND: The Lancet Low Back Pain (LBP) Series highlighted the lack of LBP data from low- and middle-income countries (LMICs). The study aimed to describe (1) what LBP care is currently delivered in LMICs and (2) how that care is delivered. DESIGN: An online mixed-methods study. METHODS: A Consortium for LBP in LMICs (n = 65) was developed with an expert panel of leading LBP researchers (>2 publications on LBP) and multidisciplinary clinicians and patient partners with 5 years of clinical/lived LBP experience in LMICs. Quantitative data were analyzed using descriptive statistics. Two researchers independently analyzed qualitative data using inductive and deductive coding and developed a thematic framework. RESULTS: Forty-seven (85%) of 55 invited panel members representing 32 LMICs completed the survey (38% women, 62% men). The panel included clinicians (34%), researchers (28%), educators (6%), and people with lived experience (4%). Pharmacotherapies and electrophysiological agents were the most used LBP treatments. The thematic framework comprised 8 themes: (1) self-management is ubiquitous, (2) medicines are the cornerstone, (3) traditional therapies have a place, (4) society plays an important role, (5) imaging use is very common, (6) reliance on passive approaches, (7) social determinants influence LBP care pathway, and (8) health systems are ill-prepared to address LBP burden. CONCLUSION: LBP care in LMICs did not consistently align with the best available evidence. Findings will help research prioritization in LMICs and guide global LBP clinical guidelines. J Orthop Sports Phys Ther 2024;54(8):560-572. Epub 11 April 2024. doi:10.2519/jospt.2024.12406.

Are religious beliefs and practices of Buddhism associated with disability and salivary cortisol in office workers with chronic low back pain?

BACKGROUND: Low back pain (LBP) is common among office workers. A number of studies have established a relationship between Christianity and physical and mental health outcomes among chronic pain patients. The purpose of this study was to examine the relationship between the religious beliefs and practices of Buddhism and disability and psychological stress in office workers with chronic LBP. METHODS: A cross-sectional survey was conducted with a self-administered questionnaire delivered by hand to 463 office workers with chronic LBP. Saliva samples were collected from a randomly selected sub-sample of respondents (n=96). Disability due to LBP was assessed using the Roland-Morris Disability Questionnaire and psychological stress was assessed based on salivary cortisol. Two hierarchical regression models were built to determine how much variance in disability and psychological stress could be explained by religious beliefs and practices of Buddhism variables after controlling for potential confounder variables. RESULTS: Only 6% of variance in psychological stress was accounted for by the religious beliefs and practices of Buddhism. Those with high religiousness experienced lower psychological stress. No association between the religious beliefs and practices of Buddhism and disability level was found. Depressive symptoms were attributed to both psychological stress and disability status in our study population. CONCLUSIONS: The findings suggest that, although being religious may improve the psychological condition in workers with chronic LBP, its effect is insufficient to reduce disability due to illness. Further research should examine the role of depression as a mediator of the effect of psychological stress on disability in patients with chronic LBP.

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.