A Longitudinal Evaluation of Risk Factors and Interactions for the Development of Nonspecific Neck Pain in Office Workers in Two Cultures.

OBJECTIVE: To identify risk factors for the development of interfering neck pain in office workers including an examination of the interaction effects between potential risk factors. BACKGROUND: The 1-year incidence of neck pain in office workers is reported as the highest of all occupations. Identifying risk factors for the development of neck pain in office workers is therefore a priority to direct prevention strategies. METHODS: Participants included 214 office workers without neck pain from two cultures. A battery of measures evaluating potential individual and workplace risk factors were administered at baseline, and the incidence of interfering neck pain assessed monthly for 12 months. Survival analysis was used to identify relationships between risk factors and the development of interfering neck pain. RESULTS: One-year incidence was 1.93 (95% CI [1.41, 2.64]) per 100 person months. Factors increasing the risk of developing interfering neck pain were older age, female gender, increased sitting hours, higher job strain, and stress. A neutral thorax sitting posture, greater cervical range of motion and muscle endurance, and higher physical activity were associated with a decreased risk of neck pain. The effects of some risk factors on the development of neck pain were moderated by the workers' coping resources. CONCLUSION: Multiple risk factors and interactions may explain the development of neck pain in office workers. Therefore, plans for preventing the development of interfering neck pain in office workers should consider multiple individual and work-related factors with some factors being potentially more modifiable than others.

Are Measures of Postural Behavior Using Motion Sensors in Seated Office Workers Reliable?

OBJECTIVE: In this study, the reliability of measures of upper body postural behavior (head, thorax, neck, and arm) during sustained office work was evaluated. BACKGROUND: Although there has been a substantial body of research examining the technical aspects of posture measurement in office workers using motion sensors, there is a paucity of literature examining whether posture-related behaviors are actually consistent among office workers in the field on different days and times. METHOD: Thirty one office workers performed their usual work for three, 1-hr sessions (two morning sessions and one afternoon session) while wearing wireless motion sensors. Reliability coefficients of the derived measures of postural behavior were calculated. RESULTS: Most (30/31) of the postural behavior measures demonstrated modest to excellent reliability (ICC 2.1: 0.48-0.84). Reliability appeared to be mildly affected by factors such as the time of day recordings were taken and variations in desk setups. CONCLUSION: The findings suggest these measures may be a reliable method for evaluating postural behavior in the office work environment in future studies. APPLICATION: Postural measurement using a technical motion sensor described an acceptable reliability to be used for risk assessment in the workplace. Consideration of assessment time and desk setting would increase the accuracy of postural measurement.

Physical risk factors for developing non-specific neck pain in office workers: a systematic review and meta-analysis.

INTRODUCTION: Identifying risk factors associated with the development of work-related neck pain in office workers is necessary to facilitate the development of prevention strategies that aim to minimise this prevalent and costly health problem. The aim of this systematic review is to identify individual worker (e.g., lifestyle activity, muscular strength, and posture) and workplace (e.g., ergonomics and work environment) physical factors associated with the development of non-specific neck pain in office workers. METHODS: Studies from 1980 to 2016 were identified by an electronic search of Pubmed, CINAHL, EMBASE, Psychlnfo and Proquest databases. Two authors independently screened search results, extracted data, and assessed risk of bias using the epidemiological appraisal instrument (EAI). A random effect model was used to estimate the risk of physical factors for neck pain. RESULTS: Twenty papers described the findings of ten prospective cohort studies and two randomized controlled trials. Low satisfaction with the workplace environment (pooled RR 1.28; CI 1.07-1.55), keyboard position close to the body [pooled RR 1.46; (CI 1.07-1.99)], low work task variation [RR 1.27; CI (1.08-1.50)] and self-perceived medium/high muscular tension (pooled RR 2.75/1.82; CI 1.60 /1.14-4.72/2.90) were found to be risk factors for the development of neck pain. CONCLUSIONS: This review found evidence for a few number of physical risk factors for the development of neck pain, however, there was also either limited or conflicting factors. Recommendations for future studies evaluating risk factors are reported and how these may contribute to the prevention of neck pain in office workers.

The ratio of change in muscle thickness between superficial and deep cervical flexor muscles during the craniocervical flexion test and a suggestion regarding clinical treatment of patients with musculoskeletal neck pain.

[Purpose] The purpose of this study was to identify the imbalance of muscle recruitment in cervical flexor muscles during the craniocervical flexion test by using ultrasonography and to propose the optimal level of pressure in clinical craniocervical flexion exercise for people with neck pain. [Subjects and Methods] A total of 18 students (9 males and 9 females) with neck pain at D University in Gyeongsangbuk-do, South Korea, participated in this study. The change in muscle thickness in superficial and deep cervical flexor muscles during the craniocervical flexion test was measured using ultrasonography. The ratio of muscle thickness changes between superficial and deep muscles during the test were obtained to interpret the imbalance of muscle recruitment in cervical flexor muscles. [Results] The muscle thickness ratio of the sternocleidomastoid muscle/deep cervical flexor muscles according to the incremental pressure showed significant differences between 22 mmHg and 24 mmHg, between 24 mmHg and 28 mmHg, between 24 mmHg and 30 mmHg, and between 26 mmHg and 28 mmHg. [Conclusion] Ultrasonography can be applied for examination of cervical flexor muscles in clinical environment, and practical suggestion for intervention exercise of craniocervical flexors can be expected on the pressure level between 24 mmHg and 26 mmHg enabling the smallest activation of the sternocleidomastoid muscle.

The effect of deep neck flexor endurance on craniovertebral angle changes and neck and shoulder muscle activities during a computer task.

The deep neck flexors are important for maintaining neck posture by stabilizing and supporting it through low-intensity contraction, ensuring static endurance. The subjects performed computer tasks after having their deep neck flexor endurance measured using a pressure biofeedback unit. The craniovertebral angle (CVA) and the muscle activities were measured while participants were completing computer tasks for 10 min. The deep neck flexor endurance was significantly negatively correlated with CVA changes at 0-2 min. The deep neck flexor endurance was significantly negatively correlated with sternocleidomastoid muscle and upper trapezius activity at 0-2 min. The deep neck flexor endurance negatively predicted CVA changes at 0-2 min and explained 28.8% of the variance in the CVA changes. The lower the deep neck flexor endurance, the earlier the simultaneous changes occurred in the CVA and the neck and shoulder muscle activities during computer tasks.

Economic burden of patients living with heart disease in the last years of life in Australia: a retrospective analysis using linked data.

AIMS: People living with heart disease are at elevated risk of hospitalization during the last years of their life. The aim of this study was to describe hospitalization-related usage patterns, and associated cost burden, for patients living with heart disease in the last 6 years of their life. METHODS AND RESULTS: The study was an observational cohort study, using routinely collected and linked data from hospital admission (HA), emergency department (ED) presentation and death registry data in Queensland, Australia. The study sample included 1000 randomly selected patients who died in 2017 due to any cause who had been living with heart disease for at least the prior 6 years. The two main outcomes of interest in this study were cost of HAs and cost of ED presentation in the last 6 years before death. Total cost was calculated as a sum of direct and overhead costs from each of the hospital presentations. The mean HA per patient in the sixth year, second year, and last year prior to death was 5.3, 6.6, and 7.5, respectively, with a similar pattern observed for ED presentations. The associated costs per patient from HA followed a similar trajectory increasing gradually from $17 711 in the sixth year to $26 658 in the second last year prior to death. A similar pattern was observed for ED presentation costs. CONCLUSION: The large increase cost in the last year of life was primarily attributable to higher treatment cost per HA at end of life.

Financial Costs of Emergency Department Presentations for Australian Patients With Heart Disease in the Last 3 Years of Life.

Aims: This study described emergency department (ED) resource use patterns and associated costs among patients with heart disease in their last 3 years of life in a high-income country. Methods: This study used linked data from ED and death registry databases in Australia. A random sample of 1000 patients who died due to any cause in 2017, and who had been living with heart disease for at least the prior 10-years were included. The outcomes of interest were number of ED presentations over each of the last 3 years prior to death and relative cost contributions of ED-related items. Results: The number of patients needing ED care and number of ED presentations per patient increased as patients were closer to death, with 85% experiencing at least one ED presentation in their last year of life. Mean per patient ED presentation cost increased with each year closer to death. Costs related to labor, pathology, patient travel, and goods and services contributed more than 85% of the total cost in each of the 3 years. Conclusion: The increase in cost burden as patients neared death was attributable to more frequent ED presentations per person rather than more expensive ED presentations. The scope of this study was limited to ED presentations, and may not be representative of heart-disease-related end-of-life care more broadly.

Comparing Central Pain Processing in Individuals With Non-Traumatic Neck Pain and Healthy Individuals: A Systematic Review and Meta-Analysis.

This systematic review and meta-analysis examined the evidence for altered central pain processing in people with nontraumatic neck pain and the relationship among central pain processing, demographics, and pain-related characteristics. Case-control studies reporting measures of altered central pain processing using quantitative sensory testing were reviewed. Standardized mean differences (SMDs) and 95% confidence intervals between people with nontraumatic neck pain and controls were calculated. Meta-analysis was performed using random-effects models when appropriate. Associations between SMDs with demographics and pain-related characteristics were explored on a study level using metaregression. Twenty-six studies were eligible with 25 included for meta-analysis. Meta-analysis demonstrated mechanical hyperalgesia at remote nonpainful sites in the full sample (sample size [n] = 1305, SMD = -0.68) and in the subgroup with moderate/severe disability (n = 165, SMD = -0.86; moderate-quality evidence). Metaregression indicated that remote mechanical hyperalgesia was negatively associated with age (R2 = 25.4%, P = 0.031). Very low- to low-quality evidence of remote cold and heat hyperalgesia and dysfunctional conditioned pain modulation were identified. This review suggests that altered central pain processing is present in people with nontraumatic neck pain and may be associated with disability levels and age. PERSPECTIVE: This review found moderate-quality evidence of mechanical hyperalgesia at remote nonpainful sites in patients with nontraumatic neck pain compared with controls, indicating altered central pain processing. However, more studies are needed to confirm findings from dynamic quantitative sensory testing.

Job strain and psychological distress in office workers: The role of coping.

BACKGROUND: Work-related psychosocial factors such as job strain are thought to contribute to elevated psychological stress in office workers. One factor that may impact the relationship between job strain and psychological distress is the individual's coping resources. OBJECTIVE: The purpose of this study is to examine the interaction effect of coping resources on the relationship between job strain and psychological distress in office workers. METHODS: 220 office workers in Australia and Korea completed the Job Content Questionnaire (to evaluate job strain and social support at work), the Depression, Anxiety, and Stress Scale, (DASS-21, a measure of psychological distress), and the Coping with Job Stress Scale to assess control and escape coping. Hierarchical regression analyses were executed to examine the interaction and moderating effect of coping resources. RESULTS: Job strain had a direct positive relationship with all three domains of psychological distress. The relationship between job strain and depression was positively moderated by escape coping, but negatively moderated by social support. Use of higher levels of escape coping predicted higher levels of depression and anxiety symptoms when higher levels of job strain were perceived. CONCLUSIONS: Findings suggest there may be a direct relationship between job strain and psychological distress in office workers. This relationship, however, may be moderated by the office workers coping resources (coping strategies and social support). It is suggested that the evaluation of coping might be a key consideration in the elements of the assessment of psychological distress in office workers.

Cross-cultural adaptation and validation of the Latack Coping Scale in the general working population in Korea.

BACKGROUND: Currently, there are no assessment tools for measuring coping strategies for stress at work in the Korean language. OBJECTIVE: The purpose of this study was to translate the Latack Coping Scale to workplace stress into Korean and examine its psychometric properties in a Korean working population. METHODS: Translation of the the Latack Coping Scale was performed according to the scientific guidelines for cross-cultural adaptation. Two hundred and forty one general workers in Korea completed the new Korean version of the Latack Coping Scale as well as the Type D Personality Scale-14 (negative affectivity). Psychometric properties (reliability and validity) were evaluated. RESULTS: Factor analysis yielded a model that was consistent with the originally proposed subscales of the questionnaire. Good to excellent internal consistency and measurement consistency over a one week interval were obtained for five subscales (Cronbach's alpha; 0.61 to 0.86 and ICC (2.2); 0.80 to 0.87). Escape coping scales were positively associated with Type D personality while control coping scales were negatively associated with Type D personality. CONCLUSIONS: This Korean version of the Latack Coping Scale has shown excellent validity and reliability in the Korean working population. Organizations investigating work stress and coping methods in Korean workers can use this instrument with confidence.

Cross-cultural adaptation and validation of the Depression, Anxiety and Stress Scale-21 (DASS-21) in the Korean working population.

BACKGROUND: In this study, we developed a new Korean translation for the shortened version of the Depression, Anxiety, and Stress Scale (DASS-21) and examined its psychometric properties in a Korean working population. OBJECTIVE: To develop a new Korean version of the DASS-21 and test its psychometric properties specific to the Korean working population. METHODS: The DASS-21 was translated to the Korean language in accordance with scientific guidelines for cross-cultural adaptation. A total of 228 general workers from Korea then completed the newly translated version of the DAS S-21 and its psychometric properties were evaluated. RESULTS: Most of the questionnaire items were correctly loaded on the proposed scales of the original questionnaire. Excellent internal consistency and measurement consistency over a one week interval were obtained for all scales (Cronbach's alpha; 0.87, 83, and 83, and ICC (2, 1); 0.84, 0.94, and 0.89 for depression, anxiety and stress scales, respectively). All three scales were negatively associated with the level of life satisfaction (p < 0.05). CONCLUSIONS: The new Korean version of DASS-21 has shown excellent validity and reliability of measurement in the Korean working population. Organizations investigating the prominent health issue of affective disorders in Korean workers can use this instrument with confidence.