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Strength training program reduces neck and shoulder pain among industrial workers
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November 2013
Strength training program reduces neck and shoulder pain among industrial workers
Study Type:Therapy
OE Level Evidence:2
Journal Level of Evidence:N/A
Implementation of neck/shoulder exercises for pain relief among industrial workers: a randomized controlled trial
BMC Musculoskelet Disord. 2011 Sep 21;12:205. doi: 10.1186/1471-2474-12-205Did you know you're eligible to earn 0.5 CME credits for reading this report? Click Here
Synopsis
537 industrial workers were randomized to examine the effect of strength training at the workplace on non-specific neck and shoulder pain. Participants received 20 weeks of either high-intensity strength training for the neck and shoulders (3 sessions per week) or a control treatment, where patients received advice to stay physically active (1 session per week). The assessment after 20 weeks revealed that high-intensity strength training led to better overall reduction in neck and shoulder pain among industrial workers.
Publication Funding Details
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Funding:
Non-Industry funded
Sponsor:
Danish Working Environment Research Fund
Conflicts:
None disclosed
Was the allocation sequence adequately generated?
Was allocation adequately concealed?
Blinding Treatment Providers: Was knowledge of the allocated interventions adequately prevented?
Blinding Outcome Assessors: Was knowledge of the allocated interventions adequately prevented?
Blinding Patients: Was knowledge of the allocated interventions adequately prevented?
Was loss to follow-up (missing outcome data) infrequent?
Are reports of the study free of suggestion of selective outcome reporting?
Were outcomes objective, patient-important and assessed in a manner to limit bias (ie. duplicate assessors, Independent assessors)?
Was the sample size sufficiently large to assure a balance of prognosis and sufficiently large number of outcome events?
Was investigator expertise/experience with both treatment and control techniques likely the same (ie.were criteria for surgeon participation/expertise provided)?
Yes = 1
Uncertain = 0.5
Not Relevant = 0
No = 0
The Reporting Criteria Assessment evaluates the transparency with which authors report the methodological and trial characteristics of the trial within the publication. The assessment is divided into five categories which are presented below.
2/4
Randomization
1/4
Outcome Measurements
3/4
Inclusion / Exclusion
4/4
Therapy Description
4/4
Statistics
Detsky AS, Naylor CD, O'Rourke K, McGeer AJ, L'Abbé KA. J Clin Epidemiol. 1992;45:255-65
The Fragility Index is a tool that aids in the interpretation of significant findings, providing a measure of strength for a result. The Fragility Index represents the number of consecutive events that need to be added to a dichotomous outcome to make the finding no longer significant. A small number represents a weaker finding and a large number represents a stronger finding.
Why was this study needed now?
Of the musculoskeletal conditions that are often reported in association with the workplace, neck and shoulder pain represent two of the most commonly reported ailments. The discomfort is thought to be mainly manifested through physical factors, such as repetitive tasks and tiring postures. Strength training has been offered as a efficacious intervention to alleviate neck and shoulder pain, although the evidence in support of strength training has been primarily focused in office workers. Accordingly, the effectiveness of strength training in other job settings, specifically the industrial sector, needed to be determined
What was the principal research question?
Was participating in high-intensity strength training more effective in improving neck and shoulder pain among industrial workers compared to receiving advice to stay physically active, assessed at 20 weeks?
Study Characteristics
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Population:
537 employees from two large industrial production units. Both settings featured daily work consisting of repetitive tasks and static postures.
Intervention:
Training group: Participants received high-intensity specific strength training for the neck and shoulder muscles with 5 exercises (front raise, lateral raise, reverse flies, shrugs, and wrist extensions). The training regime involved 3 sessions per week, each consisting of 20 minutes (n = 282).
Comparison:
Control group: Participants received advice to stay physically active and were consulted once a week by a supervisor during the 20 week period (n = 255).
Outcomes:
The primary outcome measure was the neck and shoulder pain intensity, which was rated subjectively on a scale ranging from 0-9. Adherence to the program was recorded, which was based on follow-up questionnaire replies on training frequency. To investigate the effect of the intervention on rehabilitation, the study estimated the odds ratio of being free of pain (pain intensity during the last week < 3) at follow-up, among cases (pain intensity > = 3). To investigate the effect on prevention of pain development, the study estimated the odds ratio of being in pain at follow-up, among those who were non-cases at baseline.
Methods:
RCT
Time:
20 weeks
What were the important findings?
- Regular adherence to the training program (at least once a week) was 85%.
- Pain intensity in the neck decreased significantly in the training group in comparison to the control group (-0.6, 95% CI: -1.0 to -0.1, P < 0.001).
- Pain intensity in the shoulder tended to decrease in the training group (-0.2, 95% CI: -0.5 to 0.1, P = 0.07).
- In respect to the rehabilitative effect of training, the odds ratio for participants defined as cases at baseline (in the training group compared to the control group) for being non-cases at follow-up was 2.0 (95% CI: 1.0 to 4.2) for the neck and 3.9 (95% CI: 1.7 to 9.4) for the shoulder.
- In terms of preventative effect on training, the odds ratio for participants defined as non-cases at baseline (in the training group compared to the control group) for being cases at follow-up was 0.6 (95% CI: 0.2 to 1.5) for the neck and 0.6 (95% CI: 0.3 to 1.3) for the shoulder.
What should I remember most?
This study revealed that the specific strength training program reduced the overall neck and shoulder pain among industrial workers when compared to the control treatment.
How will this affect the care of my patients?
This study suggests that the strength training program provides clinically important reductions in neck and shoulder pain in a population of industrial workers over 20 weeks. However, maintenance of improvements in neck and shoulder pain should be determine in studies with follow-up periods. Comparisons to other exercise/training protocols should also be considered.
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