prevalence of neck pain in office workers

Janwantanakul The latter finding may represent a floor effect, as individuals who are pain free at baseline may dilute the impact of theintervention on pain intensity. This study reported the prevalence of neck pain and to identified associated occupational factors in a cohort of office workers. \bigcirc }$| = very low, |${\bigoplus \! Recent reviews conducted on workplace-based interventions found very low to low quality, or mixed evidence for the beneficial effects of exercise and ergonomic interventions on neck pain severity. Statistical heterogeneity was examined using the I2 statistics, with values of 25%, 50%, and 75% indicating low, moderate, and high heterogeneity, respectively.20, For continuous data, standardized mean differences (SMD) with 95% CI in pain intensity were calculated with a random-effects model.21 The SMD (95% CI) for pain intensity was calculated by having the mean differences between the intervention and comparator groups divided by the pooled SD. Mahmud Hence, a total of 27 RCTs were interpreted from the 35 papers, as reflected in the rest of this review. Neck pain is more common among office workers than any other occupation, while the annual prevalence ranges from 42-63%. Data not reported in published study and provided by author(s) on request. , Hytten K, Skauli G, Christensen CC, Ursin H. Mekhora \bigoplus \! We additionally recommend future studies to adopt transparency with the reporting of adverse effects. \bigcirc }$| = low, |${\bigoplus \! Coombes, V. Johnston, S. OLeary, G. Sjgaard, Writing: X. Chen, B.K. The high prevalence of neck pain in office workers in our study was quite similar with previous studies (Jensen et al., 2003; . , Christensen KB, Holtermann Aet al. , Sgaard K, Hansen EA, Hannerz H, Sjgaard G. Pedersen Also, all RCTs did not meet the outcome assessor blinding criteria, as the primary outcome (pain) was self-reported.19 Overall, 11 RCTs (41%) were rated unclear for participation, and 5 trials (19%) were rated high risk of bias. Church T A comprehensive work injury prevention program with clerical and office workers: phase I. However, more studies are needed to confirm the recommendations for cutoffs and standards for reporting participation. Andersen Abstract. Neck and low back pain are common in sedentary office workers. Most evidence focused on exercise interventions, with less attention directed toward ergonomic interventions. One further large RCT (n = 567) of high-quality evidence recruited participants without neck pain but lower than normal neck flexion range and neck flexor muscle endurance (at risk office workers).5 A large effect was found in favor of 52 weeks of combined neck endurance and stretching exercises (RR = 2.20; 95% CI = 1.50 to 3.22) in reducing neck pain incidence in the at risk office workers compared to no intervention. T Higgins , Violante FS. , Krause N, Rempel DM. Authors were contacted for additional data when not available in the published manuscript. 1- 3 The annual prevalence of neck pain in office workers varies from 42% to 63%, 1, 4, 5 and office workers have the highest incidence of neck disorders among all other occupations, at 17% to 21%. KI An extensive cross-sectional questionnaire was used to estimate the prevalence of neck pain and to identify risk factors (short term to long term) in the occurrence of neck pain in military office workers. This study aims to assess the prevalence and risk factors of neck pain among office workers at the Ministry of Health in Saudi Arabia. However, there is high-quality evidence based on a single trial that combined neck endurance and stretching exercises might be efficacious for the at risk office workers.5 For ergonomic interventions, the available, albeit limited evidence suggests that multiple workstation adjustments are effective in office workers who are symptomatic,45 while evidence for a general population of office workers was conflicting and of low quality. The results of the study indicated a positive trend towards the proposed hypothesis that . The results from this review are relevant for employers and policymakers. This is due to the increasing responsibility of companies toward employee health, and the potential cost-savings and productivity gains associated with a healthy workforce.3 Workplace-based interventions are broadly grouped into those that target the workers health and/or knowledge (eg, exercise, education), or those that target the job task and environment (eg, ergonomics). The quality of evidence for all individual or pools of RCTs begin as high quality, and quality could be downgraded by 1 or 3 levels to very low, low, or moderate evidence.19,24 Downgrading for risk of bias was applied when the included studies (eg, Chiarotto et al25) did not meet at least 50% of the 12-item checklist by Furlan et al.19 For a set of trials, risk of bias was applied when more than 25% of total participants were from studies that did not meet the 50% cutoff of the same checklist.19,26 Downgrading for inconsistency was applied when there was high statistical heterogeneity (I275%), or when the direction of the study results was different in the majority (75%) of studies.19 Evidence was downgraded for indirectness when there was uncertainty about the generalizability of the results based on the inclusion criteria defined in this review.19 Imprecision was downgraded when a large CI was observed, when CIs were not reported in 1 or more studies, or when only 1 small study reported the outcome (total number of participants: <300).19,26 Publication bias was downgraded when the study results provided differed from the original protocol or study objectives.19 The criterion was scored as unclear if the authors could not be contacted or if the information is no longer available.19, The following definitions of quality of evidence were applied in this review: high-quality evidence means further research is very unlikely to change confidence in the estimate of effect; moderate-quality evidence means further research is likely to have an important impact on confidence in the estimate of effect and may change the estimate; low-quality evidence means further research is very likely to have an important impact on confidence in estimate of effect and is likely to change the estimate; and very low-quality evidence means very little confidence in the effect estimate.19. However, the participation levels in the trial varied from 30% (stretching exercise) to 57% (neck endurance exercise). (C) Forest plot for improvement in pain intensity after general fitness exercises versus no training in office workers who were symptomatic (with neck pain) on the basis of a pooled analysis of 2 trials. CH , Lall R, Hansen Z, Lamb SE. Randomized controlled trials (RCTs) were included if the following criteria were present: the population consisted of office workers performing computer work for most of their work time; the intervention was performed on-site at the workplace only, and outcome measures included pain intensity or incidence/prevalence of neck pain. The authors completed the ICJME Form for Disclosure of Potential Conflicts of Interest and reported no conflicts of interest. , Glasziou PP, Boutron Iet al. Risk of bias was assessed by 2 independent reviewers using the 2015 Cochrane Back and Neck Group guidelines. LL Single study representing duplicate articles (with same randomized controlled trial numbers). , Sandsjo L, Vollenbroek-Hutten MM, Larsman P, Kadefors R, Hermens HJ. (15,16,17) Present study reported one year prevalence of neck pain similar to studies in developed countries. Two standardized scales (Neck Disability Index and Tampa Scale for Kinesiophobia) allowed assessment of the impact of neck pain on . Prevalence was considered as the number/proportion of cases of neck pain, while incidence was considered as the number/proportion of new cases identified at a given time. , Tuntland H, Holte KAet al. All statistics were calculated using RevMan5 (version 5.3).21, Qualitative analyses to evaluate the quality of evidence for single trials and the overall quality of evidence for pooled analyses were done using Grading of Recommendations Assessment, Development, and Evaluation criteria.21 In these criteria, 5 main domains (risk of bias, imprecision, inconsistency, indirectness, and publication bias) are used to categorize evidence quality. A \bigoplus \! (1) Background: Neck pain is the most common type of musculoskeletal problem affecting office workers. Conclusions were based on reported results or effect statistics (SMD or RR) calculated using the random-effects model, when possible. However, these reviews examined all occupational categories, including office workers.3,11,12 In contrast, other reviews have studied solely office workers, but not performed meta-analysis, nor considered the potential influence of individual factors, such as neck pain presence at baseline, or intervention characteristics, including participation in an intervention.1315 Current reviews have also not distinguished between studies investigating workers with and without neck symptoms (general population of office workers), and those with symptoms (office workers who are symptomatic). Chiarotto MG When studies demonstrated clinical homogeneity (ie, similar study intervention, comparator intervention, postintervention time frames, and pain outcome),20 data were pooled using a weighted mean difference. , Liberati A, Tetzlaff J, Altman D, Group P. Singh , Bredahl TG, Pedersen MT, Boyle E, Andersen LL, Sjgaard G. Andersen Various occupational risk factors have been linked to neck pain. Greater effects were observed with greater participation in exercise. Inconsistencies in definitions have been acknowledged in previous studies to affect study outcomes,66,67 hence future research with specific case definitions and subgrouping of the study population may yield more consistent and stronger clinical recommendations. Andersen , Swanson NG, Sauter SL, Hurrell JJ, Schleifer LM. \bigoplus }$|, |${\bigoplus \! Two RCTs (n = 127) studied the effect of 1 hour of general fitness training per week on office workers who were symptomatic in comparison to no training.32,49 In the trial that found a significant effect, training consisted of 52weeks of all-around fitness exercises involving the whole body,32 while the other that trial that found no significant effect consisted of 10 weeks of purely leg cycling.49 When the 2 studies were pooled, meta-analysis found moderate-quality evidence (downgraded for imprecision) of a small effect in favor of 1 hour of general fitness training per week on reducing pain intensity in office workers who were symptomatic (SMD = 0.43; 95% CI = 0.08 to 0.78) (I2 = 0%) (Fig. 42014006905). The possible results of the assessment include high, low, or unclear risk of bias. All authors made substantial contributions to the concept and design, data acquisition, data analysis and interpretation, and writing and revision of the paper and approved the final version for submission. ), and examples of the search terms used included neck pain AND workplace AND office work (Appendix). , Linton SJ. It is relevant to also investigate the effectiveness of workplace interventions in the general population of office workers given the lack of evidence for the prevention of neck pain.1. In original published study, estimates were adjusted on the basis of sex and baseline neck pain. Reported results (insignificance) differed from original published results (significance) because of unadjusted estimates. \bigcirc \! Interventions performed partially at the worksite (eg, outpatient clinic combined with workplace interventions), or those performed in combination with manual therapy and physical therapy adjuncts, such as traction, acupuncture, neck collars, or nonportable electrotherapy, were excluded. The RRs were calculated using pain incidence or prevalence values of the individual studies, and the pooled analysis was based on the random-effects model (in order of increasing RR and where weight = weighted average21). Methods The PubMed . C M was funded by the Australian Postgraduate Award. This review extends previous reviews by doing subgroup analysis of 2 study populationsoffice workers who were symptomatic (ie, with neck pain) and a general population of office workers (ie, with or without neck pain)and by exploring potential sources of heterogeneity, including the influence of participation rates. , Kenny DT, Md Zein R, Hassan SN. Voerman The lack of high-quality ergonomic intervention trials targeted at office workers who were symptomatic warrants future research. The aim of the current study was to estimate the one-year prevalence of neck pain among office workers and to determine which physical, psychological and . \bigcirc \! , Pensri P, Jiamjarasrangsri V, Sinsongsook T. Sihawong , Curran-Everett D, Maluf KS. Risk of bias was assessed by 2 independent reviewers (X.C., D.J.) Bold type indicates statistically significant results (P<.05). Coombes, V. Johnston, S. OLeary, G. Sjgaard, Data collection: X. Chen, B.K. , Swanson N, Sauter S, Dunkin R, Hurrell J, Schleifer L. Sjgren In addition, a large amount of research on pain was encountered during the preliminary literature search, warranting the review to focus on the neck pain outcome only. Generally, this review found the ergonomic trials were of lower quality and smaller sample size than the ergonomic interventions, and hence more ergonomic RCTs are required to form firmer conclusions. P If available, intention-to-treat data were used in favor of per-protocol data. M A recent study recommended 70% participation as the cutoff point for per-protocol analysis,68 a recommendation that is supported by our observation that participation of greater than or equal to 66% was associated with a larger effect size. T Gram , Amick BCIII, Dennerlein JTet al. Background: Persisting neck pain is common in society. Figure 1 shows the process of study selection, leading to 35 papers meeting the inclusion criteria. Address all correspondence to Ms Chen at: Search for other works by this author on: School of Biomedical Sciences, University of Queensland, Department of Sport Science and Clinical Biomechanics, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark, School of Health and Rehabilitation Sciences, University of Queensland, School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, and Department of Physiotherapy, Royal Brisbane and Women's Hospital, Queensland Health, Brisbane St. Lucia, Queensland. This study aimed to investigate the presence of scapular dyskinesis (SD) in office workers with neck and scapular complaints. Most RCTs addressing exercise interventions (67%), education, breaks, and myofeedback interventions (71%) focused on office workers who were symptomatic; whereas only 13% of trials of ergonomic interventions were undertaken in the symptomatic population. CM C , van der Velde G, Cassidy JDet al. \bigoplus \! Higgins All RCTs did not meet the patient and care provider blinding criteria, as it is not possible for the type of interventions performed in this review. CM No funding was received for the design, conduct, or reporting of this review. While some studies report that between 33% and 65% of people have recovered from an episode of neck pain at 1 year, most cases run an episodic course over a person's lifetime and, thus . Updated method guidelines for systematic reviews in the Cochrane Collaboration Back Review Group. The SMD was used, as it standardizes the results of studies to a uniform scale before they are combined.21 A positive SMD (>0) indicated an effect in favor of the intervention, and a negative SMD (<0) favored the comparator.22 When the CI did not cross 0, effects were deemed statistically significant.22 An SMD of less than 0.5 indicated a small effect, SMDs of 0.5 to 0.8 indicated a medium effect, and an SMD of greater than 0.8 indicated a large effect.22,23, For dichotomous data, relative risk (RR) with corresponding 95% CI were calculated using postintervention neck pain incidence/prevalence values with a random-effects model.21 The intervention was favored when RR was greater than 1, and the comparator was favored when RR was less than 1. Neck pain is a prevalent and burdensome condition particularly in office workers compared to other occupations.13 The annual prevalence of neck pain in office workers varies from 42% to 63%,1,4,5 and office workers have the highest incidence of neck disorders among all other occupations, at 17% to 21%.6,7 Approximately 34% to 49% of workers report a new onset of neck pain during a 1-year follow-up.1,2,5,8 The impact of neck pain is significant not just for the individual, but also for industry and society.3 Workers who do not return to work within 1 to 2 months are at high risk of developing disability and may cease work altogether.3 Costs associated with neck pain place a burden on employers, society, and the individual through care-seeking behavior, reduced productivity, and workers compensation claims.3,9,10, Workplace-based interventions are becoming important to reduce the burden of neck pain. Two reviewers (X.C., D.J.) \bigcirc \! N Of the exercise trials that reported participation, 73% scored low risk of bias. 2017 American Physical Therapy Association. Neck and low back pain are a major health problem for many, and in particular for office workers. Back pain is super common. Point estimates of effect were deemed statistically significant if the 95% CI for RR did not cross 1.22 An RR of 1 to 1.25 or 0.8 to 1 indicated a small effect, an RR of 1.25 to 2 or 0.5 to 0.8 indicated a medium effect, and an RR of greater than 2 or less than 0.5 indicated a large effect.22,23, Data to calculate effect statistics were obtained from postintervention (final values) or, where possible, change from baseline values. Standardized mean differences (SMDs) calculated from change from baseline values for individual studies and pooled analysis based on random-effects model (in order of increasing SMD and where weight = weighted average21). Nine trials5,27,32,45,4751 investigated the effectiveness of workplace-based strengthening exercises consisting of resistance exercises targeted to the neck/shoulder region using dumbbells or resistance band/tubing compared to no training. , Kjaer M, Sgaard K, Hansen L, Kryger AI, Sjgaard G. Kietrys No effect sizes displayed because of lack of change from baseline data. Grnningaeter K First, data could not be obtained from some authors for a more comprehensive analysis. A key finding of the review was that neck/shoulder-specific strengthening exercise was effective in reducing neck pain intensity in office workers who were symptomatic, but did not demonstrate effectiveness in a general population of office workers. This study aims to assess the prevalence and risk factors of neck pain among office workers at the Ministry of Health in Saudi Arabia. independently extracted data using predefined data fields, and another author (B.K.C.) T A The low participation in stretching may be related to the higher frequency of exercises expected by the study protocol (daily during break times versus twice per week for endurance exercise). Data from the 4-week intervention could not be subjected to a meta-analysis due to lack of data for change from baseline and the short intervention period.50 Meta-analysis of the other 2 trials24,28 (n = 674) found moderate quality evidence (downgraded for inconsistency) for the ineffectiveness of neck/shoulder strengthening in comparison to no training in a general population of office workers (SMD = 0.03; 95% CI = 0.39 to 0.33) (Fig. In addition, with the increasing aging population of medium- and low-income countries, the . Ever wonder why your back hurts at the end of the day. \bigcirc }$|, Receive exclusive offers and updates from Oxford Academic, Neck/shoulder strengthening exercise vs no training, Job: 449 office workers from a national public admin authority, Type: 3 strengthening intervention arms: 1 60 (1 h/wk), 3 20 (20 min, 3 times/wk), 9 7 (7 min, 9 times/wk) Description: Specific strength training using 5 dumbbell exercises: front raises, lateral raises, reverse flies, shrugs, and wrist extensions Providers: Experienced exercise instructors Mode: Face-to-face in a group Duration: 20 wk, 3 intervention groups combined: SMD = 0.14 (0.08 to 0.37), 56% of participants participated at least 20 min/wk, Job: 549 office workers from a public admin authority, Type: Dynamic and specific strength training, 20 min, 3 times/wk Description: Dynamic resistance training included seated static exercises for the neck and explosive rowing and kayaking ergometer exercises for the shoulders; specific resistance training with dumbbells included shoulder extension, abduction, and lift Providers: Experienced exercise instructors Mode: Face-to-face in a group Duration: 52 wk, 45% of participants participated at least 20min/wk (mean of 54% the first half and 35% the second half of the intervention), Job: 72 office workers from a university and from insurance, physical therapy, and software companies, Type: Strength training twice daily Description: Resistance training included isometric neck rotation with manual resistance (5-s hold, 5 repetitions), shoulder shrugs, and scapular retraction with elastic band resistance (12 repetitions each) Provider: Not reported Mode: Face-to-face in a group Duration: 4 wk, No training (deep breathing and ankle pumps), 74% of planned training attended (average daily frequency of exercise = 1.47 times/d), Job: 256/449 office workers (subset of general population from Andersen etal, 2012, 3 intervention groups combined: SMD = 0.23 (0.07 to 0.52), Job: 100/549 office workers (subset of general population from Blangsted etal, 2008, 45% of participants participated at least 20 min/wk (mean of 54% the first half and 35% the second half of the intervention), Job: 48 female participants from banks, post offices, national admin offices, and an industrial production unit Condition: Trapezius myalgia, Type: Strength training, 20min, 3 times/wk Description: Specific strength training using 5dumbbell exercises: 1-arm row, shoulder abduction, elevation, reverse flies, and upright row Provider: Exercises were supervised Mode: Face-to-face in a group Duration: 10 wk, Job: 198 office workers Condition: Neck/shoulder pain with intensity of 2 (out of 10) during the past 3 mo, at least 30 d during the past year, Type: 2 strengthening intervention arms: 2 min/d, 12 min/d, 5 times/wk Description: Both intervention groups did resistance training with elastic tubing, performing shoulder abductions (lateral raises) Providers: Physical therapists Mode: Face-to-face initially and then individually thereafter Duration: 10 wk, 2 min/d: SMD = 0.60 (0.32 to 1.03) 12 min/d: SMD = 0.90 (0.54 to 1.26) 2 min+12 min/d: SMD = 0.74 (0.43 to 1.05), 2 min/d: 65% of planned training sessions attended 12 min/d: 66% of planned training sessions attended, Job: 47 office workers from a university Condition: Neck/shoulder pain with intensity of 3 (out of 9) in the previous month, Type: Scapular functional training, 20 min, 3 times/wk Description: Scapular exercises targeting serratus anterior and lower trapezius muscles to a high extent and upper trapezius muscle to a lower extent; elastic bands were provided for extra resistance if required Provider: Experienced exercise instructor Mode: Face-to-face in a group Duration: 10 wk, 70% of planned training sessions attended, Job: 393 female office workers from a health care center Condition: Nonspecific neck pain of 12 wk, Type: Dynamic muscle training, 30 min, 3 times/wk Description: Dynamic muscle training using dumbbells to activate large muscle groups in the neck/shoulder region, followed by stretching Provider: Physical therapist Mode: Face-to-face in a group Duration: 12 wk, 39% of planned training sessions attended, Neck/shoulder strengthening exercise vs physical therapy, Job: 33 female office workers Condition: Neck/shoulder pain with intensity of 3 (out of 6) for last 6 mo and 2 wk, and pain for 3 d continuously for last 2 wk.

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