[Show abstract][Hide abstract] ABSTRACT: [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.
[Show abstract][Hide abstract] ABSTRACT: Objective:
The etiology of nonspecific neck pain is widely accepted to be multifactorial. Each risk factor has not only direct effects on neck pain but may also exert effects indirectly through other risk factors. This study aimed to test this hypothesized model in office workers.
A one-year prospective cohort study of 559 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 neck pain. A regression model was built to analyze factors predicting the onset of neck pain. Path analysis was performed to examine direct and indirect associations between identified risk factors and neck pain.
The onset of neck pain was predicted by female gender, having a history of neck pain, monitor position not being level with the eyes, and frequently perceived muscular tension, of which perceived muscular tension was the strongest effector on the onset of neck pain. Gender, history of neck pain, and monitor height had indirect effects on neck pain that were mediated through perceived muscular tension. History of neck pain was the most influential effector on perceived muscular tension.
The results of this study support the hypothesis that each risk factors may contribute to the development of neck pain both directly and indirectly. The combination of risk factors necessary to cause neck pain is likely occupation specific. Perceived muscular tension is hypothesized to be an early sign of musculoskeletal symptoms.
Journal of Occupational Health 12/2014; 57(2). DOI:10.1539/joh.14-0124-OA · 1.11 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: 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.
European Spine Journal 09/2014; 24(3). DOI:10.1007/s00586-014-3577-3 · 2.07 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: 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.
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.
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.
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.
Journal of Manipulative and Physiological Therapeutics 09/2014; 37(7). DOI:10.1016/j.jmpt.2014.07.004 · 1.48 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: 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.
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.
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.
International journal of occupational safety and ergonomics: JOSE 06/2014; 20(2):339-53. DOI:10.1080/10803548.2014.11077048 · 0.35 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Background
This study aimed to examine the correlation of physical activity levels assessed by pedometer and those by the Global Physical Activity Questionnaire (GPAQ) in a population of office workers.
A cross-sectional study was conducted on 320 office workers. A self-administered questionnaire was distributed to each office worker by hand. Physical activity level was objectively assessed by a pedometer for 7 consecutive days and subjectively assessed by the GPAQ. Based on the pedometer and GPAQ outcomes, participants were classified into 3 groups: inactive, moderately active, and highly active.
No correlation in the physical activity level assessed by the pedometer and GPAQ was found (rs = .08, P = 0.15). When considering the pedometer as the criterion for comparison, 65.3% of participants had underestimated their physical activity level using the GPAQ, whereas 9.3% of participants overestimated their physical activity level.
Physical activity level in office workers assessed by a subjective measure was greatly different from assessed by an objective tool. Consequently, research on physical activity level, especially in those with sedentary lifestyle, should consider using an objective measure to ensure that it closely reflects a person’s physical activity level.
BMC Research Notes 05/2014; 7(1):280. DOI:10.1186/1756-0500-7-280
[Show abstract][Hide abstract] ABSTRACT: 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.
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.
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.
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.
European Spine Journal 02/2014; 23(4). DOI:10.1007/s00586-014-3212-3 · 2.07 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: 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.
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.
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.
The exercise programme reduced incident neck pain and increased neck flexion movement for office workers with lower-than-normal neck flexion movement.
Occupational and environmental medicine 10/2013; 71(1). DOI:10.1136/oemed-2013-101561 · 3.27 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: 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.
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.
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.
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.
[Show abstract][Hide abstract] ABSTRACT: [Purpose] This study aimed to examine the 1 year incidence and identify biopsychosocial factors predicting the onset and persistence of thoracic spine pain in undergraduate students. [Subject] A 1 year prospective study was carried out among 684 healthy undergraduate students. [Methods] At baseline, a self-administered questionnaire and standardized physical examination were employed to gather biopsychosocial data. Follow-up data on the incidence of thoracic spine pain were collected every 3 months. Two regression models were built to analyze factors predicting the onset and persistence of thoracic spine pain. [Results] The 1 year incidence of thoracic spine pain was 27%, and 23% of subjects reported persistent symptoms. The onset of thoracic spine pain was predicted by female gender, poor neck extensor muscle endurance and high percentage duration of mouse use during computer work. Female students being in the second year of their studies and unsupported elbows during computer use were predictors of persistent symptoms. [Conclusion] Thoracic spine pain is quite common among undergraduate students and many of them may have persistent symptoms. Interventions aimed at reducing the occurrence of symptoms in undergraduate students should, at the least, include teaching 2nd year female students how to perform computer work safely.
[Show abstract][Hide abstract] ABSTRACT: The purpose of this study was to systematically review prospective cohort studies to identify risk factors for the onset of low back pain (LBP) in office workers.
Online searches were conducted on PubMed, CINAHL Plus with full text, ScienceDirect, PEDro, ProQuest, and Scopus databases from 1980 to November 2011 using the following keywords: low back pain paired with risk or prognostic factors and office or computer or visual display unit (VDU) or visual display terminal (VDT). The methodological quality of each study was assessed using a 21-item checklist, which was divided into 2 parts: the internal validity (11 items) and descriptive quality (10 items) of studies. Strength of evidence for risk factors associated with the development of nonspecific LBP was assessed by defining 5 levels of evidence based on the number of studies and the quality score of studies.
Eighteen full-text articles were identified, and 15 were excluded. A total of 3 articles were judged to meet the selection criteria and were included in the methodological quality assessment. Risk factors were divided into 3 groups: individual, work-related physical, and work-related psychosocial risk factors. There was strong evidence that history of LBP is a predictor of the onset of LBP. Limited evidence was found that the combination of postural risk factors and job strain is associated with the onset of LBP.
After review of 3 high-quality prospective studies on the association between risk factors and the onset of nonspecific LBP in office workers, few risk factors were found to predict the onset of LBP in office workers.
Journal of manipulative and physiological therapeutics 08/2012; 35(7):568-77. DOI:10.1016/j.jmpt.2012.07.008 · 1.48 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: To assess two aspects of the external validity of acupuncture research for osteoarthritis knee pain and determine the common acupoints and treatment parameters used.
The external validity of 16 randomised controlled trials (RCTs) was investigated using a scale consisting of two aspects: reporting and performance. The reporting aspect included acupuncturist's background, study location, treatment detailed, patient characteristics, positive trial results, adverse effects and between-group statistical differences, whereas treatment appropriateness, appropriate controls and outcomes were classified as the performance aspect. Acupuncture treatment in RCTs was compared with common practice according to the literature sources and survey of acupuncturists working in different parts of Thailand.
The levels of external validity for the reporting and performance aspects were in the range of 31.3% to 100%. Statistic values such as mean difference and confidence interval were reported by the minority of trials (43.8%). Patient satisfaction and quality of life were seldom used (31.3%). There were minor differences between research and practice in terms of the points used (25.0%), number of treatment sessions (6.3%) and frequency (12.5%). The most frequently used points were ST34, ST35, ST36, SP6, SP9, SP10, GB34, Xiyan and ah shi points, and the commonly used treatment parameters were 20 minutes, 10-15 sessions and two treatments weekly.
Reporting of the external validity of acupuncture RCTs for knee pain was notably inadequate in terms of trial setting, treatment provider and statistical reporting. The majority of studies involved appropriate controls and outcomes and applied acupuncture treatments in line with practice.
Acupuncture in Medicine 07/2012; 30(3):187-94. DOI:10.1136/acupmed-2012-010140 · 1.50 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: To examine whether the incidences of neck and low-back symptoms were elevated during the severe floods that occurred in Bangkok, Thailand in 2011, and to explore flood-related risk factors for neck and low-back symptoms.
Prospective cohort design.
Severe flooding occurred in Bangkok and surrounding neighbourhoods between October and December, 2011. After the flood had subsided (January 2012), 377 healthy office workers, who were already taking part in a study on musculoskeletal symptoms, were asked about their contact with floodwater. Data were gathered from subjects, who had reported no neck and low-back symptoms at the end of September 2011 and who were affected by the flood. Two regression models for the outcomes of 3-month incidence of neck and low-back symptoms, respectively, were performed.
Eighty-two percent of the subjects were affected by the flood. No flood-related factor was found to associate significantly with either neck or low-back symptoms. However, neck symptoms may be associated with commuting frequently through flooded areas, and low-back symptoms may be associated with the subjects' homes or workplaces being flooded.
These findings indicate that more attention needs to be paid to the problem of musculoskeletal symptoms during flooding in urban areas, and that preventive measures are required.
Journal of rehabilitation medicine: official journal of the UEMS European Board of Physical and Rehabilitation Medicine 06/2012; 44(8):624-8. DOI:10.2340/16501977-1013 · 1.68 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Objective: This study aimed to investigate the 3-month prevalence of musculoskeletal symptoms at the spine attributed to computer use and to identify biopsychosocial factors associated with the prevalence in undergraduate students. Participants: Undergraduate students who studied at a public university in Thailand. Methods: A cross-sectional survey was conducted with a self-administered questionnaire delivered to 3,545 students.Results: A total of 2,511 students (73.7%) returned the questionnaires. Cervical symptoms (22.3%) were the most frequently reported, followed by thoracic (11%) and lumbar symptoms (10.7%). Females, daily computer use greater than three hours and too-high keyboard's position were significantly associated with a high prevalence of cervical symptoms. A significan association was found between higher undergraduate year of the study and too-high keyboard's position and a high prevalence of thoracic symptoms. Higher undergraduate year of the study and daily computer use greater than three hours were significantly related to a high prevalence of lumbar symptoms. Better-than-normal mental health status was associated with a low prevalence of lumbar symptoms. Conclusion: Spinal symptoms are common among undergraduate students. Various factors were identified to be associated with high prevalence of spinal symptoms. Further research investigating the causal relation between these factors and musculoskeletal symptoms should be conducted.
Work 05/2012; 43(4). DOI:10.3233/WOR-2012-1387 · 0.52 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: 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.
Occupational and environmental medicine 05/2012; 69(9):610-8. DOI:10.1136/oemed-2011-100459 · 3.27 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: [Purpose] This pilot study aimed to investigate the effectiveness of brief education combined with home exercise programs on pain and disability of office workers with chronic non-specific LBP. [Subject] A quasi-experimental study of single group, pretest-posttest design with 30 workers as subjects serving as their own controls was conducted. [Methods] Initially, demographic characteristics and outcome measures, including pain intensity using a visual analogue scale and the Roland-Morris disability score, were collected every 2 weeks for 6 weeks. Participants then received interventions for 8 weeks, consisting of brief education regarding LBP and individually designed home exercise programs, focusing on core stability, stretching and mobility exercises. After that, outcome measures were collected every 2 weeks for 6 weeks. [Results] Pain intensity and disability gradually decreased after completion of the interventions. However, pain intensity decreased to a significant level only after completion of the intervention for 4-6 weeks. No significant difference in disability level was found between pre- and postintervention. [Conclusion] The combination of brief education and a home exercise program can alleviate the pain intensity of office workers with chronic non-specific LBP. Further research using a randomized controlled trial design is required to validate this preliminary finding.
[Show abstract][Hide abstract] ABSTRACT: This study aimed to examine the 12-month incidence and risk factors for the onset and persistence of low back pain (LBP) in undergraduate students. A 1-year prospective study was carried out among 684 healthy students in a large public university in Thailand. Data were collected using a self-administered questionnaire and a physical examination. Follow-up data were collected every 3 months. A total of 524 (77%) students were followed for 1 year. A total of 31% reported a new onset of LBP, of whom 31% reported persistent LBP. Having no low back support during computer work was a significant predictor for the onset and persistence of LBP. The onset of LBP was also associated with quadriceps muscle tightness. LBP is common among undergraduate students, and many of them may have persistent symptoms. Physical risk factor plays a significant role for the onset and persistence of LBP among the study population.
Asia-Pacific Journal of Public Health 12/2011; 27(2). DOI:10.1177/1010539511427579 · 1.46 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The aim of this study was to examine the 12-mo prevalence of low back pain (LBP) and to identify individual, flight-related, and psychosocial factors associated with the prevalence of LBP in commercial airline pilots.
A cross-sectional survey was conducted with a self-administered questionnaire delivered by hand to 708 Thai airline pilots visiting the Institute of Aviation Medicine, Royal Thai Air Force, for their regular medical examinations. A multivariable logistic regression model was used to assess the associations between the prevalence of LBP and statistically significant factors.
A total of 684 subjects (97%) returned the questionnaires. The 12-mo prevalence of self-reported LBP among commercial airline pilots was 55.7%. An elevated risk of experiencing LBP was associated with occasionally to frequently encountering turbulence in the previous year, lifting luggage four or more times per duty period, perception of noise in the cockpit as being too loud, and perception of work hazards at intermediate to high levels, assessed by the JCQ Thai version. On the other hand, the factors that reduced the risk of experiencing LBP were performing vigorous exercise regularly and having 5-23 h rest breaks between flights.
LBP is common among commercial airline pilots. Our findings suggest that LBP in commercial airline pilots is occupation-related. Interventions aimed at reducing the occurrence of LBP in commercial airline pilots should focus on work condition adjustment and mental stress reduction.
Aviation Space and Environmental Medicine 09/2011; 82(9):879-84. DOI:10.3357/ASEM.3044.2011 · 0.88 Impact Factor