Protocol for shoulder function training reducing musculoskeletal pain in shoulder and neck: a randomized controlled trial

Christoffer H Andersen, Lars L Andersen, Ole S Mortensen, Mette K Zebis, Gisela Sjøgaard, Christoffer H Andersen, Lars L Andersen, Ole S Mortensen, Mette K Zebis, Gisela Sjøgaard

Abstract

Background: Neck and shoulder complaints are common among employees in sedentary occupations characterized by intensive computer use. Such musculoskeletal pain - which is often associated with restricted range of motion and loss of muscle strength - is one of the most common conditions treated by physical therapists. The exact mechanism of neck pain is rarely revealed by clinical examination and the treatment has varied from passive rest to active treatments. Active treatments have often been divided into either training of the painful area or the surrounding musculature avoiding direct training of the painful area. Our study investigates the effect of the latter approach.

Methods/design: A randomized controlled trial of 10 weeks duration is currently being conducted. Employed office workers with severe neck-shoulder pain are randomized to 3 × 20 min shoulder function training with training supervision or to a reference group receiving advice to stay physically active. Shoulder function training primarily focuses on the serratus anterior and lower trapezius muscle with only minimal activation the upper trapezius.An announcement was sent to the administrative section of the university including jobs characterized by intensive computer work. The first 100 positive replies entered the study. Among these inclusion criteria were pain intensity in the neck/shoulder of at least 3 on a 0-9 scale. Exclusion criteria were cardiovascular disease, trauma, hypertension, or serious chronic disease. Before and after the intervention period the participants replied to a questionnaire about musculoskeletal disorders and work disability, and underwent a standardized clinical examination of the neck and shoulder girdle. Further, on a weekly basis the participants log pain intensity of the neck and shoulder during the previous week.The primary outcome measure is pain in the neck and shoulders at week 10 based on the weekly pain registration and results from the clinical examination. Secondary outcomes are strength and work disability.

Trial registration: ClinicalTrials (NCT): NCT01205542.

Figures

Figure 1
Figure 1
Flow chart.
Figure 2
Figure 2
The two main shoulder function exercises: 1) press-up, 2) push-up plus.

References

    1. Blangsted AK, Sogaard K, Hansen EA, Hannerz H, Sjogaard G. One-year randomized controlled trial with different physical-activity programs to reduce musculoskeletal symptoms in the neck and shoulders among office workers. Scand J Work Environ Health. 2008;12:55–65.
    1. Hakala P, Rimpela A, Salminen JJ, Virtanen SM, Rimpela M. Back, neck, and shoulder pain in Finnish adolescents: national cross sectional surveys. BMJ. 2002;12:325–743.
    1. Ijmker S, Huysmans MA, Blatter BM, van der Beek AJ, van MW, Bongers PM. Should office workers spend fewer hours at their computer? A systematic review of the literature. Occup Environ Med. 2007;12:211–222. doi: 10.1136/oem.2006.026468.
    1. Lin JJ, Hanten WP, Olson SL, Roddey TS, Soto-quijano DA, Lim HK, Sherwood AM. Functional activity characteristics of individuals with shoulder dysfunctions. J Electromyogr Kinesiol. 2005;12:576–586. doi: 10.1016/j.jelekin.2005.01.006.
    1. Pedersen BK, Saltin B. Evidence for prescribing exercise as therapy in chronic disease. Scand J Med Sci Sports. 2006;12(Suppl 1):3–63. doi: 10.1111/j.1600-0838.2006.00520.x.
    1. Proper KI, Koning M, van der Beek AJ, Hildebrandt VH, Bosscher RJ, van Mechelen W. The effectiveness of worksite physical activity programs on physical activity, physical fitness, and health. Clin J Sport Med. 2003;12:106–117. doi: 10.1097/00042752-200303000-00008.
    1. Verhagen AP, Karels C, Bierma-Zeinstra SM, Feleus A, Dahaghin S, Burdorf A, Koes BW. Exercise proves effective in a systematic review of work-related complaints of the arm, neck, or shoulder. J Clin Epidemiol. 2007;12:110–117. doi: 10.1016/j.jclinepi.2006.05.006.
    1. Ylinen J. Physical exercises and functional rehabilitation for the management of chronic neck pain. Eura Medicophys. 2007;12:119–132.
    1. Sjøgaard G, Lundberg U, Kadefors R. The role of muscle activity and mental load in the development of pain and degenerative processes at the muscle cell level during computer work. Eur J Appl Physiol. 2000;12:99–105.
    1. Andersen LL, Kjaer M, Søgaard K, Hansen L, Kryger A, Sjøgaard G. Effect of two contrasting types of physical exercises on chronic neck muscle pain. Arthritis Rheum. 2008;12:84–91. doi: 10.1002/art.23256.
    1. Ylinen J, Takala EP, Nykänen M, Häkkinen A, Mälkiä E, Pohjolainen T, Karppi SL, Kautiainen H, Airaksinen O. Active neck muscle training in the treatment of chronic neck pain in women: a randomized controlled trial. JAMA. 2003;12:2509–2516. doi: 10.1001/jama.289.19.2509. 21-5.
    1. Lin JJ, Lim HK, Soto-quijano DA, Hanten WP, Olson SL, Roddey TS, Sherwood AM. Altered patterns of muscle activation during performance of four functional tasks in patients with shoulder disorders: interpretation from voluntary response index. J Electromyogr Kinesiol. 2006;12:458–468. doi: 10.1016/j.jelekin.2005.09.008.
    1. Kuorinka I, Jonsson B, Kilbom Å, Vinterberg H, Biering-Sørensen F, Andersson G, Jørgensen K. Standardised Nordic questionnaires for the analysis of musculoskeletal symptoms. Appl Ergo. 1987;12:233–237. doi: 10.1016/0003-6870(87)90010-X.
    1. Reed GR, Velicer WF, Prochaska JO, Rossi JS, Marcus BH. What makes a good staging algorithm: examples from regular exercise. Am J Health Promot. 1997;12:57–66.
    1. Pronk NP, Martinson B, Kessler RC, Beck AL, Simon GE, Wang P. The association between work performance and physical activity, cardiorespiratory fitness, and obesity. J Occup Environ Med. 2004;12:19–25. doi: 10.1097/01.jom.0000105910.69449.b7.
    1. Beaton DE, Katz JN, Fossel AH, Wright JG, Tarasuk V, Bombardier C. Measuring the whole or the parts? Validity, reliability and responsiveness of the disabilities of the arm, shoulder and hand outcome measure in different regions of the upper extremity. J Hand Ther. 2001;12:128–146.
    1. Marcus BH, Selby VC, Niaura RS, Rossi JS. Self-efficacy and the stages of exercise behavior change. Res Q Exerc Sport. 1992;12:60–66.
    1. Juul-Kristensen B, Kadefors R, Hansen K, Byström P, Sandsjö L, Sjøgaard G. Clinical signs and physical function in neck and upper extremities among elderly female computer users: the NEW-study. Eur J Appl Physiol. 2006;12:136–145. doi: 10.1007/s00421-004-1220-4.
    1. Juul-Kristensen B, Hilt K, Enoch F, Remvig L, Sjøgaard G. Scapular dyskinesis in trapezius myalgia and intra-examiner reproducibility of clinical tests. Physiotherapy in Theory and Practice'. 2011. in press .
    1. Nielsen PK, Andersen LL, Olsen HB, Rosendal L, Sjogaard G, Sogaard K. Effect of physical training on pain sensitivity and trapezius muscle morphology. Muscle Nerve. 2010;12:836–844. doi: 10.1002/mus.21577.

Source: PubMed

スポンサーと協力者

医学的状態

薬物療法

3
購読する