Differential effects of mental concentration and acute psychosocial stress on cervical muscle activity and posture. Risk factors in the onset of neck/shoulder pain in a prospective study of workers in industrial and service companies Shoulder muscle activity in young and older people during a computer mouse task. Differential effects of mental load on proximal and distal arm muscle activity Effect of two contrasting types of physical exercise on chronic neck muscle pain. Shoulder muscle co-ordination during chronic and acute experimental neck-shoulder pain. An occupational pain study Group-based exercise at workplace: short-term effects of neck and shoulder resistance training in video display unit workers with work-related chronic neck pain—a pilot randomized trial Impact of regular relaxation training and psychosocial working factors on neck-shoulder tension and absenteeism in hospital cleaners. Effects of the Workplace Health Promotion Activities Soccer and Zumba on Muscle Pain, Work Ability and Perceived Physical Exertion among Female Hospital Employees Follow-up of neck and shoulder pain among sewing machine operators: The Los Angeles garment study. Changes in Pain, Disability, and Muscle Activation Patterns in Chronic Whiplash Patients After Ambulant Myofeedback Training Upper trapezius muscle activation patterns in neck–shoulder pain patients and healthy controls Effects of static contraction and cold stimulation on cardiovascular autonomic indices, trapezius blood flow and muscle activity in chronic neck–shoulder pain Are Work Disability Prevention Interventions Effective for the Management of Neck Pain or Upper Extremity Disorders? A Systematic Review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration Influence of Self-Efficacy on Compliance to Workplace Exercise A randomized controlled intervention trial to relieve and prevent neck/shoulder pain. Effect of two contrasting interventions on upper limb chronic pain and disability: a randomized controlled trial. Muscle Tenderness in Pericranial and Neck-Shoulder Region in Children with Headache. A Controlled Study Effects of a workplace physical exercise intervention on the intensity of headache and neck and shoulder symptoms and upper extremity muscular strength of office workers: A cluster randomized controlled cross-over trial The effect of pain reduction on perceived tension and EMG-recorded trapezius muscle activity in workers with shoulder and neck pain. A Tailored Workplace Exercise Program for Women at Risk for Neck and Upper Limb Musculoskeletal Disorders: A Randomized Controlled Trial Effects of physical activity programmes in the workplace (PAPW) on the perception and intensity of musculoskeletal pain experienced by garment workers. Implementation of specific strength training among industrial laboratory technicians: long-term effects on back, neck and upper extremity pain
Physical and psychosocial stressors in the workplace have been independently associated with the development of  neck pain  , yet interactions among these risk factors remain unclear . The purpose of this study was to compare the effects of mentally challenging computer work performed with and without exposure to a psychosocial stressor on cervical muscle activity and posture . Changes in cervical posture and electromyography of upper trapezius , cervical extensor , and sternocleidomastoid muscles were compared between a resting seated posture at baseline , a low stress condition with mental concentration , and a high stress condition with mental concentration and psychosocial stress in sixty healthy office workers .  Forward head posture significantly increased with mental concentration compared to baseline , but did not change with further introduction of the stressor . Muscle activity significantly increased from the low stress to high stress condition for both the dominant and non-dominant upper trapezius , with no corresponding change in activity of the cervical extensors or flexors between stress conditions . These findings suggest that upper trapezius muscles are selectively activated by psychosocial stress independent of changes in concentration or posture , which may have implication s for the prevention of stress-related trapezius myalgia in the workplace Aims : To quantify the relative contribution of work related physical factors , psychosocial workplace factors , and individual factors and aspects of somatisation to the onset of neck/shoulder pain .  Methods : Four year prospect i ve cohort study of workers from industrial and service companies in Denmark . Participants were 3123 workers , previously enrolled in a cross sectional study , where objective measurement of physical workplace factors was used . Eligible participants were followed on three subsequent occasions with approximately one year intervals . Outcomes of interest were : new onset of neck/shoulder pain ( symptom cases ) ; and neck/shoulder pain with pressure tenderness in the muscles of the neck/shoulder region ( clinical cases ) . Results : During follow up , 636 ( 14.1 % ) participants reported neck/shoulder pain of new onset ; among these , 82 ( 1.7 % ) also had clinical signs of substantial muscle tenderness . High shoulder repetition was related to being a future symptom case , and a future clinical case . Repetition was strongly intercorrelated with other physical measures . High job dem and s were associated with future status as a symptom case , and as a clinical case . A high level of distress predicted subsequent neck/shoulder pain , and neck/shoulder pain with pressure tenderness . Conclusions : High levels of distress , and physical and psychosocial workplace factors are predictors of onset of pain in the neck and /or shoulders , particularly pain with pressure tenderness in the muscles OBJECTIVE Assessment of the age effect in relation to computer work . BACKGROUND Increasingly , more older people are using computers , while hardware and software are not design ed with special consideration of their needs . METHODS Eight young and nine older females performed different computer mouse tasks .  Shoulder muscle activity was recorded from the right deltoid muscle , right and left upper trapezius muscle , and the neck extensor muscles . RESULTS Mean trapezius muscle activity was significantly higher in the older people ( 2.8%/3.7 % EMG(max ) for R/L ) compared to the young ( 1.1%/1.2 % EMG(max ) ) . There was a tendency to a higher activity in the older people for the deltoid muscle and the neck extensor muscles . There were small differences in shoulder muscle activation levels between mouse actions , target directions , and between precision dem and s. CONCLUSIONS Shoulder muscle activity during computer work is affected by age , but only to a minor extent by the type of computer mouse task . The deltoid and the trapezius muscle activities are low during computer mouse use when there is efficient forearm support by the table . Relevance An increasing number of people use computers for hours every day . Intensive use of computers increases the risk of development of work-related musculoskeletal symptoms in the shoulder region Work-related upper extremity disorders ( WRUEDs ) that result from keyboarding  tasks are prevalent and costly . Although the precise mechanisms causing the disorder are not yet fully understood , several risk factors have been proposed . These include the repetitive nature of the motor task and the associated sustained static working postures , but also more psychological factors such as mental load . Epidemiological surveys have shown that WRUEDs are more prone to develop in the postural muscles of the neck/shoulder area than in the executive muscles controlling the h and . The present study investigated whether the activation patterns of these two muscle types are differentially affected by an additional mental load during the performance of a repetitive tapping task .  Participants tapped various keying patterns with their dominant index finger at two prescribed tempi . Mental load was manipulated by means of an auditory short-term memory task . We recorded the  EMG activity of two neck/shoulder muscles ( trapezius and deltoid ) , two upper arm muscles ( biceps and triceps ) , and four forearm muscles ( flexor digitorum superficialis , extensor digitorum , extensor carpi radialis longus and extensor carpi ulnaris ) and analyzed the kinematics and impact forces of the index finger . The results confirmed that the upper limb has two functions . Specifically , activity of the executive distal musculature was increased during tapping at the higher pace , while the activity of the postural upper limb musculature was elevated due to the memory task . We argue that continuously increased muscular activity can lead to fatigue and thus eventually cause musculoskeletal complaints . The results are discussed with respect to biomechanical adaptation strategies that deal with the consequences of increased noise in the neuromotor system due to enhanced mental processing OBJECTIVE The prevalence of neck muscle pain has steadily increased and especially pain from the descending part of the trapezius muscle has been associated with monotonous work tasks such as computer work . Physical exercise is generally recommended as treatment , but it is unclear which type of training is most effective . Our objective was to determine the effectiveness of specific strength training of the painful muscle versus general fitness training without direct involvement of the painful muscle ( leg bicycling ) on work-related neck muscle pain . METHODS We conducted a r and omized controlled trial and recruited subjects from 7 workplaces characterized by monotonous jobs ( e.g. , computer-intensive work ) . Forty-eight employed women with chronic neck muscle pain ( defined as a clinical diagnosis of trapezius myalgia ) were r and omly assigned to 10 weeks of specific strength training locally for the affected muscle , general fitness training performed as leg bicycling with relaxed shoulders , or a reference intervention without physical activity . The main outcome measure was an acute and prolonged change in intensity of neck muscle pain ( 100-mm visual analog scale [ VAS ] ) . RESULTS A decrease of 35 mm ( approximately 79 % ; P<0.001 ) in the worst VAS pain score over a 10-week period was seen with specific strength training , whereas an acute and transient decrease in pain ( 5 mm ; P<0.05 ) was found with general fitness training . CONCLUSION Specific strength training had high clinical relevance and led to marked prolonged relief in neck muscle pain .  General fitness training showed only a small yet statistically significant acute pain reduction Abstract Little is known about the mechanisms leading to chronic neck-shoulder musculoskeletal disorders  ( MSD ) . The aim of the present study was to investigate and compare motor function during controlled , low load , repetitive work together with chronic or acute experimental neck-shoulder pain . The clinical study was performed on workers with ( n = 12 ) and without ( n = 6 ) chronic neck-shoulder pain . In the experimental study , experimental muscle pain was induced in healthy subjects by intra-muscular injection of hypertonic saline into the trapezius muscle ( n = 10 ) . The assessed parameters related to motor performance were : work task event duration , cutting forces , surface electromyogram ( EMG ) activity in four shoulder muscles , displacement of the centre of pressure , and arm and trunk 3D movements . For controlled cutting force levels , chronic and acute experimental pain provoked a series of changes : a decreased working rhythm and a protective reorganisation of muscle synergy ( experimental study ) , higher EMG frequency contents which may indicate altered motor unit recruitment , and greater postural activity and a tendency towards increased arm and trunk movements . These pain-related changes can play a role in the development of MSD . The present clinical and experimental study demonstrated similar interactions between motor co-ordination and neck-shoulder pain in occupational setting s. We therefore suggest that this experimental model can be used to study mechanisms related to MSD . Information on such modulatory processes may help in the design of new strategies aim ed at reducing the development of MSD Effectiveness of exercise therapy in video display unit ( VDU ) workers with work-related chronic neck pain ( W-RCNP ) is unclear . The aim of the study was to assess the efficacy of group-based neck-shoulder resistance exercises on symptoms and muscular function in VDU workers with W-RCNP . Thirty-five employees with CNP were r and omly assigned to neck-shoulder resistance exercise ( NSRE ) group or to conventional stretching and postural exercise ( SPE ) group . Participants trained 45 min , twice a week for 7 weeks . Primary outcomes were pain intensity ( 0–10 numeric rating scale , NRS ) and pain-related disability ( Vernon Neck Disability Index , NDI ) . Secondary outcomes were cervical active range of motion ( AROM ) , endurance of neck flexors , strength of shoulder abductors , and health-related quality of life ( SF-36 ) . Post-treatment , pain and disability decreased 2.5 and 5 points in NSRE ( p = 0.001 ) and 5 and 8 points in SPE ( p = 0.002 ) , with no significant differences between groups . AROM improved significantly in both groups ; between-group differences were not significant . Neck flexors endurance and shoulder abductors strength improved by 59.6 and 34.2 % ( p = 0.001 ) in the NSRE group and by 27.6 % ( p = 0.009 ) and 2.3 % ( p = 0.002 ) in the SPE group ; between-group differences were significant ( p = 0.016 and p < 0.001 , respectively ) . SF-36 score remained unchanged . NSRE and SPE are feasible and equally effective in reducing pain and pain-related disability as group exercises in W-RCNP . NSRE may provide some advantage in improving strength and endurance in neck muscles . Further , larger studies should confirm these findings and assess whether a better muscle function confers long-term clinical advantages Occupational stress in hospital cleaners ( n = 50 ) , and the effect of relaxation training ( n = 25 , age matched , r and omized ) , were studied by recording the electrical activity of the upper trapezius muscle at rest and during working conditions at the beginning , middle , and end of a 6-month follow-up period . A short ( 15-minute ) relaxation program was practice d daily at the workplace to provide stress management . The amount of sick leave was counted , and the extent of depression and some psychosocial working factors were screened . Intercorrelations were found between the neck-shoulder tension , psychosocial factors , depression , and the absentee rate . The relaxation training  diminished tension in the neck-shoulder region efficiently ; nevertheless , the decrease in absenteeism might have been related mainly to the social support offered by the research maneuver itself Objectives This 40-week workplace physical training RCT investigated the effect of soccer and Zumba , respectively , on muscle pain intensity and duration , work ability , and rating of perceived exertion ( RPE ) during work among female hospital employees . Methods 107 hospital employees were cluster-r and omized into two training groups , and a control group . The training was conducted outside working hours as two-three 1-h sessions per week for the first 12 weeks , and continued as one-two 1-h sessions per week for the last 28 weeks . Muscle pain intensity and duration , work ability , and RPE during work were measured at baseline and after 12 and 40 weeks . Results After 12 weeks , both the soccer ( −1.9 , 95 % CI , −3.0 , −0.8 , P = 0.001 ) and the Zumba group ( −1.3 , 95 % CI , −2.3 , −0.3 , P = 0.01 ) reduced the pain intensity ( on a scale from 0 to 10 ) in the neck-shoulder region ( eta squared = 0.109 ) , whereas only the soccer group ( −1.9 , 95 % CI , −3.2 , −0.7 , P = 0.002 , eta squared = 0.092 ) showed a reduction after 40 weeks referencing the control group . After 40 weeks , both the soccer ( -16.4 days , 95 % CI , −29.6 , −3.2 , P<0.02 ) and the Zumba group ( -16.6 days , 95 % CI , −28.9 , −4.2 , P<0.01 ) reduced the pain duration during the past 3 months in the neck-shoulder region ( eta squared = 0.077 ) . No significant effects on intensity or duration of pain in the lower back , RPE during work or work ability were found . Conclusions The present study indicates that workplace initiated soccer and Zumba training improve neck-shoulder pain intensity as well as duration among female hospital employees . Trial Registration International St and ard R and omized Controlled Trial Number Register IS RCT N 61986892 BACKGROUND The aim of the present study is to explore factors affecting or modifying self-reported neck/shoulder pain in sewing machine operators . METHODS We investigated self-report neck/shoulder pain in 247 workers who participated in a 4-month prospect i ve intervention study for musculoskeletal disorders . All participants were immigrants . We examine the influence of individual and work-related factors on changes in neck/shoulder pain during follow-up employing linear mixed models with time-spline functions . RESULTS We observed a dramatic decline ( 72 % ) in self-reported pain intensity in the first month of follow-up , followed by a small increase from the first to fourth month ( 4 % per month ) . Workers who perceived and reported their physical workload as high or worked overtime experienced less overall pain reduction . Higher baseline pain intensity , being of Hispanic ethnicity ( vs. Asian ) , and taking cumulative daily rest time during work of 35 min or more allowing for muscles to rest were associated with a larger pain reduction in the first month , but not thereafter . CONCLUSION Our findings indicate that some work-related factors may be of clinical relevance for reducing neck/shoulder pain . Having lower physical workloads and less overtime work should be considered when treating patients or planning workplace interventions for managing work-related musculoskeletal disorders in this underserved immigrant population Objective The aim of this exploratory study was to investigate changes in pain , disability , and muscle activation patterns in patients with chronic whiplash-associated disorder ( WAD ) after 4 weeks of myofeedback training . Methods Eleven WAD patients received ambulatory myofeedback training  , during which upper trapezius muscle activation and relaxation were continuously recorded and processed for 4 weeks . Feedback was provided when muscle relaxation was insufficient . Pain in neck , shoulders , and upper back ( Visual Analogue Scale ) , disability ( Neck Disability Index ) , and muscle activation patterns during rest , typing , and stress tasks ( surface electromyography ) were assessed before and after the 4 weeks of training . Results Pain intensity decreased after 4 weeks of training . Clinical ly relevant changes were found with regard to pain in the neck and upper back region ( 55 % of the patients ) , right shoulder ( 64 % ) , and left shoulder ( 18 % ) . A trend for decreased disability was found which was clinical ly relevant in 36 % of the patients . A remarkable reduction was found in the Neck Disability Index items concerning headache and lifting weights . Overall , muscle activation was lower and muscle relaxation was higher after the training period with the largest differences during rest . Clinical ly relevant changes in surface electromyography parameters were found in a minority of patients . Conclusion Four weeks of ambulant training may be beneficial in reducing pain and disability levels and normalizing muscle activation patterns in chronic WAD patients . A r and omized-controlled study is recommended to further explore the effects of myofeedback training This study aim ed at investigating whether patients with neck – shoulder complaints from different aetiologies ( work-related musculo-skeletal disorders , WMSD ; whiplash associated disorders , WAD ) show comparable muscle activation patterns , characterised by higher activation and lower relaxation levels of the trapezius muscles compared to healthy controls . Twenty healthy controls , 21 WMSD and 20 WAD patients with non-acute neck-shoulder pain were recruited for this cross-sectional study .  Surface electromyography ( sEMG ) recordings were performed at the upper trapezius muscles during reference contractions , st and ardised computer tasks ( typing and unilateral stress task ) , and rest measurements . sEMG was continuously recorded during these measurements .  Outcome measures were root mean square ( RMS ) to study muscle activity , and relative rest time ( RRT ) to study muscle relaxation . Statistical analysis comprised the bootstrap technique and Kruskall – Wallis tests . Results showed no clear evidence for abnormal muscle activation patterns in WMSD and WAD patients compared to healthy controls . However , a tendency was observed for higher RMS levels during the reference contractions and computer tasks in both patient groups compared to healthy controls , and lower RRT levels at the non-dominant side during stress . Both patient groups also showed larger variability in RMS and RRT values . This variability has more often been reported in literature and may suggest the existence of subgroups of pain patients with corresponding different muscle activation patterns not related to aetiology . Future research may focus on identifying these subgroups of patients with neck-shoulder pain The aim of the present study was to investigate reactions in trapezius muscle blood flow ( MBF ) , muscle activity , heart rate variability ( HRV ) and systemic blood pressure ( BP ) to autonomic tests in subjects with chronic neck – shoulder pain and healthy controls . Changes in muscle activity and blood flow due to stress and unfavourable muscle loads are known underlying factors of work-related muscle pain . Aberration of the autonomic nervous system ( ANS ) is considered a possible mechanism . In the present study , participants ( n = 23 Pain , n = 22 Control ) performed autonomic tests which included a resting condition , static h and grip test ( HGT ) at 30 % of maximal voluntary contraction , a cold pressor test ( CPT ) and a deep breathing test ( DBT ) . HRV was analysed in time and frequency domains . MBF and muscle activity were recorded from the upper trapezius muscles using photoplethysmography and electromyography ( EMG ) . The pain group showed reduced low frequency-HRV ( LF ) and SDNN during rest , as well as a blunted BP response and increased LF-HRV during HGT ( ∆systolic 22 mm Hg ; ∆LF(nu ) 27 % ) compared with controls ( ∆systolic 27 ; ∆LF(nu ) 6 % ) . Locally , the pain group had attenuated trapezius MBF in response to HGT ( Pain 122 % Control 140 % ) with elevated trapezius EMG following HGT and during CPT . In conclusion , only HGT showed differences between groups in systemic BP and HRV and alterations in local trapezius MBF and EMG in the pain group . Findings support the hypothesis of ANS involvement at systemic and local levels in chronic neck – shoulder pain Abstract Purpose We conducted a systematic review to critically appraise and synthesize literature on the effectiveness of work disability prevention ( WDP ) interventions in workers with neck pain , whiplash-associated disorders ( WAD ) , or upper extremity disorders . Methods We search ed electronic data bases from 1990 to 2012 . R and om pairs of independent review ers critically appraised eligible studies using the Scottish Intercollegiate Guidelines Network criteria . Scientifically admissible studies were summarized and synthesized following best- evidence synthesis methodology . Results Of the 6,359 articles retrieved , 16 r and omized controlled trials were eligible for critical appraisal and five were admissible . We found that a return-to-work coordination program ( including workplace-based work hardening ) was superior to clinic-based work hardening for persistent rotator cuff tendinitis . Workplace high-intensity strength training and workplace advice had similar outcomes for neck and shoulder pain . Mensendieck/Cesar postural exercises and strength and fitness exercises had similar outcomes for non-specific work-related upper limb complaints . Adding a brief job stress education program to a workplace ergonomic intervention was not beneficial for persistent upper extremity symptoms . Adding computer-prompted work breaks to ergonomic adjustments and workplace education benefited workers ’ recovery from recent work-related neck and upper extremity complaints . Conclusions At present , no firm conclusions can be drawn regarding the effectiveness of WDP interventions for managing neck pain , WAD , and upper extremity disorders . Our review suggests a return-to-work coordination program is more effective than clinic-based work hardening . Also , adding computer-prompted breaks to ergonomic and workplace interventions benefits workers ’ recovery . The current quality of evidence does not allow for a definitive evaluation of the effectiveness of ergonomic interventions Background Continuous neck and shoulder pain is a common musculoskeletal complaint . Physical exercise can reduce pain symptoms , but compliance to exercise is a challenge . Exercise-specific self-efficacy has been found to be a predictor of participation in preplanned exercise . Little is known about the influence of exercise-specific self-efficacy on compliance to workplace physical exercise . Purpose To determine the influence of exercise-specific self-efficacy on compliance to specific strength exercises during working hours for laboratory technicians . Methods We performed a cluster-r and omized controlled trial , including laboratory technicians from two industrial production units in Copenhagen , Denmark . The participants were r and omized to supervised specific strength exercises for the neck and shoulder muscles  for 20 minutes three times a week ( n = 282 ) or to a reference group ( n = 255 ) . The participants answered baseline and follow-up questions regarding self-efficacy and registered all exercises in a diary . Results Overall compliance to exercises was 45 % . Compliance in company A ( private sector ) differed significantly between the three self-efficacy groups after 20 weeks . The odds ratio of compliance was 2.37 for moderate versus low self-efficacy , and 2.93 for high versus low self-efficacy . No significant difference was found in company B ( public sector ) or in the intervention group as a whole . Conclusion We did not find self-efficacy to be a general statistically significant predictor of compliance to exercises during 20 weeks , but found self-efficacy to be a predictor of compliance in a private sector setting . Workplace-specific differences might be present and should be taken into account PURPOSE The objective of this study is to investigate the effect of three different workplace interventions on long-term compliance , muscle strength gains , and neck/shoulder pain in office workers . METHODS A 1-yr r and omized controlled intervention trial was done with three groups :  specific resistance training ( SRT , n = 180 ) , all-round physical exercise ( APE , n = 187 ) , and reference intervention ( REF , n = 182 ) with general health counseling . Physical tests were performed and question naires answered at pre- , mid- , and postintervention . The main outcome measures were compliance , changes in maximal muscle strength , and changes in intensity of neck/shoulder pain ( scale 0 - 9 ) in those with and without pain at baseline . RESULTS Regular participation was achieved by 54 % , 31 % , and 16 % of those of the participants who answered the question naire in SRT ( 78 % ) , APE ( 81 % ) , and REF ( 80 % ) , respectively , during the first half of the intervention period , and decreased to 35 % , 28 % and 9 % , respectively , during the second half . Shoulder elevation strength increased 9 - 11 % in SRT and APE ( P < 0.0001 ) . Participants with neck pain at baseline decreased the intensity of neck pain through SRT , from 5.0 + /- 0.2 to 3.4 + /- 0.2 ( P < 0.0001 ) , and through APE , from 5.0 + /- 0.2 to 3.6 + /- 0.2 ( P < 0.001 ) , whereas REF caused no change . For participants without shoulder pain at baseline , there was a significantly greater increase in pain over the 1-yr period in REF compared with SRT and APE ( P < 0.01 ) . CONCLUSION Compliance was highest in SRT but generally decreased over time . SRT and APE caused increased shoulder elevation strength , were more effective than REF to decrease neck pain among those with symptoms at baseline , and prevent development of shoulder pain in those without symptoms at baseline BACKGROUND Chronic pain and disability of the arm , shoulder , and h and severely affect labor market participation . Ergonomic training and education is the default strategy to reduce physical exposure and thereby prevent aggravation of pain . An alternative strategy could be to increase physical capacity of the worker by physical conditioning . OBJECTIVES To investigate the effect of 2 contrasting interventions , conventional ergonomic training ( usual care ) versus resistance training , on pain and disability in individuals with upper limb chronic pain exposed to highly repetitive and forceful manual work . STUDY DESIGN Examiner-blinded , parallel-group r and omized controlled trial with allocation concealment . SETTING Slaughterhouses located in Denmark , Europe . METHODS Sixty-six adults with chronic pain in the shoulder , elbow/forearm , or h and /wrist and work disability were r and omly allocated to 10 weeks of specific resistance training for the shoulder , arm , and h and muscles for 3 x 10 minutes per week , or ergonomic training and education ( usual care control group ) .  Pain intensity ( average of shoulder , arm , and h and , scale 0 - 10 ) was the primary outcome , and disability ( Work module of DASH question naire ) as well as isometric shoulder and wrist muscle strength were secondary outcomes . RESULTS Pain intensity , disability , and muscle strength improved more following resistance training than usual care ( P < 0.001 , P = 0.05 , P < 0.0001 , respectively [ corrected ] ) . Pain intensity decreased by 1.5 points ( 95 % confidence interval -2.0 to -0.9 ) following resistance training compared with usual care , corresponding to an effect size of 0.91 ( Cohen 's d ) . LIMITATIONS Blinding of participants is not possible in behavioral interventions . However , at baseline outcome expectations of the 2 interventions were similar . CONCLUSION Resistance training at the workplace results in clinical relevant improvements in pain , disability , and muscle strength in adults with upper limb chronic pain exposed to highly repetitive and forceful manual work . TRIAL REGISTRATION NCT01671267 Increased pericranial muscle tenderness is connected with tension-type headache in adults . In children , the importance of muscle tenderness in the pericranial or neck-shoulder region in the pathogenesis of different types of headache is unknown . The present study evaluated muscle tenderness in the pericranial and neck-shoulder region in children with migraine , those with tension-type headache and those without headache . An unselected population -based question naire study concerning headache was carried out in 1135 Finnish schoolchildren aged 12 years . Of them , 183 children were r and omly selected for a face-to-face interview and a clinical examination . Muscle tenderness was recorded by manual palpation and dolorimeter .  Children with migraine had increased overall tenderness , recorded by manual palpation , compared with those without headache . They also self-reported tenderness in the neck-shoulder region during daily activities more often than the children of the other groups . Muscle tenderness was not associated with paediatric tension-type headache . The mean pressure pain thresholds did not differ among the three groups . However , a negative correlation between the total tenderness score and the dolorimeter score was found in each group . In conclusion , children with migraine had increased muscle tenderness at palpation of the pericranial and neck-shoulder muscles and they also reported pain symptoms in the neck-shoulder region most frequently . Instead , increased pericranial and neck-shoulder muscle tenderness was not associated with tension-type headache in children & NA ; The purpose of the study was to examine the effects of a workplace physical exercise intervention on the perceived intensity of headache and the intensity of symptoms in the neck and shoulders , as well as on the extension and flexion strength of the upper extremities . The study was a cluster r and omized controlled trial . The cross‐over design consisted of physical exercise intervention ( 15 weeks ) and no‐intervention ( 15 weeks ) . The subjects ( n=53 ) were office workers ( mean age 46.6 ( SD 8.4 ) ) who reported headache ( n=41 ) symptoms in the neck ( n=37 ) or shoulders ( n=41 ) , which had restricted their daily activities during the last 12 months . Pain symptoms were measured using the Borg CR10 scale and muscular strength with a 5RM test . Statistical analyses were based on linear mixed models . Physical exercise intervention result ed in a slight , but statistically significant , decrease in the intensity of headache and neck symptoms , as well as an increase in the extension strength of the upper extremities . The mean decrease in headache during the 5‐week period was 0.64 CR10 ( 95 % CI 0.28–1.00 ) ( P=0.001 ) or 49 % ( 95 % CI 22–77 ) , and 0.42 CR10 ( 95 % CI 0.11–0.72 ) ( P=0.002 ) or 49 % ( 95 % CI 13–85 ) in the intensity of neck symptoms . The mean increase in the extension strength of the upper extremities was 1.3 kg ( 95 % CI 0.5–2.1 ) ( P=0.001 ) or 4 % ( 95 % CI 1–6 ) . The intervention had no effect on the intensity of shoulder symptoms or the flexion strength of the upper extremities . Specific exercise may be clinical ly important to alleviate headache and neck symptoms The study was initiated to evaluate the effect of pain-reducing therapies on factors previously associated with work-related shoulder and neck pain , namely increased muscle activity in the upper trapezius and perceived general tension . Thirty-three women in three groups were assessed before and after an intervention period and by question naire 6 months later . The purpose of this study was primarily to investigate associations between upper trapezius muscle activity , perceived general tension and pain , and secondly , to compare effects of individually based physiotherapy and group exercise for workers with shoulder and neck myalgia . All three groups reported a significant alleviation of pain and perceived general tension , while the electromyographically ( EMG ) recorded upper trapezius muscle activity level remained unchanged or increased . Improvements were similar in all three treatment groups , but individual-based therapies were rated more beneficial on subjective measures . Significant correlation was found between pain and perceived general tension ( r = 0.66 , p < 0.01 ) , while there was no correlation between pain or perceived general tension and recorded muscle activity Objective : The aim of this study was to evaluate a tailored physical activity protocol performed in a work environment with a group of female workers employed in manual precision tasks to reduce upper limb pain . Methods : Sixty female subjects were r and omly assigned to an intervention group or a control group . The IG was administered of a 6-month , twice-a-week , tailored exercise program , whereas the CG received no intervention . Results : The IG showed a reduction on shoulder pain accompanied by increases on the range of motion measures . In addition , reductions in upper limb pain and neck disability were detected with concomitant increases in grip strength . Conclusions : This study indicated positive effects of a tailored workplace exercise protocol in female workers exposed to moderate risk for work-related musculoskeletal disorders , showing clinical ly meaningful reductions of pain symptoms and disability on upper limb and neck regions OBJECTIVE The physical activity programmes in the workplace ( PAPW ) are applied to minimize the prevalence , incidence and intensity of pain . This study evaluated the perception of pain and quantifies its intensity among garment workers before and after performing a PAPW . PARTICIPANTS We included 61 workers of a clothing company , who were classified r and omly into experimental group ( n = 44 ) 28.7 ± 8.8 years old and a control group ( n = 17 ) 27.8 ± 7.4 years ( 20 - 43 years ) . METHODS The Trigger Points test question naire was used to assess pain perception and quantify its intensity . The PAPW was conducted in 15-minute sessions per day , consisting of stretching exercises ( 40 % ) , muscular endurance ( 40 % ) , self-massage relaxation and massage techniques ( 10 % ) , and group dynamics ( 10 % ) . RESULTS The garment workers who participated in the PAPW showed a significant reduction of pain felt in the neck and wrists , and also a reduction in pain intensity in shoulders , arms , fingers and wrists that are most often strained during sewing . CONCLUSIONS Our findings suggest that PAPW that target muscle groups that are more tense in sewing tasks , may be considered by companies for supporting adaptation to the work environment and improving health by reducing muscle and joint pain Background Previous studies have shown positive effects of physical exercise at the workplace on musculoskeletal disorders . However , long-term adherence remains a challenge . The present study evaluates long-term adherence and effects of a workplace strength training intervention on back , neck and upper extremity pain among laboratory technicians . Methods Cluster-r and omized controlled trial involving 537 industrial laboratory technicians . Subjects were r and omized at the cluster level to one of two groups : training group 1 ( TG1 , n = 282 ) performing supervised strength training from February to June 2009 ( round one ) or training group 2 ( TG2 , n = 255 ) performing supervised strength training from August to December 2009 ( round two ) . The outcome measures were changes in self-reported pain intensity ( 0–9 ) in the back , neck and upper extremity as well as Disability of the Arm , Shoulder and H and ( DASH , 0–100 ) . Results Regular adherence , defined as at least one training session per week , was achieved by around 85 % in both groups in the supervised training periods . In the intention-to-treat analyses there were significant group by time effects for pain in the neck , right shoulder , right h and and lower back and DASH - result ing in significant reductions in pain ( mean 0.3 to 0.5 ) and DASH ( mean 3.9 ) in the scheduled training group compared to the reference group . For TG1 there were no significant changes in pain in round two , i.e. they maintained the pain reduction achieved in round one . Subgroup analyses among those with severe pain ( > = 3 on a scale of 0–9 ) showed a significant group by time effect for pain in the neck , right shoulder , upper back and lower back . For these subgroups the pain reduction in response to training ranged from 1.1 to 1.8 . Conclusions Specific strength training at the workplace can lead to significant long-term reductions in spinal and upper extremity pain and DASH . The pain reductions achieved during the intensive training phase with supervision appears to be maintained a half year later
In subgroup analyses , we found an equal effect of different stressor types ( i.e. cognitive/emotional stress , work pace , and precision ) on muscle activity in both body regions .
In conclusion , simulated workplace stressors result in an increase in neck-shoulder and forearm muscle activity .
No indications were found that different types of stressors affect these body regions differently .
Workplace stressors have been indicated to play a role in the development of neck and upper extremity pain possibly through an increase of sustained ( low-level ) muscle activity .
The aim of this review was to study the effects of workplace stressors on muscle activity in the neck-shoulder and forearm muscles .
An additional aim was to find out whether the muscles of the neck-shoulder and the forearm are affected differently by different types of workplace stressors .