An Ergonomic Training With Exercise Program for Work-related Musculoskeletal Disorders Among Hemodialysis Nurse

Study Overview
=================
Brief Summary
-----------------
This study aimed to examine the effectiveness of the 12-week ergonomic intervention developed by Person-Environment-Occupation (PEO) model in improving musculoskeletal discomfort and muscle strength for hemodialysis nurses. The maintenance effects of the intervention were also evaluated after another 12-week follow-up.

Detailed Description
-----------------
Methods A cluster experimental design was used to conduct this study. Participants were recruited from hemodialysis units at two medical centers in Taiwan and had complaints of work-related musculoskeletal disorders (WMSDs) within the past six months. By PEO model, the 12-week intervention including ergonomic education and exercise program was designed based on the job contents of hemodialysis nurses. In the study period, we used a mobile massager app to reminder them and monitor their implementation of exercises. The outcome indicators were measured before and after intervention as well as the follow-up after another 12 weeks. A generalized estimating equations model was adopted to analyze the repeated measurements.

Official Title
-----------------
Occupational Therapy for Work-related Musculoskeletal Disorders Among Hemodialysis Nurse

Conditions
-----------------
Musculoskeletal Disorders

Intervention / Treatment
-----------------
* Other: ergonomic training


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: 20 to 65 years old, which is the legal age range of adult for work in Taiwan registered nurses to work full time in the hemodialysis unit more than 6 months, having complaint of WMSDs within previous 6 months before this study. Exclusion Criteria: having no musculoskeletal disorder related to the job to care less than 4 patients in 4 hours, which was below the Taiwan workload reference for nurse in hemodialysis job to have any other consideration to keep from 12- week physical exercise program (such as pregnancy, injury, disease, leave…, etc.).

Ages Eligible for Study
-----------------
Minimum Age: 20 Years
Maximum Age: 65 Years

Sexes Eligible for Study
-----------------
Female

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Supportive Care
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Ergonomic training group<br>The ergonomic training group received a 12-week ergonomic training program. | Other: ergonomic training<br>* ergonomic education & exercise training<br>|
| No Intervention: No training group<br>The no training group did not receive any training program. | |

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| severity degree of muscular discomfort | self reported by Nordic Musculoskeletal Questionnaire (0-5 points; the higher score indicates the more discomfort) | week 0 | 
| muscle strength | grip and pinch power; the muscle strength of neck extension, shoulder flexion/extension, and wrist flexion/extension of the dominant (maximal force of the muscles movement against in kilograms, the higher the stronger) | week 0 | 
| severity degree of muscular discomfort | self reported by Nordic Musculoskeletal Questionnaire (0-5 points; the higher score indicates the more discomfort) | week 12 | 
| muscle strength | grip and pinch power; the muscle strength of neck extension, shoulder flexion/extension, and wrist flexion/extension of the dominant (maximal force of the muscles movement against in kilograms, the higher the stronger) | week 12 | 
| severity degree of muscular discomfort | self reported by Nordic Musculoskeletal Questionnaire (0-5 points; the higher score indicates the more discomfort) | week 24 | 
| muscle strength | grip and pinch power; the muscle strength of neck extension, shoulder flexion/extension, and wrist flexion/extension of the dominant (maximal force of the muscles movement against in kilogram, the higher the stronger) | week 24 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Subjective quality of life | World Health Organization Quality of Life, Brief edition, Taiwan version (1-5, higher score for higher quality of life) | week 0 | 
| Subjective quality of life | World Health Organization Quality of Life, Brief edition, Taiwan version (1-5, higher score for higher quality of life) | week 24 |