title: Process evaluation of a participatory ergonomics programme to prevent low back pain and neck pain among workers The Effectiveness of a Web-Based Computer-Tailored Intervention on Workplace Sitting: A Randomized Controlled Trial Effectiveness of a questionnaire based intervention programme on the prevalence of arm, shoulder and neck symptoms, risk factors and sick leave in computer workers: A cluster randomised controlled trial in an occupational setting Supplementary breaks and stretching exercises for data entry operators: a follow-up field study. Stay@Work: Participatory Ergonomics to prevent low back and neck pain among workers: design of a randomised controlled trial to evaluate the (cost-)effectiveness Evaluation of sit-stand workstations in an office setting: a randomised controlled trial Effects on musculoskeletal pain from "Take a Stand!" - a cluster-randomized controlled trial reducing sitting time among office workers. A field study of supplementary rest breaks for data-entry operators Office ergonomics education: a comparison of traditional and participatory methods. Effort-reward imbalance and one-year change in neck-shoulder and upper extremity pain among call center computer operators. Predictors of Persistent Elbow Tendonitis Among Auto Assembly Workers Effectiveness of a feedback signal in a computer mouse on upper extremity musculoskeletal symptoms: a randomised controlled trial with an 8-month follow-up Participatory ergonomics to reduce exposure to psychosocial and physical risk factors for low back pain and neck pain: results of a cluster randomised controlled trial A randomised controlled trial evaluating the effects of two workstation interventions on upper body pain and incident musculoskeletal disorders among computer operators Effects of ergonomic intervention on work-related upper extremity musculoskeletal disorders among computer workers: a randomized controlled trial The economic evaluation of a participatory ergonomics programme to prevent low back and neck pain. A field intervention examining the impact of an office ergonomics training and a highly adjustable chair on visual symptoms in a public sector organization. The effectiveness of sit-stand workstations for changing office workers’ sitting time: results from the Stand@Work randomized controlled trial pilot Effects of participatory ergonomic intervention on the development of upper extremity musculoskeletal disorders and disability in office employees using a computer A randomised controlled trial of postural interventions for prevention of musculoskeletal symptoms among computer users The effectiveness of participatory ergonomics to prevent low-back and neck pain--results of a cluster randomized controlled trial. Office ergonomics training and a sit-stand workstation: effects on musculoskeletal and visual symptoms and performance of office workers. A test of two training interventions to prevent work-related musculoskeletal disorders of the upper extremity. Can a New Behaviorally Oriented Training Process to Improve Lifting Technique Prevent Occupationally Related Back Injuries Due to Lifting? Computer terminal work and the benefit of microbreaks. A controlled trial of an educational program to prevent low back injuries. Effects of an ergonomic training program on workers with video display units. A randomised controlled trial evaluating an alternative mouse and forearm support on upper body discomfort and musculoskeletal disorders among engineers A pilot randomised control trial of the effectiveness of a biofeedback mouse in reducing self-reported pain among office workers Job task and psychosocial risk factors for work-related musculoskeletal disorders among newspaper employees. A Randomized Controlled Trial to Prevent Patient Lift and Transfer Injuries of Health Care Workers The Effect of Alternate Style Keyboards on Severity of Symptoms and Functional Status of Individuals with Work Related Upper Extremity Disorders Breaking up workplace sitting time with intermittent standing bouts improves fatigue and musculoskeletal discomfort in overweight/obese office workers Effects of an active ergonomics training program on risk exposure, worker beliefs, and symptoms in computer users. Effects of ergonomic intervention in work with video display units. Musculoskeletal, visual and psychosocial stress in VDU operators before and after multidisciplinary ergonomic interventions. Effects of Ergorest® Arm Supports on Muscle Strain and Wrist Positions During the Use of the Mouse and Keyboard in Work With Visual Display Units: A Work Site Intervention Alternating bouts of sitting and standing attenuate postprandial glucose responses. Health-related effects of worksite interventions involving physical exercise and reduced workhours. A randomized controlled trial evaluating an alternative mouse or forearm support on change in median and ulnar nerve motor latency at the wrist. A workplace exercise versus health promotion intervention to prevent and reduce the economic and personal burden of non-specific neck pain in office personnel: protocol of a cluster-randomised controlled trial. Multi dimensional system for evaluating preventive program for upper extremity disorders among computer operators.
abstract: Background Both low back pain ( LBP ) and neck pain ( NP ) are major occupational health problems . In the workplace , participatory ergonomics ( PE ) is frequently used on musculoskeletal disorders . However , evidence on the effectiveness of PE to prevent LBP and NP obtained from r and omised controlled trials ( RCTs ) is scarce . This study evaluates the process of the Stay@Work participatory ergonomics programme , including the perceived implementation of the prioritised ergonomic measures . Methods This cluster- RCT was conducted at the departments of four Dutch companies ( a railway transportation company , an airline company , a steel company , and a university including its university medical hospital ) . Directly after the r and omisation outcome , intervention departments formed a working group that followed the steps of PE during a six-hour working group meeting . Guided by an ergonomist , working groups identified and prioritised risk factors for LBP and NP , and composed and prioritised ergonomic measures . Within three months after the meeting , working groups had to implement the prioritised ergonomic measures at their department . Data on various process components ( recruitment , reach , fidelity , satisfaction , and implementation components , i.e. , dose delivered and dose received ) were collected and analysed on two levels : department ( i.e. , working group members from intervention departments ) and participant ( i.e. , workers from intervention departments ) . Results A total of 19 intervention departments ( n = 10 with mental workloads , n = 1 with a light physical workload , n = 4 departments with physical and mental workloads , and n = 4 with heavy physical workloads ) were recruited for participation , and the reach among working group members who participated was high ( 87 % ) . Fidelity and satisfaction towards the PE programme rated by the working group members was good ( 7.3 or higher ) . The same was found for the Stay@Work ergocoach training ( 7.5 or higher ) . In total , 66 ergonomic measures were prioritised by the working groups . Altogether , 34 % of all prioritised ergonomic measures were perceived as implemented ( dose delivered ) , while the workers at the intervention departments perceived 26 % as implemented ( dose received ) . Conclusions PE can be a successful method to develop and to prioritise ergonomic measures to prevent LBP and NP . Despite the positive rating of the PE programme the implementation of the prioritised ergonomic measures was lower than expected . Trial registration Current Controlled Trials IS RCT Background Effective interventions to influence workplace sitting are needed , as office-based workers demonstrate high levels of continued sitting , and sitting too much is associated with adverse health effects . Therefore , we developed a theory-driven , Web-based , interactive , computer-tailored intervention aim ed at reducing and interrupting sitting at work . Objective The objective of our study was to investigate the effects of this intervention on objective ly measured sitting time , st and ing time , and breaks from sitting , as well as self-reported context -specific sitting among Flemish employees in a field-based approach . Methods Employees ( n=213 ) participated in a 3-group r and omized controlled trial that assessed outcomes at baseline , 1-month follow-up , and 3-month follow-up through self-reports . A sub sample ( n=122 ) were willing to wear an activity monitor ( activPAL ) from Monday to Friday . The tailored group received an automated Web-based , computer-tailored intervention including personalized feedback and tips on how to reduce or interrupt workplace sitting . The generic group received an automated Web-based generic advice with tips . The control group was a wait-list control condition , initially receiving no intervention . Intervention effects were tested with repeated- measures multivariate analysis of variance . Results The tailored intervention was successful in decreasing self-reported total workday sitting ( time × group : P<.001 ) , sitting at work ( time × group : P<.001 ) , and leisure time sitting ( time × group : P=.03 ) , and in increasing objective ly measured breaks at work ( time × group : P=.07 ) ; this was not the case in the other conditions . The changes in self-reported total nonworkday sitting , sitting during transport , television viewing , and personal computer use , objective ly measured total sitting time , and sitting and st and ing time at work did not differ between conditions . Conclusions Our results point out the significance of computer tailoring for sedentary behavior and its potential use in public health promotion , as the effects of the tailored condition were superior to the generic and control conditions . Trial Registration Clinical trials.gov NCT02672215 ; http:// clinical trials.gov/ct2/show/NCT02672215 ( Archived by WebCite at http://www.webcitation.org/6glPFBLWv Background Arm , shoulder and neck symptoms are very prevalent among computer workers . In an attempt to reduce these symptoms , a large occupational health service in the Netherl and s developed a preventive programme on exposure to risk factors , prevalence of arm , shoulder and neck symptoms , and sick leave in computer workers . The purpose of this study was to assess the effectiveness of this intervention programme . Methods The study was a r and omised controlled trial . The participants were assigned to either the intervention group or the usual care group by means of cluster r and omisation . At baseline and after 12 months of follow-up , the participants completed the RSI QuickScan question naire on exposure to the risk factors and on the prevalence of arm , shoulder and neck symptoms . A tailor-made intervention programme was proposed to participants with a high risk profile at baseline . Examples of implemented interventions are an individual workstation check , a visit to the occupational health physician and an education programme on the prevention of arm , shoulder and neck symptoms . The primary outcome measure was the prevalence of arm , shoulder and neck symptoms . Secondary outcome measures were the scores on risk factors for arm , shoulder and neck symptoms and the number of days of sick leave . Sick leave data was obtained from the companies . Multilevel analyses were used to test the effectiveness . Results Of the 1,673 persons invited to participate in the study , 1,183 persons ( 71 % ) completed the baseline question naire and 741 persons participated at baseline as well as at 12-month follow-up . At 12-month follow-up , the intervention group showed a significant positive change ( OR = 0.48 ) in receiving information on healthy computer use , as well as a significant positive change regarding risk indicators for work posture and movement , compared to the usual care group . There were no significant differences in changes in the prevalence of arm , shoulder and neck symptoms or sick leave between the intervention and usual care group . Conclusions The effects of the RSI QuickScan intervention programme were small , possibly as a result of difficulties with the implementation process of the proposed interventions . However , some significant positive effects were found as to an increase in receiving education and a decrease in exposure to adverse postures and movements . With regard to symptoms and sick leave , only small and non-significant effects were found . Trial registration Netherl and s National Trial Register BACKGROUND This study exp and ed previous NIOSH-IRS research examining the effects of rest breaks and stretching exercises on symptoms and performance in data -entry workers . METHODS All workers spent 4 weeks with conventional breaks ( two 15 min breaks per day ) and 4 weeks with supplementary breaks ( two 15 min breaks plus four 5 min breaks per day ) . One-half were assigned at r and om to a group instructed to perform brief stretching exercises during breaks . The remainder comprised the " no stretching " ( control ) group . RESULTS 51 workers ( stretch group n = 21 ; no stretch group n = 30 ) completed the study symptom question naires . Discomfort and eyestrain were significantly lower with supplementary breaks , and supplementary breaks attenuated accumulation of discomfort and eyestrain during work sessions . Data -entry speed was significantly faster with supplementary breaks so that work output was maintained , despite replacing 20 min of work time with break time . In the stretch group , workers reported  stretching  during only 25 % of conventional breaks and 39 % of supplementary breaks , and no significant effects of stretching on discomfort or performance were observed . CONCLUSIONS These results provide further converging evidence that supplementary breaks reliably minimize discomfort and eyestrain without impairing productivity . Low compliance in performing stretches prevented valid assessment of stretching effects . Further research on stretching exercises and exercise compliance is warranted Background Low back pain ( LBP ) and neck pain ( NP ) are a major public health problem with considerable costs for individuals , companies and society . Therefore , prevention is imperative . The Stay@Work study investigates the (cost-)effectiveness of Participatory Ergonomics ( PE ) to prevent LBP and NP among workers . Methods In a r and omised controlled trial ( RCT ) , a total of 5,759 workers working at 36 departments of four companies is expected to participate in the study at baseline . The departments consisting of about 150 workers are pre-stratified and r and omised . The control departments receive usual practice and the intervention departments receive PE . Within each intervention department a working group is formed including eight workers , a representative of the management , and an occupational health and safety coordinator . During a one day meeting , the working group follows the steps of PE in which the most important risk factors for LBP and NP , and the most adequate ergonomic measures are identified on the basis of group consensus . The implementation of ergonomic measures at the department is performed by the working group . To improve the implementation process , so-called ' ergocoaches ' are trained . The primary outcome measure is an episode of LBP and NP . Secondary outcome measures are actual use of ergonomic measures , physical workload , psychosocial workload , intensity of pain , general health status , sick leave , and work productivity . The cost-effectiveness analysis is performed from the societal and company perspective . Outcome measures are assessed using question naires at baseline and after 6 and 12 months . Data on the primary outcome as well as on intensity of pain , sick leave , work productivity , and health care costs are collected every 3 months . Discussion Prevention of LBP and NP is beneficial for workers , employers , and society . If the intervention is proven (cost-)effective , the intervention can have a major impact on LBP and NP prevention and , thereby , on work disability prevention . Results are expected in 2010.Trial registration IS RCT Background Excessive sitting time is a risk factor for cardiovascular disease mortality and morbidity independent of physical activity . This aim of this study was to evaluate the impact of a sit-st and workstation on sitting time , and vascular , metabolic and musculoskeletal outcomes in office workers , and to investigate workstation acceptability and feasibility . Methods A two-arm , parallel-group , individually r and omised controlled trial was conducted in one organisation . Participants were asymptomatic full-time office workers aged ≥18 years . Each participant in the intervention arm had a sit-st and workstation installed on their workplace desk for 8 weeks . Participants in the control arm received no intervention . The primary outcome was workplace sitting time , assessed at 0 , 4 and 8 weeks by an ecological momentary assessment diary . Secondary behavioural , cardiometabolic and musculoskeletal outcomes were assessed . Acceptability and feasibility were assessed via question naire and interview . ANCOVA and magnitude-based inferences examined intervention effects relative to controls at 4 and 8 weeks . Participants and research ers were not blind to group allocation . Results Forty-seven participants were r and omised ( intervention n = 26 ; control n = 21 ) . Relative to the control group at 8 weeks , the intervention group had a beneficial decrease in sitting time ( −80.2 min/8-h workday ( 95 % CI = −129.0 , −31.4 ) ; p = 0.002 ) , increase in st and ing time ( 72.9 min/8-h workday ( 21.2 , 124.6 ) ; p = 0.007 ) and decrease in total cholesterol ( −0.40 mmol/L ( −0.79 , −0.003 ) ; p = 0.049 ) . No harmful changes in musculoskeletal discomfort/pain were observed relative to controls , and beneficial changes in flow-mediated dilation and diastolic blood pressure were observed . Most participants self-reported that the workstation was easy to use and their work-related productivity did not decrease when using the device . Factors that negatively influenced workstation use were workstation design , the social environment , work tasks and habits . ConclusionS hort-term use of a feasible sit-st and workstation reduced daily sitting time and led to beneficial improvements in cardiometabolic risk parameters in asymptomatic office workers . These findings imply that if the observed use of the sit-st and workstations continued over a longer duration , sit-st and workstations may have important ramifications for the prevention and reduction of cardiometabolic risk in a large proportion of the working population .Trial registration Clinical Trials.gov NCT02496507 Objectives Prolonged sitting at work has been found to increase risk for musculoskeletal pain . The office-based intervention " Take a St and ! " was effective in reducing sitting time at work . We aim ed to study the effect of the intervention on a secondary outcome : musculoskeletal pain . Methods Take a St and ! included 19 offices ( 317 workers ) at four workplaces cluster r and omized to intervention or control . The multicomponent intervention lasted three months and included management support , environmental changes , and local adaptation . Control participants behaved as usual . Musculoskeletal pain was measured by self-report question naire assessing pain in neck-shoulders , back and extremities in three categories at baseline , and one and three months follow-up . Results At one month , there was no difference in odds ratio ( OR ) for pain in neck-shoulders between the two groups . However , after three months , the OR was 0.52 [ 95 % confidence interval ( 95 % CI ) 0.30 - 0.92 ] for pain in neck-shoulders in the intervention compared to the control group . No differences were found between the intervention and control group for pain in back and extremities over the three months . For total pain score a slight reduction was found in the intervention compared to the control group at one and three months [ -0.13 ( 95 % CI -0.23- -0.03 ) and -0.17 ( 95 % CI -0.32- -0.01 ) ] . Conclusions The secondary analyses showed that the office-based intervention Take a St and ! reduced neck-shoulder pain after three months and total pain score after one and three months among office workers , but not neck-shoulder pain after one month or pain in the back and extremities This study examined the effects of supplementary rest breaks on musculoskeletal discomfort , eyestrain , mood , and performance in data -entry workers . Two rest break schedules were compared in a within-subjects design . Workers alternated between a ‘ conventional ’ and a ‘ supplementary ’ schedule in 4-week intervals . The conventional schedule contained a 15-min break during the first half of the work shift and a 15-min break during the second half of the shift . The supplementary schedule contained the same two 15-min breaks , and a 5-min break during each hour which otherwise did not contain a break , for a total of 20 extra minutes of break time . Results are based on data from 42 workers . They indicated that discomfort in several areas of the body , and eyestrain , were significantly lower under the supplementary than under the conventional schedule . While symptoms increased from pre- to post-work periods under both schedules , the magnitude of the increases was significantly less under the supplementary schedule . In addition , increases in discomfort of the right forearm , wrist and h and over the course of the work week under the conventional schedule were eliminated under the supplementary schedule . These beneficial effects were obtained without reductions in data -entry performance Health and safety literature stresses the value of programs aim ed at preventing musculoskeletal injuries . The concepts of empowerment learning are often recommended as guidelines for worker education yet these approaches are largely untested . The present study compares the traditional approach involving lecture and discussion with a participatory method .  A sample of 102 participants employed at a central ized reservation facility was used . Participants were r and omly assigned to either the  traditional education group or  the participatory education group . Data collection utilized surveys completed by study participants and observational checklists completed by a trained observer . Data were collected prior to intervention and at approximately 3 , 6 , and 12 months post intervention . Results of data analysis provide no evidence that participatory methods are more effective than traditional methods in encouraging workers to position their work equipment correctly or to maintain good working postures to prevent musculoskeletal injuries OBJECTIVE The literature on psychosocial job factors and musculoskeletal pain is inconclusive in part due to insufficient control for confounding by biomechanical factors . The aim of this study was to investigate prospect ively the independent effects of effort-reward imbalance ( ERI ) at work on regional musculoskeletal pain of the neck and upper extremities of call center operators after controlling for ( i ) duration of computer use both at work and at home , ( ii ) ergonomic workstation design , ( iii ) physical activities during leisure time , and ( iv ) other individual worker characteristics . METHODS This was a one-year prospect i ve study among 165 call center operators who participated in a r and omized ergonomic intervention trial that has been described previously . Over an approximate four-week period , we measured ERI and 28 potential confounders via a question naire at baseline . Regional upper-body pain and computer use was measured by weekly surveys for up to 12 months following the implementation of ergonomic interventions .  Regional pain change scores were calculated as the difference between average weekly pain scores pre- and post intervention . RESULTS A significant relationship was found between high average ERI ratios and one-year increases in right upper-extremity pain after adjustment for pre-intervention regional mean pain score , current and past physical workload , ergonomic workstation design , and anthropometric , sociodemographic , and behavioral risk factors . No significant associations were found with change in neck-shoulder or left upper-extremity pain . CONCLUSIONS This study suggests that ERI predicts regional upper-extremity pain in -computer operators working > or=20 hours per week . Control for physical workload and ergonomic workstation design was essential for identifying ERI as a risk factor Introduction : Lateral and medial epicondylitis associated with work activity is a common upper extremity musculoskeletal disorder with a prevalence of 4–30 % depending upon the work setting and diagnostic criteria . The influence of treatment , ergonomic factors , medical history , psychosocial variables , and aging on the improvement of symptoms has not been well defined . Methods : This was a prospect i ve cohort study of a cohort of 45 workers with active elbow tendonitis for an average of 13 months .  Complete resolution of symptoms was the defined outcome measure . Results : The predictive factors for persistent elbow tendonitis included older age ( OR = 1.1 , 95 % CI : 0.99 , 1.33 ) , higher h and repetition level for their job(s ) ( OR = 2.5 , 95 % CI : 1.00 , 6.25 ) , more deviation from a neutral wrist position during the work activity ( OR = 2.0 , 95 % CI : 0.80 , 5.56 ) , and lower perceived decision authority on the job ( OR = 0.9 , 95 % CI : 0.79 , 0.98 ) . Other ergonomic , psychosocial , and electrophysiologic measures were not predictive . The models had relatively high sensitivity and specificity . Treatment effects could not be evaluated due to incomplete data available . Conclusions : Older workers with jobs requiring more repetition and awkward wrist postures , and less decision authority were less likely to have resolution of their elbow tendonitis . Implication s : Workers at highest risk for persistent elbow tendonitis should be placed at jobs with lower repetition levels and that use more neutral wrist postures . Effective interventions must address both the ergonomic and psychosocial risk factors in a multifaceted approach to this problem Objectives : To study the effectiveness of using a computer mouse with a feedback signal for upper extremity musculoskeletal symptoms in office workers . Methods : A r and omised controlled trial with 8 months of follow-up was carried out . The intervention consisted of a computer mouse with a feedback signal . In total , 354 subjects were allocated to the intervention group or the  control group . Measurements were performed with electronic question naires at baseline , after 4 months and after 8 months . Outcome variables were the prevalence and incidence of upper extremity musculoskeletal symptoms and disability in the upper extremities . The intervention process was evaluated by software registration . Results : The use of the mouse with a feedback signal result ed in a significant decrease in duration of mouse usage over time . No differences were found in the number of mouse usage rest breaks . No differences were found in the prevalence ( p = 0.29 ) or incidence ( p = 0.832 ) of upper extremity musculoskeletal symptoms between the groups 8 months after baseline . The prevalence decreased from 49 % at baseline to 44 % after 8 months in the control group , while it remained at 36 % in the intervention group . The incidence was 21 % in the control group and 22 % in the intervention group . Among the population with upper extremity musculoskeletal symptoms at baseline , the risk of experiencing symptoms after 8 months did not differ between the groups ( p = 0.49 ) . Minor disability was found in both groups . In the intervention group , a lower level of physical disability over time was reported than in the control group ( p = 0.02 ) . Conclusions : A feedback signal computer mouse does not affect the prevalence and incidence of upper extremity musculoskeletal symptoms , but it does lower disability scores . Given the high prevalence , study ing preventive interventions for upper extremity musculoskeletal symptoms is of high importance . Trial registration number : IS RCT N13222474 Objectives This study investigated the effectiveness of the Stay@Work participatory ergonomics programme to reduce workers′ exposure to psychosocial and physical risk factors . Methods 37 departments ( n=3047 workers ) from four Dutch companies participated in this cluster r and omised controlled trial ; 19 ( n=1472 workers ) were r and omised to an intervention group ( participatory ergonomics ) and 18 ( n=1575 workers ) to a  control group ( no participatory ergonomics ) . During a 6 h meeting guided by an ergonomist , working groups devised ergonomic measures to reduce psychosocial and physical workload and implemented them within 3 months in their departments . Data on psychosocial and physical risk factors for low back pain and neck pain were collected at baseline and after 6 months . Psychosocial risk factors were measured using the Job Content Question naire and physical risk factors using the Dutch Musculoskeletal Question naire . Intervention effects were studied using multilevel analysis . Results Intervention group workers significantly increased on decision latitude ( 0.29 points ; 95 % CI 0.07 to 0.52 ) and decision authority ( 0.16 points ; 95 % CI 0.04 to 0.28 ) compared to control workers . However , exposure to awkward trunk working postures significantly increased in the intervention group ( OR 1.86 ; 95 % CI 1.15 to 3.01 ) compared to the control group . No significant differences between the intervention and control group were found for the remaining risk factors . After 6 months , loss to follow-up was 35 % in the intervention group and 29 % in the control group . Conclusion Participatory ergonomics was not effective in reducing exposure to psychosocial and physical risk factors for low back pain and neck pain among a large group of workers . Trial registration IS RCT N27472278 Background : Call centre work with computers is associated with increased rates of upper body pain and musculoskeletal disorders . Methods : This one year , r and omised controlled intervention trial evaluated the effects of a wide forearm support surface and a trackball on upper body pain severity and incident musculoskeletal disorders among 182 call centre operators at a large healthcare company . Participants were r and omised to receive ( 1  ) ergonomics training only , ( 2 ) training plus a trackball , ( 3 ) training plus a forearm support , or ( 4 ) training plus a trackball and forearm support . Outcome measures were weekly pain severity scores and diagnosis of incident musculoskeletal disorder in the upper extremities or the neck/shoulder region based on physical examination performed by a physician blinded to intervention . Analyses using Cox proportional hazard models and linear regression models adjusted for demographic factors , baseline pain levels , and psychosocial job factors . Results : Post-intervention , 63 participants were diagnosed with one or more incident musculoskeletal disorders  . Hazard rate ratios showed a protective effect of the armboard for neck/shoulder disorders ( HR = 0.49 , 95 % CI 0.24 to 0.97 ) after adjusting for baseline pain levels and demographic and psychosocial factors . The armboard also significantly reduced neck/shoulder pain ( p = 0.01 ) and right upper extremity pain ( p = 0.002 ) in comparison to the control group . A return-on-investment model predicted a full return of armboard and installation costs within 10.6 months . Conclusion : Providing a large forearm support combined with ergonomic training is an effective intervention to prevent upper body musculoskeletal disorders and reduce upper body pain associated with computer work among call centre employees Purpose The aim of the study was to determine effects of ergonomic intervention on work-related upper extremity musculoskeletal disorders ( WUEMSDs )  among computer workers . Methods Four hundred computer workers answered a question naire on work-related upper extremity musculoskeletal symptoms ( WUEMSS ) . Ninety-four subjects with WUEMSS using computers at least 3 h a day participated in a prospect i ve , r and omized controlled 6-month intervention . Body posture and workstation layouts were assessed by the Ergonomic Question naire . We used the Visual Analogue Scale to assess the intensity of WUEMSS . The Upper Extremity Function Scale was used to evaluate functional limitations at the neck and upper extremities . Health-related quality of life was assessed with the Short Form-36 . After baseline assessment , those in the intervention group participated in a multicomponent ergonomic intervention program including a comprehensive ergonomic training consisting of two interactive sessions , an ergonomic training brochure , and workplace visits with workstation adjustments . Follow-up assessment was conducted after 6 months . Results In the intervention group , body posture ( p < 0.001 ) and workstation layout ( p = 0.002 ) improved over 6 months ; furthermore , intensity ( p < 0.001 ) , duration ( p < 0.001 ) , and frequency ( p = 0.009 ) of WUEMSS decreased significantly in the intervention group compared with the control group . Additionally , the functional status ( p = 0.001 ) , and physical ( p < 0.001 ) , and mental ( p = 0.035 ) health-related quality of life improved significantly compared with the controls . There was no improvement of work day loss due to WUEMSS ( p > 0.05 ) . Conclusions Ergonomic intervention programs may be effective in reducing ergonomic risk factors among computer workers and consequently in the secondary prevention of WUEMSDs This study was an economic evaluation conducted alongside a cluster r and omised controlled trial with a follow-up of 12 months . The aim was to evaluate the cost-effectiveness and cost-benefit of the Stay@Work Participatory Ergonomics programme ( PE ) compared to a control group ( no PE ) . In total , 37 departments ( n=3047 workers ) were r and omised into either the intervention ( PE ) or control group ( no PE ) . During a meeting , working groups followed the steps of PE , and composed and prioritized ergonomic measures aim ed to prevent low back pain ( LBP ) and neck pain ( NP ) . Working groups had to implement the ergonomic measures within three months in their department . Cost data included those directly related to LBP and NP . Cost-effectiveness analyses ( CEA ) and cost-benefit analyses ( CBA ) were performed . After 12 months , health care costs and costs of productivity losses were higher in the intervention group than in the control group ( the mean total cost difference was $ /euro$127 ; 95 % CI $ /euro$-164 - $ /euro$418 ) . From a societal perspective , the CEA showed that PE was not cost-effective compared to control for LBP and NP prevalence , work performance , and sick leave . The CBA from a company perspective showed a monetary loss of $ /euro$78 per worker . The PE programme was neither cost-effective nor cost-beneficial on any of the effect measures OBJECTIVE Examine the effect of a multi-component office ergonomics intervention on visual symptom reductions . METHODS Office workers were assigned to either a group receiving a  highly adjustable chair with office ergonomics training ( CWT ) , a training-only group ( TO ) or a control group ( C ) . A work environment and health question naire was administered 2 and 1 month(s ) pre-intervention and 3 , 6 , and 12 months post-intervention . Multi-level statistical models tested hypotheses . RESULTS The CWT intervention lowered daily visual symptoms ( p < 0.01 ) post-intervention . The TO group did not significantly differ from the control group . The CWT group differed significantly from the TO group ( p = 0.01 ) post-intervention . CONCLUSION Workers who received a highly adjustable chair and office ergonomics training  had reduced visual symptoms and the effect was maintained through twelve months post-intervention . The lack of a training-only group effect supports implementing training in conjunction with the highly adjustable chair to reduce visual symptoms Background Prolonged sitting time is detrimental for health . Individuals with desk-based occupations tend to sit a great deal and sit-st and workstations have been identified as a potential strategy to reduce sitting time . Hence , the objective of the current study was to examine the effects of using sit-st and workstations on office workers ’ sitting time at work and over the whole day . Methods We conducted a r and omized controlled trial pilot with crossover design and waiting list control in Sydney , Australia from September 2011 to July 2012 ( n = 42 ; 86 % female ; mean age 38 ± 11 years ) . Participants used a sit-st and workstation for four weeks in the intervention condition . In the time-matched control condition , participants received nothing and crossed over to the intervention condition after four weeks . The primary outcomes , sitting , st and ing and walking time at work , were assessed before and after using the workstations with ActivPALs and self-report question naires . Secondary outcomes , domain-specific sitting over the whole day , were assessed by self-report . Linear mixed models estimated changes in outcomes adjusting for measurement time , study grouping and covariates . Results Intervention participants significantly reduced objective ly assessed time spent sitting at work by 73 min/workday ( 95 % CI : -106,-39 ) and increased st and ing time at work by 65 min/workday ( 95 % CI : 47 , 83 ) ; these changes were significant relative to controls ( p = 0.004 and p < 0.001 , respectively ) . Total sitting time significantly declined in intervention participants ( -80 min/workday ; 95 % CI : -155 , -4 ) . Conclusions This study shows that introducing sit-st and workstations in the office can reduce desk-based workers ’ sitting time at work in the short term . Larger scale studies on more representative sample s are needed to determine the public health impact of sit-st and workstations . Trial registration Objective : To evaluate the participatory ergonomic method on the development of upper extremity musculoskeletal disorders and disability in office employees . Methods : This study is a r and omized controlled intervention study . It comprised 116 office workers using computers . Those in the intervention group were taught office ergonomics and the risk assessment method . Cox proportional hazards model and generalized estimating equations ( GEEs ) were used . Results : In the 10-month postintervention follow-up , the possibility of developing symptoms was 50.9 % . According to multivariate analysis results , the possibility of developing symptoms on the right side of the neck and in the right wrist and h and was significantly less in the intervention group than in the control group ( p<0.05 ) . Neck disability/symptom scores over time were significantly lower in the intervention group compared with the control group ( p<0.05 ) . Conclusion : The participatory ergonomic intervention decreases the possibility of musculoskeletal complaints and disability/symptom level in office workers Aims : To examine the effect of two workstation and postural interventions on the incidence of  musculoskeletal symptoms among computer users . Methods : R and omised controlled trial of two distinct workstation and postural interventions ( an alternate intervention and a conventional intervention ) among 376 persons using computer keyboards for more than 15 hours per week . The incidence of neck/shoulder symptoms and h and /arm symptoms during six months of follow up among individuals in the intervention groups was compared to the incidence in computer users who did not receive an intervention ( comparison group ) . For individuals in the intervention groups , study staff adjusted workstations , where possible , and trained individuals to assume the intervention postures . Individuals reported musculoskeletal symptoms in a weekly diary . Participants who reported discomfort intensity of 6 or greater on a 0–10 visual analogue scale or who reported musculoskeletal symptoms requiring use of analgesic medication were considered symptomatic . Results : There were no significant differences in the incidence of musculoskeletal symptoms among the three intervention groups . Twenty two ( 18.5 % ) participants in the alternate intervention group , 25 ( 20.2 % ) in the conventional intervention group , and 25 ( 21.7 % ) in the comparison group developed incident arm or h and symptoms . Thirty eight ( 33.3 % ) participants in the alternate intervention group , 36 ( 31.0 % ) in the conventional intervention group , and 33 ( 30.3 % ) in the comparison group developed incident neck or shoulder symptoms . Compliance with all components of the intervention was attained for only 25–38 % of individuals , due mainly to the inflexibility of workstation configurations . Conclusions : This study provides evidence that two specific workplace postural interventions are unlikely to reduce the risk of upper extremity musculoskeletal symptoms among computer users OBJECTIVE The aim of this r and omized controlled trial ( RCT ) was to investigate the effectiveness of the Stay@Work participatory ergonomics ( PE ) program to prevent low-back and neck pain . METHODS A total of 37 departments were r and omly allocated to either the  intervention ( PE ) or control group ( no PE ) . During a six-hour meeting , working groups followed the PE steps and composed and prioritized ergonomic measures aim ed at preventing low-back and neck pain . Subsequently , working groups were requested to implement the ergonomic measures in the departments . The primary outcomes were low-back and neck pain prevalence and secondary outcomes were pain intensity and duration . Data were collected by question naires at baseline , and after 3- , 6- , 9- , and 12-months follow-up . Additionally , the course of low-back and neck pain ( transitions from no symptoms to symptoms and from symptoms to no symptoms ) was modeled . RESULTS The r and omization procedure result ed in 19 intervention departments ( N=1472 workers ) and 18 control departments ( N=1575 workers ) . After 12 months , the intervention was not more effective than the control group in reducing the prevalence of low-back and neck pain or reducing pain intensity and duration .  PE did not increase the probability of preventing low-back pain [ odds ratio ( OR ) 1.23 , 95 % confidence interval ( 95 % CI ) 0.97 - 1.57 ) or neck pain ( OR 1.01 , 95 % CI 0.74 - 1.40 ) . However , PE increased the probability of recovering from low-back pain ( OR 1.41 , 95 % CI 1.01 - 1.96 ) , but not from neck pain ( OR 0.95 , 95 % CI 0.72 - 1.26 ) . CONCLUSION PE neither reduced low-back and neck pain prevalence nor pain intensity and duration nor was it effective in the prevention of low-back and neck pain or the recovery from neck pain . However , PE was more effective in the recovery from low-back pain Work Related Musculoskeletal Disorders ( WMSDs ) among office workers with intensive computer use is widespread and the prevalence of symptoms is growing . This r and omized controlled trial investigated the effects of an office ergonomics training combined with a sit-st and workstation on musculoskeletal and visual discomfort , behaviors and performance .  Participants performed a lab-based customer service job for 8 h per day , over 15 days and were assigned to :  Ergonomics Trained ( n = 11 ) or Minimally Trained ( n = 11 ) . The training consisted of : a 1.5-h interactive instruction , a sit/st and practice period , and ergonomic reminders . Ergonomics Trained participants experienced minimal musculoskeletal and visual discomfort across the 15 days , varied their postures , with significantly higher performance compared to the Minimally Trained group who had a significantly higher number of symptoms , suggesting that training plays a critical role . The ability to mitigate symptoms , change behaviors and enhance performance through training combined with a sit-st and workstation has implication s for preventing discomforts in office workers We investigated , on behalf of a large electronics manufacturer , two types of worker training interventions  for their efficacy in preventing unnecessary muscle tension and the symptoms of work-related musculoskeletal disorders . The first intervention , Muscle Learning Therapy ( MLT ) , used electromyographic ( sEMG ) feedback and operant conditioning to decrease muscle tension during complex work tasks . The second intervention used adult learning and cognitive behavioral techniques in small group discussion to advance the worker 's capabilities for symptom and stress management and problem-solving . Workers were r and omly assigned to a control group or one of the two treatment conditions . Prior to training , baseline data were collected using symptom diaries and sEMG recordings of the trapezius and forearm muscles of the left and right arms . The training interventions were conducted for 6 weeks with reinforcement training provided at 18 and 32 weeks post-baseline . Follow-up data were collected after the initial 6-week training period and at 32 weeks , prior to the reinforcement training . Symptom outcomes demonstrated significant differences at 6 weeks , increasing in severity for the control group and declining modestly for the educational group , with little change for the MLT group . These differences were not maintained at further follow-up . The MLT group was consistently effective in reducing muscle tension in the trapezius areas after 6 and 32 weeks , and was partially effective for the forearms . Further testing is recommended of these training interventions , especially with the inclusion of strategic , periodic reinforcement of the worker 's learning Study Design . A prospect i ve r and omized control trial . Objective . To determine the degree to which a new behavior-based lift training program ( LiftTrainer ™ ; Ascension Technology , Burlington , VT ) could reduce the incidence of  low back disorder in distribution center jobs that require repetitive lifting . Summary of Background Data . Most studies show programs aim ed at training lifting techniques to be ineffective in preventing low back disorders , which may be due to their conceptual rather than behavioral learning approach . Methods . A total of 2144 employees in 19 distribution centers were r and omized into either the LiftTrainer ™ program or a video control group . In the LiftTrainer ™ program , participants were individually trained in up to 5 , 30-minute sessions while instrumented with motion capture sensors to quantify the L5/S1 moments . Twelve months following the initial training , injury data were obtained from company records . Results . Survival analyses ( Kaplan-Meier ) indicated that there was no difference in injury rates between the 2 training groups . Likewise , there was no difference in the turnover rates . However , those with a low ( < 30 Nm ) average twisting moment at the end of the first session experienced a significantly ( P < 0.005 ) lower rate of low back disorder than controls . Conclusions . While overall the LiftTrainer ™ program was not effective , those with twisting moments below 30 Nm reported fewer injuries , suggesting a shift in focus for “ safe ” lifting programs Microbreaks are scheduled rest breaks taken to prevent the onset or progression of cumulative trauma disorders in the computerized workstation environment . The authors examined the benefit of microbreaks by investigating myoelectric signal ( MES ) behavior , perceived discomfort , and worker productivity while individuals performed their usual keying work . Participants were r and omly assigned to one of three experimental groups . Each participant provided data from working sessions where they took no breaks , and from working sessions where they took breaks according to their group assignment : microbreaks at their own discretion ( control ) , microbreaks at 20 min intervals , and microbreaks at 40 min intervals . Four main muscle areas were studied : the cervical extensors , the lumbar erector spinae , the upper trapezius/supraspinatus , and the wrist and finger extensors . The authors have previously shown that when computer workers remained seated at their workstation , the muscles performing sustained postural contractions displayed a cyclic trend in the mean frequency ( MNF ) of the MES ( McLean et al. , J. Electrophysiol . Kinesiol . 10 ( 1 ) ( 2000 ) 33 ) . The data provided evidence ( p < 0.05 ) that all microbreak protocol s were associated with a higher frequency of MNF cycling at the wrist extensors , at the neck when microbreaks were taken by the control and 40 min protocol groups , and at the back when breaks were taken by the 20 and 40 min protocol groups . No significant change in the frequency of MNF cycling was noted at the shoulder . It was determined ( p < 0.05 ) that microbreaks had a positive effect on reducing discomfort in all areas studied during computer terminal work , particularly when breaks were taken at 20 min intervals . Finally , microbreaks showed no evidence of a detrimental effect on worker productivity . The underlying cause of MNF cycling , and its relationship to the development of discomfort or cumulative trauma disorders remains to be determined BACKGROUND Low back injuries are common and costly , accounting for 15 to 25 percent of injuries covered by workers ' compensation and 30 to 40 percent of the payments made under that program . The high costs of injury , the lack of effective treatment . and the evidence that there are behavioral risk factors have led to widespread use of employee education programs that teach safe lifting and h and ling . The effectiveness of those programs , however , has received little rigorous evaluation . METHODS We evaluated an educational program design ed to prevent low back injury in a r and omized , controlled trial involving about 4000 postal workers . The program , similar to that in wide use in so-called back schools , was taught by experienced physical therapists . Work units of workers and supervisors were trained in a two-session back school ( three hours of training ) , followed by three to four reinforcement sessions over the succeeding few years . Injured subjects ( from both the intervention and the control groups ) were r and omized a second time to receive either training or no training after their return to work . RESULTS Physical therapists trained 2534 postal workers and 134 supervisors . Over 5.5 years of follow-up , 360 workers reported low back injuries , for a rate of 21.2 injuries per 1000 worker-years of risk . The median time off from work per injury was 14 days ( range , 0 to 1717 ) ; the median cost was $ 204 ( range , zero to $ 190,380 ) . After their return to work , 75 workers were injured again . Our comparison of the intervention and control groups found that the education program did not reduce the rate of low back injury , the median cost per injury , the time off from work per injury , the rate of related musculoskeletal injuries , or the rate of repeated injury after return to work ; only the subjects ' knowledge of safe behavior was increased by the training . CONCLUSIONS A large-scale , r and omized , controlled trial of an educational program to prevent work-associated low back injury found no long-term benefits associated with training OBJECTIVES This study evaluated the effect of an ergonomic training program on workstation changes and on the prevalence of  musculoskeletal disorders among video display unit ( VDU ) users at a large university . METHODS A pretest-posttest design with a reference group was used with r and om allocation of administrative and geographic units . In each group , the measurements involved direct observation of the workstations , a self-administered question naire , and a physical examination . The measurements were performed 2 weeks before and 6 months after the training in parallel in both groups . The study population was composed of 627 workers ( 81 % of those eligible ) . RESULTS The prevalence of all 3 of the postural stressors evaluated decreased in the experimental group after the training . In the reference group , 2 of the 3 stressors decreased in frequency but to a less extent . Some of these beneficial changes were more frequent in workers under 40 years of age . The prevalence of musculoskeletal disorders decreased among the workers under 40 years of age in the experimental group , from 29 % to 13 % determined by question naire and from 19 % to 3 % determined by physical examination . In other groups , there was no significant change in the prevalence of musculoskeletal disorders . CONCLUSIONS Improvements in postural stressors occurred more frequently in the experimental group , and these beneficial changes tended to be more frequent in workers under 40 years of age . Improvements in musculoskeletal disorders occurred in the experimental group among the workers under 40 years of age Objectives : The aim of this intervention study was to determine the effects of an alternative mouse and /or a forearm support board on the change in upper body discomfort scores and the development of incident musculoskeletal disorders . Methods : This r and omised controlled intervention trial followed 206 engineers for one year . Participants were r and omised to receive ( 1 ) a conventional mouse only , ( 2 ) an alternative mouse only , ( 3 ) a forearm support board , or ( 4 ) an alternative mouse plus forearm support board . Outcome measures included weekly upper body discomfort scores and incident musculoskeletal disorders . Results : During the study , 42 participants were diagnosed with an incident musculoskeletal disorder . The group that received the forearm support board experienced a reduction in their right upper extremity discomfort ( beta-coefficient −0.35 , 95 % CI −0.67 to −0.03 ) in comparison to those who did not receive a forearm board . The group that received the alternative mouse had a protective , but non-significant ( p = 0.20 ) , effect on incident cases of right upper extremity musculoskeletal disorders ( HR 0.57 , 95 % CI 0.24 to 1.34 ) and a non-significant reduction in neck/shoulder discomfort ( beta-coefficient −0.23 , 95 % CI −0.056 to 0.10 ) in comparison to those who received a conventional mouse . Conclusions : In engineers who use a computer for more than 20 h per week , a forearm support board may reduce right upper extremity discomfort attributed to computer use A pilot study examined the effectiveness of a biofeedback mouse in reducing  upper extremity pain and discomfort in office workers ; in addition , relative mouse use ( RMU ) , satisfaction and the feasibility of running a r and omised controlled trial ( RCT ) in a workplace setting were evaluated . The mouse would gently vibrate if the h and was idle for more than 12 s. The feedback reminded users to rest the arm in neutral , supported postures . Analysis showed a statistically significant reduction in shoulder pain and discomfort for the intervention group at T2 ( 38.7 % lower than controls ) . Statistically significant differences in RMU time between groups were seen post intervention ( −7 % at T1 and + 15 % at T2 for the intervention group ) . Fifty-five percent of the intervention group was willing to continue using the mouse . It appears feasible to perform an RCT for this type of intervention in a workplace setting . Further study including more participants is suggested . Practitioner Summary : The study findings support the feasibility of conducting r and omised control trials in office setting s to evaluate ergonomics interventions . The intervention result ed in reduced pain and discomfort in the shoulder . The intervention could be a relevant tool in the reduction of upper extremity musculoskeletal disorder . Further research will better explain the study 's preliminary findings OBJECTIVES A cross-sectional study was conducted to assess the association of upper extremity musculoskeletal disorders and work-related factors among employees using video display terminals at a large metropolitan newspaper . METHODS The study included 1050 r and omly selected workers from four departments . The workers were asked to complete question naires on symptoms , job tasks , and psychosocial and work organization conditions . Musculoskeletal disorders of the upper extremities were defined by frequency , duration , and intensity of symptoms not attributable to acute injury . Data were analyzed with the use of logistic regression . RESULTS A total of 973 workers completed the survey . The one-year period prevalence rate for any musculoskeletal disorder of the upper extremities was 41 % . Neck symptoms ( 26 % ) were the most frequently reported , followed by h and or wrist ( 22 % ) , shoulder ( 17 % ) , and elbow ( 10 % ) symptoms . Greater time working at the video display station was associated with increased h and or wrist symptoms in a dose-response relationship . In addition , variables corresponding to increased work-load dem and s ( eg , increased time working under deadline and increased job pressure ) were associated with increased neck , shoulder , and h and or wrist disorders . Women were more likely to report symptoms in several areas , but this finding may reflect the concentration of women in jobs involving more risk factors . CONCLUSIONS The results suggest a high prevalence of musculoskeletal disorders of the upper extremities among newspaper employees , and they provide additional evidence that increased work load , time pressure , and greater hours of computer use are related to the occurrence of work-related musculoskeletal disorders among these workers , particularly for disorders in the h and or wrist area Study Design . R and omized controlled trial ( RCT ) . Objectives . To compare the effectiveness of training and equipment to reduce musculoskeletal injuries , increase comfort , and reduce physical dem and s on staff performing patient lifts and transfers at a large acute care hospital . Summary of Background Data . Back injury to nursing staff during patient h and ling tasks is a major issue in health care . The value of mechanical assistive devices in reducing injuries to these workers is unclear . Methods . This three-armed RCT consisted of a “ control arm , ” a “ safe lifting ” arm , and a “ no strenuous lifting ” arm .  A medical , surgical , and rehabilitation ward were each r and omly assigned to each arm . Both intervention arms received intensive training in back care , patient assessment , and h and ling techniques . Hence , the “ safe lifting ” arm used improved patient h and ling techniques using manual equipment , whereas the “ no strenuous lifting ” arm aim ed to eliminate manual patient h and ling through use of additional mechanical and other assistive equipment . Results . Frequency of manual patient h and ling tasks was significantly decreased on the “ no strenuous lifting ” arm . Self-perceived work fatigue , back and shoulder pain , safety , and frequency and intensity of physical discomfort associated with patient h and ling tasks were improved on both intervention arms , but staff on the mechanical equipment arm showed greater improvements . Musculoskeletal injury rates were not significantly altered . Conclusions . The “ no strenuous lifting ” program , which combined training with assured availability of mechanical and other assistive patient h and ling equipment , most effectively improved comfort with patient h and ling , decreased staff fatigue , and decreased physical dem and s. The fact that injury rates were not statistically significantly reduced may reflect the less sensitive nature of this indicator compared with the subjective indicators There is evidence that performing job tasks involving repetition , vibration , sustained posture or forceful movement may contribute to symptoms of work related upper extremity disorders . Typing is one such activity ; symptoms that develop as a result of this activity can affect performance of work , self-care and leisure occupations . Studies investigating the impact of ergonomic keyboards on symptom reduction are limited , and little research exists regarding the reduction of key activation force as an intervention . Methods : This r and omized , prospect i ve study used a sample of 68 symptomatic workers employed by a single company . One group received a commercially available ergonomic keyboard , a second group used a modified version of the same keyboard design ed to reduce activation force , vibration and key travel . We measured symptoms and clinical signs , functional status , and device satisfaction in both groups over a six-month study period . Results : Between-groups analyses indicated that the groups performed similarly on the outcomes of interest . Repeated-measure analysis identified a reduction of symptoms , an improvement in functional status , preference for and increased satisfaction with the intervention keyboards , and maintenance of typing speed and accuracy for both groups . Conclusions Objectives To examine whether the introduction of intermittent st and ing bouts during the workday using a height-adjustable workstation can improve subjective levels of fatigue , musculoskeletal discomfort and work productivity relative to seated work . Methods Overweight/obese office workers ( n=23 ; age 48.2±7.9 years , body mass index 29.6±4 kg/m2 ) undertook two , 5-day experimental conditions in an equal , r and omised ( 1:1 ) order . In a simulated office environment , participants performed their usual occupational tasks for 8 h/day in a : seated work posture ( SIT condition ) ; or interchanging between a st and ing and seated work posture every 30 min using an electric , height-adjustable workstation ( ST AND -SIT condition ) . Self-administered question naires measuring fatigue , musculoskeletal discomfort and work productivity were performed on day 5 of each experimental condition . Results Participants ’ total fatigue score was significantly higher during the SIT condition ( mean 67.8 ( 95 % CI 58.8 to 76.7 ) ) compared with the ST AND -SIT condition ( 52.7 ( 43.8 to 61.5 ) ; p<0.001 ) . Lower back musculoskeletal discomfort was significantly reduced during the ST AND -SIT condition compared with the SIT condition ( 31.8 % reduction ; p=0.03 ) . Despite concentration/focus being significantly higher during the SIT condition ( p=0.006 ) , there was a trend towards improved overall work productivity in favour of the ST AND -SIT condition ( p=0.053 ) . Conclusions Transitioning from a seated to a st and ing work posture every 30 min across the workday , relative to seated work , led to a significant reduction in fatigue levels and lower back discomfort in overweight/obese office workers , while maintaining work productivity . Future investigations should be directed at underst and ing whether sustained use of height-adjustable workstations promote concentration and productivity at work . Trial Registration Number ACTRN12611000632998 OBJECTIVE The purpose of this study was to evaluate the effectiveness of an active ergonomics training ( AET ) program in computer users . Two constructs from the social-cognitive theory were adopted to provide a more comprehensive assessment of the proximal markers of behavior change . METHOD Eighty-seven symptomatic and asymptomatic employees who worked at a computer for a minimum of 10 hours per week took part in a prospect i ve r and omized controlled study . Subjects participated in a six-hour training intervention at their workplace . Key elements of the AET intervention were skill development in workstation analysis , active participation , and implementation of multiple prevention strategies . RESULTS After receiving AET , risk factor exposure was significantly reduced for participants at higher risk [ F(1,82 ) = 6.42 , p < 0.01 ] . Significant increases in knowledge [ F(1,74 ) = 8.39 , p < 0.01 ] , self-efficacy [ F(1,73 ) = 6.95 , p < 0.01 ] , and outcome expectations [ F(1,75 ) = 8.75 , p < 0.01 ] were found in the intervention group . When the participants were stratified according to the presence of symptoms at baseline , the group with pain that received the AET intervention had significantly less upper back pain intensity ( z = -2.03 , p < 0.05 ) , pain frequency ( z = -2.70 , p < 0.01 ) , and pain duration ( z = -3.25 , p < 0.01 ) post-intervention than the control group with pain . CONCLUSION Results from this study provide evidence that participative training in workstation ergonomics can improve work postures , work practice s , risk factor exposure , and pain OBJECTIVES This study evaluated the effect of an intensive ergonomic approach and education on workstation changes and  musculoskeletal disorders among workers who used a video display unit ( VDU ) . METHODS A r and omized controlled design was used . The subjects ( N=124 ) were allocated into three groups ( intensive ergonomics , ergonomic education , reference ) using stratified r and om sampling . The evaluation involved question naires , a diary of discomfort , measurements of workload , and an ergonomic rating of the workstations . The assessment s were made 2 weeks before the intervention and after 2 and 10 months of follow-up . RESULTS The intensive and training groups showed less musculoskeletal discomfort than the reference group after 2 months of follow-up . Positive effects on discomfort were seen primarily for the shoulder , neck , and upper back areas . No significant differences were found for the strain levels or prevalence of pain . After the intervention the ergonomic level was distinctly higher in the intensive ergonomic group than in the education or reference group . CONCLUSIONS Both the intensive ergonomics approach and education in ergonomics help reduce discomfort in VDU work . In attempts to improve the physical ergonomics of VDU workstations , the best result will be achieved with cooperative planning in which both workers and practitioners are actively involved The study has a parallel group design with two intervention groups ( T and S ) and one control group ( C ) of VDU operators . Three serial interventions were carried out in the T and S groups , first a new lighting system , then new workplaces and last an optometric examination and corrections if needed . The new lighting gave significantly increased illuminance levels , increased luminances of the room surfaces and better luminance distribution . The two intervention groups reported significant improvement of the lighting conditions , as well as of the visual conditions and significantly reduced visual discomfort and glare . Significant reduction of headache was found in one of the intervention groups . Optometric corrections reduced the visual discomfort in both the intervention groups . When looking at those given new corrections , a significant reduction was found in the T group and a clear tendency was also found in the S group . The C group reported no improvements for any of these health outcomes . The workplace intervention gave the operator the possibility to support the whole forearm and h and on the table top . Before the intervention there were no significant differences between the three groups regarding shoulder pain and static trapezius electromyographic ( EMG ) load . Two years after the intervention , a significant reduction of shoulder pain was reported in the T and S groups in parallel with a significant reduction in static trapezius load , while no such reduction was found in the C group . At the same time , both static trapezius load and shoulder pain were significantly lower in the T and S groups compared with the C group . Pain in the forearm and h and showed no significant changes in any of the groups during the study period . However , there seem to be a relationship between pain in the forearm and h and and the time the operator used the mouse . The C group reported significantly higher intensity of pain and used the mouse significantly more than the S group The effects of Ergorest ® arm supports on wrist angles and musculoskeletal strain in the neck-shoulder-arm region and electrical activity in the shoulder and arm muscles were studied during typing or the use of the mouse in work with a visual display unit ( VDU ) . Twenty-one women were r and omized into 3 groups ( 1 arm support , 2 arm supports , and control ) . Measurements were carried out before and after the 6-week intervention . The wrist extension of the mouse h and , the muscle activity of the trapezius muscle , and the subjective discomfort ratings indicated that 2 arm supports were better than 1 in work with a mouse . The Ergorest ® arm support alleviates muscle and joint strain in VDU work when used for both arms PURPOSE This study aim ed to examine whether reductions in sitting time through alternating 30-min bouts of sitting and st and ing can reduce postpr and ial glucose , insulin , and triglyceride responses . METHODS Twenty-three overweight/obese sedentary office workers ( 17 males and six females ; mean ± SD : age , 48.2 ± 7.9 yr ; body mass index , 29.6 ± 4.0 kg · m(-2 ) ) undertook two short-term ( 5 d ) experimental conditions in an equal , r and omized ( 1:1 ) order . In a simulated office environment , participants performed typical occupational tasks for 8 h · d(-1 ) while in a 1 ) seated work posture ( control condition ) or 2 ) interchanging between a seated and st and ing work posture every 30 min using an electric , height-adjustable workstation ( intervention condition ) . Fasting and postpr and ial blood sample s after a mixed test drink were collected hourly for 4 h on days 1 and 5 of each condition to assess serum insulin , plasma glucose , and triglycerides . Dietary intake  ( kJ · d(-1 ) ) and physical activity  were st and ardized during each condition . The trial was registered with the Australian New Zeal and Clinical Trials Registry ( ACTRN12611000632998 ) . RESULTS After adjustment for time ( days 1 and 5 ) , incremental area under the analyte time curve differed significantly between conditions for plasma glucose ( P = 0.007 ) but not for serum insulin or plasma triglycerides . Adjusted mean glucose incremental area under the analyte time curve was lowered by 11.1 % after the intervention condition ( 6.38 mM · h(-1 ) ( confidence interval , 5.04 - 7.71 ) ) relative to the control condition ( 7.18 mM · h(-1 ) ( confidence interval , 5.85 - 8.52 ) ) . No temporal changes ( days 1 vs 5 ) between conditions were observed . CONCLUSIONS Alternating st and ing and sitting in 30-min bouts results in modest beneficial effects on postpr and ial glucose responses in overweight/obese office workers OBJECTIVES This study examined the health-related effects of two worksite interventions , physical exercise and reduced workhours , on women employed in dentistry . METHODS Six workplaces were r and omized to one of the following three conditions : ( i ) 2.5 hours of weekly , m and atory physical exercise of middle-to-high intensity to be performed during workhours ( N=62 ) , ( ii ) a reduction of full-time weekly workhours from 40 to 37.5 hours ( N=50 ) , and ( iii ) reference . In all , 177 women participated . Biomarkers and self-ratings in question naires were obtained before the intervention ( T ( 1 ) ) , and six ( T ( 2 ) ) and 12 months ( T ( 3 ) ) after the intervention . RESULTS The results showed increased levels of physical activity and exercise in all of the groups , the level of physical exercise being significantly greater in the physical exercise group . Repeated- measures analyses of variance using data from T ( 1 ) and T (3)for biological measures and all three time points for self-ratings produced significant interaction effects for glucose , waist-to-hip ratio , and work ability and clear trends for general symptoms and upper-extremity disorders . Posthoc analyses showed that the results of the health-related measures differed between the interventions , decreased glucose and upper-extremity disorders in the exercise group , and increased high-density lipoprotein and waist-to-hip ratio among those working reduced hours . CONCLUSIONS These results show that the two interventions had small and varied effects on biomarkers and self-reports of different aspects of health among women . It is suggested that interventions involving a modest reduction in workhours seem to be more effective if these hours are used for physical exercise BACKGROUND The purpose of this study was to determine the effects of an alternative mouse and /or a forearm support board on  nerve function at the wrist among engineers . METHODS This r and omized controlled intervention trial followed 206 engineers for 1 year . Distal motor latency ( DML ) at baseline and follow-up was conducted for the median and ulnar nerves at the right wrist . RESULTS One hundred fifty-four subjects agreed to a nerve conduction study at the beginning and end of the study period . Those who received the alternative mouse had a protective effect ( OR = 0.47 , 95 % CI 0.22 - 0.98 ) on change in the right ulnar DML . There was no significant effect on the median nerve DML . The forearm support board had no significant effect on the median or ulnar nerve DML . CONCLUSIONS In engineers who use a computer for more than 20 hr per week , an alternative mouse may have a protective effect for ulnar nerve function at the wrist . No protective effect of a forearm support board was found for the median nerve INTRODUCTION Non-specific neck pain is a major burden to industry , yet the impact of introducing a workplace ergonomics and exercise intervention on work productivity and severity of neck pain  in a population of office personnel is unknown . RESEARCH QUESTION Does a combined workplace-based best practice ergonomic and neck exercise program reduce productivity losses and risk of developing neck pain in asymptomatic workers , or decrease severity of neck pain  in symptomatic workers , compared to a best practice ergonomic and general health promotion program ? DESIGN Prospect i ve cluster r and omised controlled trial . PARTICIPANTS AND SETTING Office personnel aged over 18 years , and who work>30 hours/week .  INTERVENTION Individualised best practice ergonomic intervention plus 3 × 20 minute weekly , progressive neck/shoulder girdle exercise group sessions for 12 weeks . CONTROL Individualised best practice ergonomic intervention plus 1-hour weekly health information sessions for 12 weeks . MEASUREMENTS Primary ( productivity loss ) and secondary ( neck pain and disability , muscle performance , and quality of life ) outcome measures will be collected using vali date d scales at baseline , immediate post-intervention and 12 months after commencement . PROCEDURE 640 volunteering office personnel will be r and omly allocated to either an intervention or control arm in work group clusters . ANALYSIS Analysis will be on an ' intent-to-treat ' basis and per protocol . Multilevel , generalised linear models will be used to examine the effect of the intervention on reducing the productivity loss in dollar units ( AUD ) , and severity of neck pain and disability . DISCUSSION The findings of this study will have a direct impact on policies that underpin the prevention and management of neck pain in office personnel Typing is associated with musculoskeletal complaints ( MSCs ) , caused by multiple risk factors . Although a wide variety of ergonomic intervention programs were conducted to reduce risk factors and MSC 's , only few of them were found evidence based . This study aim ed to test the efficacy of a workplace intervention in reducing MSC 's among computer workers . 66 computer workers were assigned r and omly to one of three intervention programs : ergonomic intervention including biofeedback , intervention without biofeedback and control group without intervention . The efficacy was tested by advanced assessment including ; pain location and severity , posture at work , upper extremity 3D kinematics , muscle activity and psychosocial status . Working hypothesis ; significant score differences will be found between the study groups which underwent ergonomic intervention and the control group on the following measures : pain complaints , upper extremity kinematics , muscle activity and psychosocial status . Significant differences were found between pre and post intervention and between research groups and the control group in pain , posture and motion . The ergonomic intervention with biofeedback had no unique contribution in comparison to other interventions . In conclusion ; the proposed intervention program was found efficient for reducing pain among computer workers
target: We found inconsistent evidence that the use of an arm support or an alternative mouse may or may not reduce the incidence of neck or shoulder MSDs .
  For other physical ergonomic interventions there is no evidence of an effect .
  For organisational interventions , in the form of supplementary breaks , there is very low- quality evidence of an effect on upper limb discomfort .
  For training and multifaceted interventions there is no evidence of an effect on upper limb pain or discomfort .
background: BACKGROUND Work-related upper limb and neck musculoskeletal disorders ( MSDs ) are one of the most common occupational disorders worldwide .
  Studies have shown that the percentage of office workers that suffer from MSDs ranges from 20 to 60 per cent .
  The direct and indirect costs of work-related upper limb MSDs have been reported to be high in Europe , Australia , and the United States .
  Although ergonomic interventions are likely to reduce the risk of office workers developing work-related upper limb and neck MSDs , the evidence is unclear .
  This is an up date of a Cochrane Review which was last published in 2012 .
  OBJECTIVES To assess the effects of physical , cognitive and organisational ergonomic interventions , or combinations of those interventions for the prevention of work-related upper limb and neck MSDs among office workers .