title: Supplementary breaks and stretching exercises for data entry operators: a follow-up field study. Effects of intraoperative breaks on mental and somatic operator fatigue: a randomized clinical trial Work related etiology of de Quervain’s tenosynovitis: a case-control study with prospectively collected data Impact of rest-break interventions on the neck and shoulder posture of symptomatic VDU operators during prolonged computer work Rest improves performance, nature improves happiness: Assessment of break periods on the abbreviated vigilance task Effect of Different Types of Rest-Break Interventions on Neck and Shoulder Muscle Activity, Perceived Discomfort and Productivity in Symptomatic VDU Operators: A Randomized Controlled Trial A field study of supplementary rest breaks for data-entry operators Effectiveness of an intervention at construction worksites on work engagement, social support, physical workload, and need for recovery: results from a cluster randomized controlled trial The effects of exercise reminder software program on office workers' perceived pain level, work performance and quality of life. Effects of activity-rest schedules on physiological strain and spinal load in hospital-based porters The Ipswich Microbreak Technique to alleviate neck and shoulder discomfort during microscopic procedures. Impact of Booster Breaks and Computer Prompts on Physical Activity and Sedentary Behavior Among Desk-Based Workers: A Cluster-Randomized Controlled Trial Evaluation of ‘I-Preventive’: a digital preventive tool for musculoskeletal disorders in computer workers—a pilot cluster randomised trial Do walking strategies to increase physical activity reduce reported sitting in workplaces: a randomized control trial Effects of software programs stimulating regular breaks and exercises on work-related neck and upper-limb disorders. Work Related Risk Factors for Neck, Shoulder and Arms Complaints: A Cohort Study Among Dutch Computer Office Workers The effectiveness of a construction worksite prevention program on work ability, health, and sick leave: results from a cluster randomized controlled trial. Point-of-choice prompts to reduce sitting time at work: a randomized trial. Oxygenation, EMG and position sense during computer mouse work. Impact of active versus passive pauses Frequent short rest breaks from computer work: effects on productivity and well-being at two field sites. Do Micropauses Prevent Surgeon's Fatigue and Loss of Accuracy Associated With Prolonged Surgery? An Experimental Prospective Study Computer terminal work and the benefit of microbreaks. Controlled breaks as a fatigue countermeasure on the flight deck. The practice of active rest by workplace units improves personal relationships, mental health, and physical activity among workers The Introduction of an Active Rest Program by Workplace Units Improved the Workplace Vigor and Presenteeism Among Workers: A Randomized Controlled Trial Intraoperative “Micro Breaks” With Targeted Stretching Enhance Surgeon Physical Function and Mental Focus: A Multicenter Cohort Study How to design efficient cluster randomised trials A pilot randomised control trial of the effectiveness of a biofeedback mouse in reducing self-reported pain among office workers Effect of rest on physicians’ performance in an emergency department, objectified by electroencephalographic analyses and psychometric tests* Post-lunch nap as a worksite intervention to promote alertness on the job Cluster trials in implementation research: estimation of intracluster correlation coefficients and sample size. Rest break interventions in stoop labor tasks. Walks4Work: assessing the role of the natural environment in a workplace physical activity intervention. Interventions to enhance recovery in healthy workers; a scoping review. Effects of an Intervention to Reduce Sitting at Work on Arousal, Fatigue, and Mood Among Sedentary Female Employees: A Parallel-Group Randomized Trial Occupational physical loading tasks and knee osteoarthritis: a review of the evidence.
abstract: 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 Intermittent work breaks are common in fields with high workload but not yet for surgeons during operations . We evaluated the effects of intraoperative breaks during complex laparoscopic surgery  ( 5 min every half hour ) on the surgeon . Methods Fifty-one operations were r and omized to a scheme with intraoperative breaks and release of the pneumoperitoneum ( intermittent pneumoperitoneum ( IPP ) ) or conventional conduct ( CPP ) .  Stress hormones and α-amylase were determined in the surgeon ’s saliva pre- , intra- , and postoperatively . Mental performance and error scores , musculoskeletal strain , and continuous ECG were secondary endpoints . Results Regular intraoperative breaks did not prolong the operation ( IPP vs. CPP group : 176 vs. 180 min , p > 0.05 ) . The surgeon ’s cortisol levels during the operation were reduced by 22 ± 10.3 % in the IPP vs. the CPP group ( p < 0.05 ) . There were significantly fewer ( p < 0.05 ) intraoperative events in the IPP vs. the CPP group , which yielded higher α-amylase peaks . The pre- to postoperative increase in the error rates of the bp-concentration test was fourfold reduced in the IPP group ( p = 0.052 ) . The relevant locomotive strain-scores were grossly reduced by IPP ( p < 0.001 ) . Conclusions Our data support the idea that work breaks during complex laparoscopic surgery can reduce psychological stress and preserve performance without prolongation of the operation time compared with the traditional work scheme Background The etiology of de Quervain 's tenosynovitis ( dQ ) has been based on conflicting small case series and cohort studies lacking method ological rigor . A prospect i ve case-control study was conducted to analyze the most common risk factors for dQ. Methods Between January 2003 and May 2011 , 189 patients surgically treated for dQ vs. 198 patients with wrist ganglia ( WG ) ( controls ) were identified in our clinic ’s electronic data base . Sample characteristics , exertional , anatomical , and medical risk factors were compared between groups . Results dQ vs. WG differed by average age ( 52 vs. 43 years ) and gender ratio ( 15/62 vs. 26/39 ) . No significant difference between dQ vs. WG was found after subgrouping professional activities ( manual labor : 18 % vs. 26 % , respectively , p = 0.23 ) . No asymmetric distribution of comorbidities , wrist trauma , forceful or repetitive manual work , or medication was observed . Conclusions Neither heavy manual labor nor trauma could be shown to be predisposing risk factors for There is limited research on the effects of different types of rest-break interventions for visual display unit ( VDU ) operators on neck and shoulder postures . This study examined the effect of rest-break interventions on the neck and shoulder postures of symptomatic VDU operators during prolonged computer work . Thirty subjects were r and omly and equally assigned to breaks with stretching , breaks with dynamic movement and passive breaks . Subjects performed the typing task for 60 min and received 3-min breaks after 20 min of work . The craniovertebral and forward shoulder angles were obtained from a 3D motion analysis system . Results showed that there were no significant differences in the craniovertebral and forward shoulder angles among any types of rest breaks . It can be concluded that the three types of rest-break interventions had positive effects on neck and shoulder posture during prolonged computer terminal work The abbreviated vigilance task can quickly generate vigilance decrements , which has been argued is due to depletion of cognitive re sources needed to sustain performance . Research ers suggest inclusion of rest breaks within vigilance tasks improve overall performance ( Helton & Russell , 2015 ; Ross , Russell , & Helton , 2014 ) , while different types of breaks demonstrate different effects . Some literature suggests exposure to natural movements/stimuli helps restore attention ( Herzog , Black , Fountaine , & Knotts , 1997 ; Kaplan , 1995 ) . Participants were r and omly assigned to one experimental condition : dog video breaks , robot video breaks , countdown breaks or continuous vigilance . We assessed task performance and subjective reports of stress/workload . The continuous group displayed worst performance , suggesting breaks help restore attention . The dog videos did not affect performance , however , decreased reports of distress . These results support the importance of rest breaks and acknowledge the benefit of natural stimuli for promoting wellbeing/stress relief , overall suggesting performance and wellbeing may be independent , which warrants future studies Objective . This study evaluated the effect of different types of activities during rest-break interventions on neck and shoulder muscle activity , muscle discomfort and productivity among symptomatic video display unit ( VDU ) operators performing prolonged computer terminal work . Study design and setting . R and omized controlled trial was used . Thirty symptomatic VDU operators were r and omly assigned to 2 active break groups ( stretching and dynamic movement ) and a reference group . The subjects performed the same typing task for 60 min and received 3-min breaks after each 20 min of work . Root mean square and median frequency were calculated for neck and shoulder muscle activity . Muscle discomfort was measured with Borg ’s CR-10 scale . Productivity was measured by counting words . Results . There were no significant differences between the types of activities during breaks on neck and shoulder muscle activity , muscle discomfort or productivity . However , there was a significant difference in the level of muscle discomfort over time . Conclusions . Three types of activity during breaks showed a favourable effect on neck and shoulder muscle activity and productivity , and a positive effect on muscle discomfort in symptomatic VDU operators 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 Background To prolong sustainable healthy working lives of construction workers , a worksite prevention program was developed which aim ed to improve the health and work ability of construction workers . The aim of the current study was to investigate the effectiveness of this program on social support at work , work engagement , physical workload and need for recovery . Methods Fifteen departments from six construction companies participated in this cluster r and omized controlled trial ; 8 departments ( n=171 workers ) were r and omized to an intervention group and 7 departments ( n=122 workers ) to a control group . The intervention consisted of two individual training sessions of a physical therapist to lower the physical workload , a Rest-Break tool to improve the balance between work and recovery , and two empowerment training sessions to increase the influence of the construction workers at the worksite . Data on work engagement , social support at work , physical workload , and need for recovery were collected at baseline , and at three , six and 12 months after the start of the intervention using question naires . Results No differences between the intervention and control group were found for work engagement , social support at work , and need for recovery . At 6 months follow-up , the control group reported a small but statistically significant reduction of physical workload . Conclusion The intervention neither improved social support nor work engagement , nor was it effective in reducing the physical workload and need for recovery  among construction workers . Trial registration In direct proportion to current technological developments , both the computer usage in the workplaces is increased and requirement of leaving the desk for an office worker in order to photocopy a document , send or receive an e-mail is decreased . Therefore , office workers stay in the same postures accompanied by long periods of keyboard usage . In recent years , with intent to reduce the incidence of work related musculoskeletal disorders several exercise reminder software programs have been developed . The purpose of this study is to evaluate the effectiveness of the exercise reminder software program on office workers ' perceived pain level , work performance and quality of life .  39 healthy office workers accepted to attend the study . Participants were r and omly split in to two groups , control group ( n = 19 ) and intervention group ( n = 20 ) . Visual Analogue Scale to evaluate the perceived pain was administered all of the participants in the beginning and at the end of the study . The intervention group used the program for 10 weeks . Findings showed that the control group VAS scores remained the same , but the intervention group VAS scores decreased in a statistically significant way ( p < 0.01 ) . Results support that such exercise reminder software programs may help to reduce perceived pain among office workers . Further long term studies with more subjects are needed to describe the effects of these programs and the mechanism under these effects Workers in physically dem and ing occupations require rest breaks to recover from physiological stress and biomechanical loading . Physiological stress can increase the risk of developing musculoskeletal disorders and repeated loading of the spine may increase the potential for incurring back pain . The aim of the study was to assess the impact of an altered activity-rest schedule on physiological and spinal loading in hospital-based porters . An existing 4-h activity-rest schedule was obtained from observations on eight male porters . This schedule formed the normal trial , which included two 5- and one 15-min breaks . An alternative 4-h schedule was proposed ( experimental condition ) that had two breaks each of 12.5 min . It was hypothesized that the experimental trial is more effective in promoting recovery from physiological strain and spinal shrinkage than the normal trial , due to the 5-min breaks being insufficient to allow physiological variables to return to resting levels or the intervertebral discs to reabsorb fluid . Ten males performed both test conditions and oxygen uptake VO2 , heart rate , minute ventilation VE , perceived exertion and spinal shrinkage were recorded . There were no significant differences in any of the measured variables between the two trials ( p > 0.05 ) . Median heart rates were 78 ( range 71–93 ) and 82 ( 71–90 ) beats.min - 1 for the normal trial and the experimental trial respectively , indicating that the activity was of low intensity . The light intensity was corroborated by the oxygen uptakes ( 0.75 , range 0.65 - 0.94 l.min - 1 . Spinal shrinkage occurred to the same extent in the two trials ( 2.12±3.16 mm and 2.88±2.92 mm in the normal trial and the experimental trial respectively ) . Varying the length and positioning of the rest breaks did not significantly affect the physiological responses or magnitude of spinal shrinkage between the two trials . More physically dem and ing work than the porters ' schedule should induce greater physiological fatigue and spinal shrinkage . The ratio between activity and rest breaks would then become more important Neck and shoulder disorders are a considerable health problem amongst frequent microscope users . We aim ed to investigate the neck and shoulder discomfort experienced during prolonged microscopic activity and to assess the benefits of minibreaks . A prospect i ve crossover study was performed on 17 healthy volunteers sitting still while looking down a bench with and without the Ipswich Microbreak Technique ( IMT ) .  We used a subjective measure of time to fatigue and pain in the neck and shoulder regions as well as objective readings from a surface electromyogram ( sEMG ) . The IMT delayed the sensation of pain in the neck and shoulder region while reducing the overall sEMG muscle activation . In conclusion , IMT is a useful strategy in reducing and delaying the pain in neck and shoulder from prolonged working under the microscope . This technique can be incorporated in other activities that involve a sustained stationary position Introduction The 15-minute work break provides an opportunity to promote health , yet few studies have examined this part of the workday . We studied physical activity and sedentary behavior among office workers and compared the results of the Booster Break program with those of a second intervention and a control group to determine whether the Booster Break program improved physical and behavioral health outcomes . Methods We conducted a 3-arm , cluster-r and omized controlled trial at 4 worksites in Texas from 2010 through 2013 to compare a group-based , structured Booster Break program to an individual-based computer-prompt intervention and a usual-break control group ; we analyzed physiologic , behavioral , and employee measures such as work social support , quality of life , and perceived stress . We also identified consistent and inconsistent attendees of the Booster Break sessions . Results We obtained data from 175 participants ( mean age , 43 y ; 67 % racial/ethnic minority ) . Compared with the other groups , the consistent Booster Break attendees had greater weekly pedometer counts ( P < .001 ) , significant decreases in sedentary behavior and self-reported leisure-time physical activity ( P < .001 ) , and a significant increase in triglyceride concentrations ( P = .02 ) ( levels remained within the normal range ) . Usual-break participants significantly increased their body mass index , whereas Booster Break participants maintained body mass index status during the 6 months . Overall , Booster Break participants were 6.8 and 4.3 times more likely to have decreases in BMI and weekend sedentary time , respectively , than usual-break participants . Conclusion Findings varied among the 3 study groups ; however , results indicate the potential for consistent attendees of the Booster Break intervention to achieve significant , positive changes related to physical activity , sedentary behavior , and body mass index Objectives I-Preventive is a digital preventive tool for musculoskeletal disorders ( MSDs ) in computer workers . We sought to determine its impact on pain in computer workers with upper limb MSDs and visual discomfort . Methods We conducted a pilot cluster r and omised trial in 2 different sites of a tyre factory in France . We r and omised 200 employees to either an  intervention group ( I-Preventive ) or control group  , each comprising symptomatic and asymptomatic employees . The workers were followed up for 5 months . The main outcome was overall recovery from symptoms following 1 month 's intervention based on Nordic-style and eyestrain question naires . Results We included 185/200 workers : 96 in the intervention group ( mean age 41.8±1.4 years ; 88.5 % males ) and 79 in the control group ( mean age 42.9±12.0 years ; 94.5 % males ) . The most painful areas ( numerical scale ≥2 ) were the neck ( 40.0 % ) , upper back ( 18.8 % ) and shoulders ( 15.7 % ) . For the most painful anatomical area , the Nordic score significantly decreased after 1 month in the intervention group ( p=0.038 ) ; no change was observed in the control group ( p=0.59 ) . After 1 month 's use , the intervention group reported less pain in the painful area and less visual discomfort symptoms ( p=0.02 ) . Adherence to the I-Preventive program was 60 % . Conclusions I-Preventive is effective in the short term on musculoskeletal symptoms and visual discomfort by promoting active breaks and eyestrain treatment . This easy-to-use digital tool allows each worker to focus on areas of their choice via personalised , easy exercises that can be performed in the workplace . Trial registration number NCT02350244 ; Pre- results Background Interventions design ed to increase workplace physical activity may not automatically reduce high volumes of sitting , a behaviour independently linked to chronic diseases such as obesity and type II diabetes . This study compared the impact two different walking strategies had on step counts and reported sitting times . Methods Participants were white-collar university employees ( n = 179 ; age 41.3 ± 10.1 years ; 141 women ) , who volunteered and undertook a st and ardised ten-week intervention at three sites .  Pre-intervention step counts  ( Yamax SW-200 ) and  self-reported sitting times  were measured over five consecutive workdays . Using pre-intervention step counts , employees at each site were r and omly allocated to a control group ( n = 60 ; maintain normal behaviour ) , a route-based walking group ( n = 60 ; at least 10 minutes sustained walking each workday ) or an incidental walking group ( n = 59 ; walking in workday tasks ) . Workday step counts and reported sitting times were re-assessed at the beginning , mid- and endpoint of intervention and group mean± SD steps/day and reported sitting times for pre-intervention and intervention measurement points compared using a mixed factorial ANOVA ; paired sample -t-tests were used for follow-up , simple effect analyses . Results A significant interactive effect ( F = 3.5 ; p < 0.003 ) was found between group and step counts . Daily steps for controls decreased over the intervention period ( -391 steps/day ) and increased for route ( 968 steps/day ; t = 3.9 , p < 0.000 ) and incidental ( 699 steps/day ; t = 2.5 , p < 0.014 ) groups . There were no significant changes for reported sitting times , but average values did decrease relative to the control ( routes group = 7 minutes/day ; incidental group = 15 minutes/day ) . Reductions were most evident for the incidental group in the first week of intervention , where reported sitting decreased by an average of 21 minutes/day ( t = 1.9 ; p < 0.057 ) . Conclusion Compared to controls , both route and incidental walking increased physical activity  in white-collar employees . Our data suggests that workplace walking , particularly through incidental movement , also has the potential to decrease employee sitting times , but there is a need for on-going research using concurrent and objective measures of sitting , st and ing and walking OBJECTIVES This study evaluated the effects on work-related neck and upper-limb disorders  among computer workers stimulated ( by a software program ) to take regular breaks and perform physical exercises . Possible effects on sick leave and productivity were studied as well . A r and omized controlled design was used with cluster r and omization . Altogether 268 computer workers with complaints in the neck or an upper limb from 22 office locations were r and omized into a control group , one intervention group stimulated to take extra breaks and one intervention group stimulated to perform exercises during the extra breaks during an 8-weekperiod . Question naires were administered before and after the intervention , and questions were generated by the software during the intervention period . Computer usage was recorded online . RESULTS The data on self-reported recovery suggested a favorable effect ; more subjects in the intervention groups than in the control group reported recovery ( 55 % versus 34 % ) from their complaints and fewer reported deterioration ( 4 % versus 20 % ) . However , a comparison between the reported pre- and postintervention scores on the severity and frequency of the complaints showed no significant differences in the change among the three groups . No effects on sick leave were observed . The subjects in the intervention groups showed higher productivity . CONCLUSIONS The use of a software program stimulating workers to take regular breaks contributes to perceived recovery from neck or upper-limb complaints . There seems to be no additional effects from performing physical exercises during these breaks Introduction This study aims to investigate the relationship between work-related physical and psychosocial characteristics and complaints of the neck , shoulder and forearm/h and s. Methods Data were used from a prospect i ve Dutch cohort study among computer office workers with a follow-up period of 2 years . The study was conducted among 264 computer users . Physical and psychosocial risk factors were tested to predict the occurrence of neck , shoulder and forearm/h and s complaints . Bivariate and multivariable logistic regression was used to identify the association between risk factors and outcome variables . Results The 2 year follow-up prevalence rates with 95 % CI for neck complaints were 0.31 ( 0.28–0.37 ) , for shoulder complaints 0.33 ( 0.27–0.39 ) and for forearm/h and s complaints 0.21 ( 0.14–0.28 ) . Four main predictors for the occurrence of neck and shoulder complaints were identified : ( 1 ) Irregular head and body posture [ OR : 1.1 ( 1.0–1.2 ) P = 0.04 ] ; ( 2 ) task difficulty ( job dem and s ) [ OR : 1.2 ( 1.0–1.5 ) P = 0.01 ] ; ( 3 ) number of working hours/day with the computer [ OR : 1.20 ( 1.0–1.4 ) P = 0.03 ] ; and ( 4 ) having had a previous history of complaints [ OR : 7.2 ( 3.8–13.2 ) P = 0.01 ] . Two predictors were identified for forearm/h and s complaints : time pressure ( job dem and s ) [ OR : 1.20 ( 1.0–1.4 ) P = 0.03 ] and having had a previous history of complaints [ OR : 7.1 ( 3.5–14.1 ) P = 0.06 ] . Conclusion This longitudinal study suggests that risk factors of upper musculoskeletal complaints in computer workers consist of a mixture of physical and psychosocial characteristics OBJECTIVE This study aim ed to investigate the effectiveness of a prevention program on work ability , health , and sick leave targeted at construction worksites . METHODS A total of 15 departments ( N = 297 workers ) from 6 construction companies participated in this cluster r and omized controlled trial and were r and omly allocated to the intervention ( 8 departments ; N = 171 workers ) or control ( 7 departments ; N = 122 workers ) group . The intervention consisted of two individual training sessions with a physical therapist aim ed at lowering the physical workload , a rest-break tool to improve the balance between work and recovery , and two empowerment training sessions to increase the worker 's influence at the worksite . Data on work ability , physical and mental health status , and musculoskeletal symptoms were collected at baseline , and at 3 , 6 , and 12 months follow-up . Sick leave data were obtained from the companies . RESULTS Overall , no differences in work ability [ β 0.02 , 95 % confidence interval ( 95 % CI ) -0.34 - 0.37 ] or physical and mental health status ( β -0.04 , 95 % CI -1.43 - 1.35 , and β 0.80 95 % CI -0.51 - 2.11 , respectively ) were found between the intervention and control group . The intervention showed an overall decline in musculoskeletal symptoms ( ranging from OR 0.68 , 95 % CI 0.34 - 1.33 , to OR 0.86 , 95 % CI 0.47 - 1.57 ) and long-term sick leave ( OR 0.44 , 95 % CI 0.13 - 1.26 ) among construction workers . Both reductions were not statistically significant . CONCLUSION The prevention program seemed to result in a beneficial but not statistically significant decline in the prevalence of musculoskeletal symptoms and long-term sick leave among construction workers , but showed no effects with regard to work ability , physical health , and mental health BACKGROUND Prolonged sitting is prevalent in the workplace and is associated with adverse health markers . PURPOSE Investigate the effects of point-of-choice ( PoC ) prompting software , on the computer used at work ( PC ) , to reduce long uninterrupted sedentary periods and total sedentary time at work . DESIGN Assessor-blinded , parallel group , active-controlled r and omized trial . SETTING / PARTICIPANTS A convenience sample of office workers from Glasgow , United Kingdom . Data were collected April to June 2010 , and analyzed October 2010 to June 2011 . INTERVENTION The education group ( n=14 ) received a brief education session on the importance of reducing long sitting periods at work .  The PoC group ( n=14 ) received the same education along with prompting software on their PC for 5 workdays , which reminded them to st and up every 30 minutes . MAIN OUTCOME MEASURES Sitting time was measured objective ly using the activPAL ™ activity monitor for 5 workdays at baseline and 5 workdays during the intervention . The number and time spent sitting in events > 30 minutes ' duration were the main outcome measures . RESULTS At baseline , participants spent 5.7±1.0 hours/day ( 76%±9 % ) of their time at work sitting . Of that time , 3.3±1.3 hours/day was spent sitting in 3.7±1.4 events > 30 minutes . There was a significant difference between the groups in the change ( intervention to baseline ) of both the number ( ANCOVA ; -6.8 % , p=0.014 ) and duration ( -15.5 % , p=0.007 ) of sitting events > 30 minutes . During the intervention , compared with baseline , the PoC group reduced the number ( paired t-test ; -0.11 events/hour , p=0.045 ) and duration ( -12.2 % , p=0.035 ) of sitting events > 30 minutes . However , there was no significant difference in total sitting time between groups ( -4.4 % , p=0.084 ) . CONCLUSIONS Point-of-choice prompting software on work computers recommending taking a break from sitting plus education is superior to education alone in reducing long uninterrupted sedentary periods at work . TRIAL REGISTRATION This trial was registered at Clinical Trials.govNCT01628861 We investigated the effects of active versus passive pauses implemented during computer mouse work on muscle oxygenation and EMG of the forearm extensor carpi radialis muscle , and on wrist position sense . Fifteen healthy female subjects ( age : 19–24 years ) performed a 60-min  mouse-operated computer task , divided into three 20 min periods , on two occasions separated by 3–6 days . On one occasion a passive pause ( subjects resting ) was implemented at the end of each 20-min period , and on another occasion an active pause ( subjects performed a number of high intensity extensions of the forearm ) was implemented . Also at the end of each 20-min period , test contractions were conducted and subjective ratings of fatigue and stress were obtained . Another parameter of interest was total haemoglobin calculated as the summation of oxy- and deoxy-haemoglobin , since it reflects blood volume changes . The most interesting findings were an overall increasing trend in total haemoglobin throughout the mouse work ( P<0.001 ) , and that this trend was greater for the active pause as compared to the passive pause ( P<0.01 ) . These data were accompanied by an overall increase in oxygen saturation ( P<0.001 ) , with a tendency , albeit not significant , toward a higher increase for the active pause ( P=0.13 ) . EMG amplitude and median frequency tended to decrease ( P=0.08 and 0.05 , respectively ) during the mouse work but was not different between pause types . Borg ratings of forearm fatigue showed an overall increase during the activity ( P<0.001 ) , but the perceptions of stress did not change . Position sense did not change due to the mouse work for either pause type . While increasing trends were found for both pause types , the present study lends support to the hypothesis of an enhancement in oxygenation and blood volume for computer mouse work implemented with active pauses . However , a presumption of an association between this enhancement and attenuated fatigue during the mouse work was not supported Computer operators at two work sites ( n = 73 , n = 19 ) were prompted to take three 30-s and one 3-min break from computer work each hour in addition to conventional rest breaks . Some operators were asked to perform stretching exercises during the short breaks . Mood state and musculoskeletal discomfort were assessed at each work site over a 2- or 3-week baseline period and a 4- or 6-week treatment period , respectively . Operator productivity measures were obtained from company records . Operators complied with about half of the added breaks but favoured 3-min breaks over 30-s breaks . No improvement in productivity or well-being was found at the larger work site . At the smaller work site , productivity , eye , leg and foot comfort all improved when the short breaks included stretching exercises . These results provide evidence that frequent short breaks from continuous computer-mediated work can benefit worker productivity and well-being when the breaks integrate with task dem and Objective : This prospect i ve experimental study evaluates the effectiveness of micropauses ( MPs ) to prevent muscular fatigue and its deleterious effect on  surgeons during prolonged surgical procedures . Background : Operating is a hazard for surgeon 's health . Beyond acute injuries and blood-borne infections , back and neck pain is a poorly recognized factor causing chronic ailment in more than half the surgeons surveyed . MP , a 20-second break every 20 minutes , is an accepted strategy used widely in the workplace . Methods : We design ed a crossover experimental study . Sixteen surgeons were tested 3 times : once in a control situation before any surgery ( CTL ) and twice after a prolonged , reproducible operation ( at least 2 hours ) , 1 of these with formal MP ( WMP ) the other without ( WOMP ) . Muscular fatigue was tested by holding a 2.5-kg weight as long as possible with a stretched arm . Accuracy was evaluated with a device , measuring the mistakes made when following a predetermined path on a board . Finally , discomfort was measured by visual analog scale . Results : We found a statistically and more importantly clinical ly significant difference between the CTL and WOMP groups in all 3 tests . MPs prevented completely or almost completely the effects of fatigue associated with surgery [ accuracy ( No. errors ) CTL : 1.1 , WOMP : 7.7 , WMP : 1.7 ; fatigue ( seconds ) CTL : 137 , WOMP : 92 , WMP : 142 ] . Conclusions : Surgical procedures are associated with significant muscular fatigue that can be measured simply and which has a direct effect on comfort and surgical accuracy . More important , this effect is completely or almost completely prevented by MPs 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 A major challenge for flight crews is the need to maintain vigilance during long , highly automated nighttime flights . No system currently exists to assist in managing alertness , and countermeasure options are limited . Surveys reveal many pilots use breaks as an in-flight countermeasure , but there have been no controlled studies of their effectiveness . HYPOTHESIS We hypothesized that brief , regular breaks could improve alertness and performance during an overnight flight . METHOD A 6-h , uneventful , nighttime flight in a Boeing 747 - 400 flight simulator was flown by fourteen two-man crews . The 14 subjects in the treatment group received 5 short breaks spaced hourly during cruise ; the 14 subjects in the control group received 1 break in the middle of cruise .  Continuous EEG/EOG , subjective sleepiness , and psychomotor vigilance performance data were collected . RESULTS During the latter part of the night , the treatment group showed significant reductions for 15 min post-break in slow eye movements , theta-b and activity , and unintended sleep episodes compared with the control group . The treatment group reported significantly greater subjective alertness for up to 25 min post-break , with strongest effects near the time of the circadian trough . There was no evidence of objective vigilance performance improvement at 15 - 25 min post-break , with expected performance deterioration occurring due to elevated sleep drive and circadian time . CONCLUSIONS The physiological and subjective data indicate the breaks reduced nighttime sleepiness for at least 15 min post-break and may have masked sleepiness for up to 25 min , suggesting the potential usefulness of short- duration breaks as an in-flight fatigue countermeasure Aim : This study was design ed to clarify the effects of active rest , with a focus on the practice of short-time group exercise by workplace units , on personal relationships , mental health , physical activity , and work ability among workers . Methods : Fifty-nine white-collar workers ( 40 males and 19 females ) performed our active rest ( short-time exercise ) program , which consists of warm-up , cognitive functional training , aerobic exercise , resistance training and cool-down for 10 minutes per day , 3 times per week during their lunch breaks for 10 weeks . Participants from a workplace unit were r and omly allocated to the intervention ( five workplaces , n=29 ) or control groups ( six workplaces , n=30 ) . The participants ' anthropometric measurements , and their Profile of Mood States ( POMS ) 2 , Brief Job Stress Question naire ( BJSQ ) , physical activity levels and Work Ability Index were examined at the baseline and after the 10-week intervention . Results : After 10 weeks , physical activity levels , especially the time spent in moderate and vigorous intensity , increased in the intervention group ( p<0.05 ) . The items of " vigor-activity " and " friendliness " improved in POMS 2 , while " vigor , " " interpersonal stress , " " support from superiors , colleagues , and family/friends , " and " job satisfaction " improved in BJSQ in the intervention group ( p<0.05 ) . In the intervention group , the number of  exercise participation was positively correlated with the change in " vigor-activity " in POMS 2 ( r=0.467 , p=0.011 ) . Conclusions : These results suggest that the practice of active rest by workplace units is important for improving personal relationships , mental health , and physical activity among workers Objective : The present study was design ed to examine the effects of active rest by workplace units on not only workers ’ individual vigor but also workplace vigor and presenteeism . Methods : A total of 130 workers performed our active rest ( short-time exercise ) program  for 10 minutes per day during their lunch breaks , three to four times per week for 8 weeks . Subjects from a workplace unit were r and omly allocated to the intervention ( n = 66 ) or control ( n = 64 ) groups . The participants ’ work engagement and Work Functioning Impairment Scale ( WFun ) were examined at the baseline and after the 8-week intervention period . Results : After 8 weeks , the intervention group showed improved “ vigor ” values in work engagement and WFun ( P < 0.05 ) . Conclusion : These results suggest that the introduction of active rest program by workplace units provides a viable means for improving workplace vigor and presenteeism Objective : The aim of this study was to investigate the effect of intraoperative targeted stretching micro breaks ( TSMBs ) on the experienced pain and fatigue , physical functions , and mental focus of surgeons . Background : Surgeons are routinely subject to mental and physical stresses through the course of their work in the operating room . One of the factors most contributory to the shortening of a surgeon 's career is work-related pain and its effects on patient safety and personal relationships . Methods : Surgeons and operating room staff from 4 medical centers rated pain/fatigue , physical , and mental performance using vali date d scales during 2 operative days : 1 day without implementing TSMB , the other including st and ardized ( 1.5 to 2 minutes ) guided TSMB at appropriate 20 to 40-minute intervals throughout each case . Case type and duration were recorded as were surgeon pain data before and after each procedure and at the end of the surgical day . Individual body part pre/postdiscomfort difference was modeled , controlling for clinical center . R and om coefficient mixed models accounted for surgeon variability . Results : Sixty-six participants ( 69 % men , 31 % women ; mean 47 years ) completed 193 “ non-TSMB ” and 148 “ TSMB ” procedures . Forty-seven percent of surgeons were concerned that musculoskeletal pain may shorten their career . TSMB  improved surgeon postprocedure pain scores in the neck , lower back , shoulders , upper back , wrists/h and s , knees , and ankles . Operative duration did not differ ( P > 0.05 ) . Improved pain scores with TSMB were statistically equivalent ( P > 0.05 ) for laparoscopic and open procedures . Surgeons perceived improvements in physical performance ( 57 % ) and mental focus ( 38 % ) ; 87 % of respondents planned to continue TSMB . Conclusions : Many surgeons are concerned about career-ending or limiting musculoskeletal pain . Intraoperative TSMB may represent a practical , effective means to reduce surgeon pain , enhance performance , and increase mental focus without extending operative time Cluster r and omised trials have diminishing returns in power and precision as cluster size increases . Making the cluster a lot larger while keeping the number of clusters fixed might yield only a very small increase in power and precision , owing to the intracluster correlation . Identifying the point at which observations start making a negligible contribution to the power or precision of the study —which we call the point of diminishing returns — is important for design ing efficient trials . Current methods for identifying this point are potentially useful as rules of thumb but do n’t generally work well . We introduce several practical aids to help research ers design cluster r and omised trials  in which all observations make a material contribution to the study . Power curves enable identification of the point at which observations begin to make a negligible contribution to a study for a given target difference . Under this paradigm , the number needed per arm under individual r and omisation gives an upper bound on the cluster size , which should not be exceeded . Corresponding precision curves can be useful for accommodating flexibility in the choice of target difference and show the point at which confidence intervals around the estimated effect size no longer decrease . To design efficient trials , the number of clusters and cluster size should be determined concurrently , not independently . Funders and research ers should be aware of diminishing returns in cluster trials . Research ers should routinely plot power or precision curves when performing sample size calculations so that the implication s of cluster sizes can be transparent . Even when data appear to be “ free , ” in the sense that few re sources are needed to obtain the data , excessive cluster sizes can have important 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 Objective The aim of the field study was to objectify physicians ’ vigilance , well-being , and cognitive performance in the course of 24-hr shifts with and without afternoon rest . Subjects , Setting , and Design Eleven residents ( four women , seven men ; age , 33.5 ± 4.7 yrs ) were observed when doing two regular 24-hr shifts  at the emergency department ( r and omized crossover design ): one without rest , the other with a period of rest in the early afternoon ( duration , 2:31 ± 1:04 hrs ) and the opportunity of having a nap ( duration , 1:07 ± 0:26 hrs , n = 6 ) . Electroencephalography and psychometric tests were carried out at 8 am and at midnight . Measurements Measurements included subjective perception of workload , stress , and sleeping behavior ; computer-analyzed electroencephalography ; adjective checklist ( Eigenschaftswörterliste 60 S , a self-rating scale ) ; complex reaction time test ; Pauli test ( number of calculations during 3 mins ) ; and numerical memory test . Results Electroencephalographic analyses showed a significant decrease in alpha power and a significant increase in beta power in the evening as compared with the morning on both days . The nocturnal increase observed in delta activity was significantly less pronounced in duties with rest than in duties without rest . Physicians felt deactivated at night . The Eigenschaftswörterliste 60 S indicated deactivation at night and a rest-induced activation in the subgroup that had taken the opportunity to sleep in the afternoon . Psychometric tests did not show any significant differences , neither between performance in the morning and evening nor between results with and without rest . Conclusion As expected , electroencephalographic recordings showed nocturnal deactivation and a vigilance-promoting effect of the afternoon rest . These objective findings were in accordance with the results derived from self-rating scales . On the other h and , in short-lasting psychometric tests , performance was found unchanged after 16 hrs of routine work . In further studies , a discrimination between resting periods with and without sleep will be important A worksite study was conducted to examine whether a 15-min nap during a post-lunch rest period would affect subsequent alertness , performance , and nocturnal sleep in eight factory workers under a 3-week protocol . Subjects were asked to take the nap at 12:30 h on a reclining chair during the nap week , and to remain awake during the no-nap week . The order of these 2 weeks was counterbalanced between the subjects . During the third , follow-up week , each subject determined whether or not she/he would nap . Alertness on the job and nocturnal sleep were assessed using a sleep diary .  Wrist activity was also recorded during sleep at night . Choice reaction time task ( RT ) was performed at 10:00 and 15:00 h every day of the nap week and every other day of the no-nap and follow-up weeks . Perceived alertness was significantly higher in the afternoon after nap than after no nap at the end of the week . Similar effects were observed during the follow-up week where almost half of the subjects napped . No significant differences between the three weeks were found for RT performance or nocturnal sleep . Workers ' attitudes toward the nap were favourable . Although further intervention research is required , our results suggest that post-lunch napping may have the potential to promote daytime alertness at work The cluster r and omized trial  with a concurrent economic evaluation is considered the gold st and ard evaluative design for the conduct of implementation research evaluating different strategies to promote the transfer of research findings into clinical practice . This has implication s for the planning of such studies , as information is needed on the effects of clustering on both effectiveness and efficiency outcomes . This paper describes the design considerations specific to implementation research studies , focusing particularly on the estimation of sample size requirements and on the need for reliable information on intracluster correlation coefficients for both effectiveness and efficiency outcomes H and cultivation and harvest of agricultural products constitute strenuous physical tasks . Working with labor-management ergonomics committees in agricultural setting s , the UC Agricultural Ergonomics Research Center ( AERC ) tested an experimental rest and recovery protocol for its impact on symptoms and productivity during two types of work tasks . The experimental condition consisted of adding a 5 min rest break to every working hour in which there was no other scheduled break ( e.g. , lunchtime ) . This result ed in an additional 20 min of rest per workday . We tested the intervention in two trials : Trial one compared workers ( n=66 ) r and omly assigned to an experimental or a control group during the harvest of commercial strawberries . Trial two utilized a cross-over design ( n=16 pairs of workers ) to compare experimental and control conditions while workers inserted bud grafts into young 18 ' ' high citrus trees . For both trials , workers under the experimental condition reported significantly less severe symptoms than workers under control conditions . The order in which the intervention was given , however , appeared to result in variations in productivity . We conclude that the introduction of frequent , brief rest breaks may improve symptoms for workers engaged in strenuous work tasks OBJECTIVES The primary aim of this study was to examine the impact of  physical activity ( PA ) in the natural environment ( eg , " green exercise " ) on resting autonomic function in the Walks4Work intervention . A secondary aim was to assess the feasibility of Walks4Work in terms of adherence , change in PA levels , and cardiovascular health parameters . METHODS In an 8-week r and omized control trial , 94 office workers in an international company were allocated to one of three groups : control , nature ( NW ) , or built ( BW ) lunchtime walking route . Both walking groups were required to undertake two lunchtime walks each week . The NW route centered around trees , maintained grass , and public footpaths . In contrast , the BW consisted of pavement routes through housing estates and industrial areas . Data were collected at baseline and following the intervention . To investigate the impact of the intervention , mixed- design analysis of variance ( ANOVA ) were performed . RESULTS A total of 73 participants completed the intervention ( drop-out rate of 22 % ) . No difference was observed in resting autonomic function between the groups . Self-reported mental health improved for the NW group only . PA levels increased at the intervention mid-point for all groups combined but adherence to the intervention was low with rates of 42 % and 43 % within the BW and NW groups , respectively . CONCLUSION Accompanying a guideline of two active lunchtimes per week with low facilitator input appears inadequate for increasing the number of active lunchtimes and modifying cardiovascular health parameters in an office population . However , this population fell within normal ranges for cardiovascular measures and future research should consider investigating at-risk population s , particularly hypertensive individuals Background Faster recovery from work may help to prevent work-related ill health . Aims To provide a preliminary assessment of the range and nature of interventions that aim to improve recovery from cognitive and physical work . Methods A scoping review to examine the range and nature of the evidence , to identify gaps in the evidence base and to provide input for systematic review s. We search ed for workplace intervention studies that aim ed at enhancing recovery . We used an iterative method common in qualitative research to obtain an overview of study elements , including intervention content , design , theory , measurements , effects and cost-effectiveness . Results We found 28 studies evaluating seven types of interventions mostly using a r and omized controlled study design . For person-directed interventions , we found relaxation techniques , training of recovery experiences , promotion of physical activity and stress management . For work-directed interventions , there were participatory changes , work-break schedules and task variation . Most interventions were based on the conservation of re sources and affect-regulation theories , none were based on the effort-recovery theory . The  need for recovery ( NfR ) and the recovery experiences question naires ( REQ ) were used most often . Study authors reported a beneficial effect of the intervention in 14 of 26 published studies . None of the studies that used the NfR scale found a beneficial effect , whereas studies that used the REQ showed beneficial effects . Three studies indicated that interventions were not cost-effective . Conclusions Feasible and possibly effective interventions are available for improving recovery from cognitive and physical workload . Systematic review s are needed to determine their effectiveness Objective : The aim of this study was to determine whether individuals who participated in an intervention to reduce sitting at work would report changes in arousal , fatigue , and mood . Methods : Inactive females with full-time sedentary occupations ( N = 49 ) were r and omly assigned to take short , frequent breaks ( SBs ) or longer , planned breaks ( LBs ) from sitting each workday for 8 weeks . At baseline and postintervention , participants completed measures of arousal , fatigue , and mood . Within- and between-group changes were examined . Results : SB participants reduced sitting and reported moderate to large improvements in all affective outcomes except calmness ( d = −0.44 to -0.82 ) , whereas effect sizes were small for the LB group ( d = 0.01 to -0.28 ) . Only changes in negative affect differed between groups ( P = 0.045 ) . Conclusion : This study suggests that taking short , frequent breaks from sitting may be an effective strategy for improving affective outcomes among sedentary female employees UNLABELLED Purpose : To perform a systematic review with best evidence synthesis examining the literature on the relationship between occupational loading tasks and  knee osteoarthritis ( OA ) . METHODS Two data bases were search ed to identify articles published between 1946 and April , 2011 . Eligible studies were those that ( 1 ) included adults reporting on their employment history ; ( 2 ) measured individuals ' exposure to work-related activities with heavy loading in the knee joint ; and ( 3 ) identified presence of knee OA ( determined by X-ray ) , cartilage defects associated with knee OA ( identified by magnetic resonance imaging ) , or joint replacement surgery . RESULTS A total of 32 articles from 31 studies met the inclusion criteria . We found moderate evidence that combined heavy lifting and kneeling is a risk factor for knee OA , with odds ratios ( OR ) varying from 1.8 to 7.9 , and limited evidence for heavy lifting ( OR=1.4 - 7.3 ) , kneeling ( OR=1.5 - 6.9 ) , stair climbing ( OR=1.6 - 5.1 ) , and occupational groups ( OR=1.4 - 4.7 ) as risk factors . When examined by sex , moderate level evidence of knee OA was found in men ; however , the evidence in women was limited . CONCLUSIONS Further high- quality prospect i ve studies are warranted to provide further evidence on the role of occupational loading tasks in knee OA , particularly in women
target: We found low- quality evidence that different work-break frequencies may have no effect on participant-reported musculoskeletal pain , discomfort and fatigue .
  For productivity and work performance , evidence was of very low- quality that different work-break frequencies may have a positive effect .
  For different types of break , there may be no effect on participant-reported musculoskeletal pain , discomfort and fatigue according to low- quality evidence .
  Furthermore , work-break interventions should be reconsidered , taking into account worker population s other than office workers , and taking into account the possibility of combining work-break intervention with other interventions such as ergonomic training or counselling , which may may possibly have an effect on musculoskeletal outcomes and work performance
background: BACKGROUND Work-related musculoskeletal disorders are a group of musculoskeletal disorders that comprise one of the most common disorders related to occupational sick leave worldwide .
  Musculoskeletal disorders accounted for 21 % to 28 % of work absenteeism days in 2017/2018 in the Netherl and s , Germany and the UK .
  There are several interventions that may be effective in tackling the high prevalence of work-related musculoskeletal disorders among workers , such as physical , cognitive and organisational interventions .
  In this review , we will focus on work breaks as a measure of primary prevention , which are a type of organisational intervention .
  OBJECTIVES To compare the effectiveness of different work-break schedules for preventing work-related musculoskeletal symptoms and disorders in healthy workers , when compared to conventional or alternate work-break schedules .