A cluster-randomized trial of workplace ergonomics and neck-specific exercise versus ergonomics and health promotion for office workers to manage neck pain – a secondary outcome analysis

Abstract

Background Neck pain is prevalent among office workers. This study evaluated the impact of an ergonomic and exercise training (EET) intervention and an ergonomic and health promotion (EHP) intervention on neck pain intensity among the All Workers and a subgroup of Neck Pain cases at baseline. Methods A 12-month cluster-randomized trial was conducted in 14 public and private organisations. Office workers aged ≥18 years working ≥30 h per week (n = 740) received an individualised workstation ergonomic intervention, followed by 1:1 allocation to the EET group (neck-specific exercise training), or the EHP group (health promotion) for 12 weeks. Neck pain intensity (scale: 0–9) was recorded at baseline, 12 weeks, and 12 months. Participants with data at these three time points were included for analysis (n = 367). Intervention group differences were analysed using generalized estimating equation models on an intention-to-treat basis and adjusted for potential confounders. Subgroup analysis was performed on neck cases reporting pain ≥3 at baseline (n = 96). Results The EET group demonstrated significantly greater reductions in neck pain intensity at 12 weeks compared to the EHP group for All Workers (EET: β = − 0.53 points 95% CI: − 0.84– − 0.22 [36%] and EHP: β = − 0.17 points 95% CI: − 0.47–0.13 [10.5%], p-value = 0.02) and the Neck Cases (EET: β = − 2.32 points 95% CI: − 3.09– − 1.56 [53%] and EHP: β = − 1.75 points 95% CI: − 2.35– − 1.16 [36%], p = 0.04). Reductions in pain intensity were not maintained at 12 months with no between-group differences observed in All Workers (EET: β = − 0.18, 95% CI: − 0.53–0.16 and EHP: β = − 0.14 points 95% CI: − 0.49–0.21, p = 0.53) or Neck Cases, although in both groups an overall reduction was found (EET: β = − 1.61 points 95% CI: − 2.36– − 0.89 and EHP: β = − 1.9 points 95% CI: − 2.59– − 1.20, p = 0.26). Conclusion EET was more effective than EHP in reducing neck pain intensity in All Workers and Neck Cases immediately following the intervention period (12 weeks) but not at 12 months, with changes at 12 weeks reaching clinically meaningful thresholds for the Neck Cases. Findings suggest the need for continuation of exercise to maintain benefits in the longer term. Clinical trial registration hACTRN12612001154897 Date of Registration: 31/10/2012.

A Multi-component Intervention (NEXpro) Reduces Neck Pain-Related Work Productivity Loss: A Randomized Controlled Trial Among Swiss Office Workers

“…According to Kotz and colleagues [ 45 ], the most important disadvantage is that an intervention is implemented in all clusters, whereas it has not yet proven to be effective. However, in our case several components of our intervention already proved to be effective in other studies [ 12 , 13 , 17 , 21 , 29 ]. Hence, a stepped-wedge design is superior both scientifically (more data) and ethically as has been pointed out by Mdege and colleagues [ 46 ].…”

“…This is particularly an advantage from an ethical point of view, given that the intervention does more good than harm. Since previous research showed that individual components of our multi-component intervention were effective in reducing neck pain [ 12 , 13 , 21 ], the choice of the design seemed more appropriate compared to other study designs such as the classic cluster RCT. Detailed information can be found in the trial profile (Fig.…”

Evaluation of an exercise and ergonomics intervention for the prevention of neck pain in office workers: exploratory analysis of a cluster randomised trial

“…While we believe that the reduction in neck cases was likely due to the exercise intervention, it is possible that factors not assessed also contributed to this finding. Nonetheless, we are confident in these results as adherence to the intervention on completion remained consistent for the control group while reducing for the exercise group 23. Other limitations include the use of self-reported outcomes and no evaluation on other potential confounders such as smoking habits.…”

“…Written informed consent was obtained from participants before data collection. The study protocol,21 and the results of the primary and secondary outcome have been published 22 23. The Consolidated Standards of Reporting Trials extension for cluster trials was observed for reporting 24.…”

“…The study ceased when this target sample size was reached. Harms and unintended effects are reported elsewhere 23…”