Department of Occupational Medicine, Sydvestjysk Sygehus, Østergade 81-83, DK-6700 Esbjerg, Denmark.
J Occup Med Toxicol. 2008 Jan 7;3:1. doi: 10.1186/1745-6673-3-1.
In a previous study of computer operators we have demonstrated the relation of upper limb pain to individual and patterns of neurological findings (reduced function of muscles, sensory deviations from normal and mechanical allodynia of nerve trunks). The identified patterns were in accordance with neural afflictions at three specific locations (brachial plexus at chord level, posterior interosseous and median nerve on elbow level). We have introduced an intervention program aiming to mobilize nerves at these locations and tested its efficacy.
125 and 59, respectively, computer operators in two divisions of an engineering consultancy company were invited to answer a questionnaire on upper limb symptoms and to undergo a blinded neurological examination. Participants in one division were subsequently instructed to participate in an upper limb stretching course at least three times during workdays in a six month period. Subjects from the other division served as controls. At the end of the intervention both groups were invited to a second identical evaluation by questionnaire and physical examination. Symptoms and findings were studied in the right upper limb. Perceived changes of pain were recorded and individual and patterns of physical findings assessed for both groups at baseline and at follow-up. In subjects with no or minimal preceding pain we additionally studied the relation of incident pain to the summarized findings for parameters contained in the definition of nerve affliction at the three locations.
Summarized pain was significantly reduced in the intervention group but unchanged in controls. After the intervention, fewer neurological abnormalities in accordance with nerve affliction were recorded for the whole material but no conclusion could be drawn regarding the relation to the intervention of this reduction. Incident pain correlated to findings in accordance with the three locations of nerve affliction.
A six month course of stretching seems to reduce upper limb symptoms in computer operators but we could not demonstrate an influence on neurological physical findings in this sample. The relation of incident symptoms to identified neurological patterns provides additional support to the construct validity of the employed neurological examination.
在之前对电脑操作人员的研究中，我们已经证明了上肢疼痛与个体和神经发现模式（肌肉功能降低、感觉偏离正常和神经干机械性痛觉过敏）之间的关系。所确定的模式与三个特定部位的神经病变（臂丛在脊索水平、骨间后神经和肘水平正中神经）相符。我们已经引入了一项旨在动员这些部位神经的干预计划，并测试了其疗效。
我们邀请了一家工程咨询公司两个部门的 125 名和 59 名电脑操作人员分别回答一份关于上肢症状的问卷，并接受盲法神经检查。一个部门的参与者随后被指示在六个月的工作日期间至少参加三次上肢伸展课程。另一部门的人员作为对照组。干预结束后，两组人员都被邀请接受第二次相同的问卷调查和体格检查。研究对象为右侧上肢。记录了疼痛的感知变化，并对两组在基线和随访时的个体和神经病变的物理发现模式进行了评估。在没有或仅有轻微先前疼痛的受试者中，我们还研究了新发生的疼痛与三个部位神经病变定义中包含的参数的综合发现之间的关系。
干预组的综合疼痛明显减轻，但对照组没有变化。在干预后，整个材料中记录到的与神经病变相符的神经异常减少，但无法得出关于这种减少与干预的关系的结论。新发疼痛与三个部位的神经病变相符的发现相关。
六个月的伸展课程似乎可以减轻电脑操作人员的上肢症状，但我们无法证明这种方法对本样本的神经物理发现有影响。新发症状与已确定的神经病变模式之间的关系为所采用的神经检查的结构有效性提供了额外的支持。
