Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China.
School of Medical and Health Sciences, Tung Wah College, Hong Kong SAR, China.
Eur J Pain. 2019 Jul;23(6):1141-1152. doi: 10.1002/ejp.1381. Epub 2019 Mar 11.
Work-related neck and shoulder pain (WRNSP) is highly prevalent among patients who seek physiotherapy treatment. Clinicians may tend to focus on teaching home exercises and provide general advice about workplace improvement. The present study investigates the short- and long-term impact of an intervention approach that emphasizes on integrating the motor control re-education with ergonomic advice.
Participants diagnosed with WRNSP (n = 101) were randomly assigned into two groups in this randomized controlled trial. The Ergo-motor Group (EM, n = 51) received an integrated intervention with ergonomic advice/modifications and motor control training individualized for each participant based on their specific work demands. Control Group (CO, n = 50) received treatment for pain relief and general exercises of their necks at a designated physiotherapy clinic. Neck pain intensity and functional outcome measures were assessed before, immediately and 1-year after the 12-week intervention programmes. Global Rating of Change Score was used to evaluate the perceived recovery at 1-year follow-up.
Both groups reported significant reductions in pain and functional disability scores at post-intervention (EM, n = 44; CO, n = 42) and 1-year follow-up (EM, n = 40; CO, n = 38); however, no significant between-group differences were found (p > 0.05). Significantly higher rating in global recovery score was reported in EM group at 1-year follow-up (p < 0.05).
Intervention integrating ergonomic advice/modification with motor control exercise was found to be equally effective as pain relief and general exercise for pain and functional recovery. However, at 1-year follow-up, such integrated approach resulted in significantly better global recovery perceived by people with WRNSP.
Integrating ergonomic intervention and motor control training achieved similar reduction in pain and functional outcomes compared to conventional physiotherapy at post-intervention and at 1-year follow-up, for patients with moderate level of work-related neck-shoulder pain and mild degree of functional disability. The Ergo-motor Group reported significantly better perceived overall recovery at 1-year follow-up.
在寻求物理治疗的患者中，与工作相关的颈部和肩部疼痛（WRNSP）非常普遍。临床医生可能倾向于专注于教授家庭锻炼，并提供有关工作场所改善的一般建议。本研究调查了一种干预方法的短期和长期影响，该方法强调将运动控制再教育与人体工程学建议相结合。
在这项随机对照试验中，将 101 名被诊断为 WRNSP 的参与者随机分为两组。运动控制组（EM，n=51）接受了一种综合干预措施，包括根据每个参与者的特定工作需求为其提供个性化的人体工程学建议/修改和运动控制训练。对照组（CO，n=50）在指定的物理治疗诊所接受针对疼痛缓解和颈部一般性锻炼的治疗。在干预计划结束前、立即和 1 年后，评估颈部疼痛强度和功能结果测量。使用整体变化评分评估 1 年后的感知恢复情况。
两组在干预后（EM，n=44；CO，n=42）和 1 年随访时（EM，n=40；CO，n=38）均报告疼痛和功能障碍评分显著降低，但组间无显著差异（p>0.05）。在 1 年随访时，EM 组报告的整体恢复评分明显更高（p<0.05）。
将人体工程学建议/修改与运动控制练习相结合的干预措施与疼痛缓解和一般性锻炼一样，对疼痛和功能恢复有效。然而，在 1 年随访时，对于有中度工作相关颈肩痛和轻度功能障碍的患者，这种综合方法导致的整体恢复感知明显更好。
与传统物理治疗相比，在干预后和 1 年随访时，将人体工程学干预与运动控制训练相结合，可在疼痛和功能结果方面取得相似的减轻，对于中度工作相关颈部肩部疼痛和轻度功能障碍的患者。运动控制组在 1 年随访时报告的整体恢复感知明显更好。
