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      Evaluation of ‘I-Preventive’: a digital preventive tool for musculoskeletal disorders in computer workers—a pilot cluster randomised trial

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          Abstract

          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 randomised trial in 2 different sites of a tyre factory in France. We randomised 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 questionnaires.

          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.

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          Most cited references29

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          International experiences with the Hospital Anxiety and Depression Scale--a review of validation data and clinical results.

          More than 200 published studies from most medical settings worldwide have reported experiences with the Hospital Anxiety and Depression Scale (HADS) which was specifically developed by Zigmond and Snaith for use with physically ill patients. Although introduced in 1983, there is still no comprehensive documentation of its psychometric properties. The present review summarizes available data on reliability and validity and gives an overview of clinical studies conducted with this instrument and their most important findings. The HADS gives clinically meaningful results as a psychological screening tool, in clinical group comparisons and in correlational studies with several aspects of disease and quality of life. It is sensitive to changes both during the course of diseases and in response to psychotherapeutic and psychopharmacological intervention. Finally, HADS scores predict psychosocial and possibly also physical outcome.
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            Work-related musculoskeletal disorders: the epidemiologic evidence and the debate.

            The debate about work-relatedness of musculoskeletal disorders (MSDs) reflects both confusion about epidemiologic principles and gaps in the scientific literature. The physical ergonomic features of work frequently cited as risk factors for MSDs include rapid work pace and repetitive motion, forceful exertions, non-neutral body postures, and vibration. However, some still dispute the importance of these factors, especially relative to non-occupational causes. This paper addresses the controversy with reference to a major report recently commissioned by the US Congress from the National Research Council (NRC) and Institute of Medicine (IOM) (2001). The available epidemiologic evidence is substantial, but will benefit from more longitudinal data to better evaluate gaps in knowledge concerning latency of effect, natural history, prognosis, and potential for selection bias in the form of the healthy worker effect. While objective measures may be especially useful in establishing a more secure diagnosis, subjective measures better capture patient impact. Examination techniques still do not exist that can serve as a "gold standard" for many of the symptoms that are commonly reported in workplace studies. Finally, exposure assessment has too often been limited to crude indicators, such as job title. Worker self-report, investigator observation, and direct measurement each add to understanding but the lack of standardized exposure metrics limits ability to compare findings among studies. Despite these challenges, the epidemiologic literature on work-related MSDs-in combination with extensive laboratory evidence of pathomechanisms related to work stressors-is convincing to most. The NRC/IOM report concluded, and other reviewers internationally have concurred, that the etiologic importance of occupational ergonomic stressors for the occurrence of MSDs of the low back and upper extremities has been demonstrated.
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              Long term sickness absence.

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                Author and article information

                Journal
                BMJ Open
                BMJ Open
                bmjopen
                bmjopen
                BMJ Open
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                2044-6055
                2016
                22 September 2016
                : 6
                : 9
                : e011304
                Affiliations
                [1 ]Department of Preventive and Occupational Medicine, University Hospital of Clermont-Ferrand (CHU) , Clermont-Ferrand, France
                [2 ]Department of Physical Medicine and Rehabilitation, University Hospital of Clermont-Ferrand (CHU) , Clermont-Ferrand, France
                [3 ]Department of Psychological & Psychosocial Stress, CNRS UMR 6024, University of Clermont Auvergne , Clermont-Ferrand, France
                [4 ]Clermont Auvergne University, France
                [5 ]University Hospital of Clermont-Ferrand (CHU), Clinical Research and Innovation Direction , Clermont-Ferrand, France
                [6 ]Michelin , Clermont-Ferrand, France
                [7 ]Faculty of Health, Australian Catholic University, School of Exercise Science , Melbourne, Victoria, Australia
                [8 ]Laboratory of Metabolic Adaptations to Exercise in Physiological and Pathological Conditions (AME2P, EA3533), University of Clermont Auvergne , Clermont-Ferrand, France
                [9 ]INRA, Human Nutrition Unit UMR1019, Clermont-Ferrand, France
                Author notes
                [Correspondence to ] Dr C Lanhers; lanhers.charlotte@ 123456gmail.com
                Author information
                http://orcid.org/0000-0002-1468-6029
                Article
                bmjopen-2016-011304
                10.1136/bmjopen-2016-011304
                5051336
                27660316
                0a398a25-14de-4158-80ad-dab7a460579e
                Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

                This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

                History
                : 27 January 2016
                : 18 June 2016
                : 5 July 2016
                Categories
                Occupational and Environmental Medicine
                Research
                1506
                1716
                1727
                1736

                Medicine
                preventive medicine,sports medicine
                Medicine
                preventive medicine, sports medicine

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