No difference between postural exercises and strength and fitness exercises for early, non-specific, work-related upper limb disorders in visual display unit workers: a randomised trial.
OBJECTIVE
Are postural exercises delivered by Mensendieck/Cesar therapists more effective in decreasing pain, reducing disability and improving health-related quality of life in visual display unit workers with early non-specific work-related upper limb disorders than strength and fitness exercises delivered by physiotherapists?


METHODS
Randomised trial with concealed allocation and intention-to-treat analysis.


METHODS
Eighty-eight (6 drop-outs) visual display unit workers with early non-specific work-related upper limb disorders.


METHODS
One group received 10 weeks of postural exercises while the other group received 10 weeks of strength and fitness exercises.


METHODS
Pain was measured with a 10-cm visual analogue scale, disability was measured with the Disabilities of Arm, Shoulder and Hand questionnaire, and health-related quality of life was measured with the Short Form-36. Number of participants experiencing upper limb complaints was also collected. Outcome measures were collected at baseline and again at 3, 6, and 12 months.


RESULTS
There was no significant difference in decrease in pain between the groups at 3 months (0.6 cm, 95% CI 0.0 to 1.2), 6 months (0.2, 95% CI -0.3 to 0.7), or at 12 months (0.1, 95% CI -0.6 to 0.8). Differences between the groups in upper limb complaints, disability, and health related quality of life were also small and not significant at any measurement occasion.


CONCLUSIONS
Postural exercises did not result in a better outcome than strength and fitness exercises. However, 55% of visual display unit workers with early non-specific work-related upper limb disorders reported being free of complaints one year after both interventions were commenced.


BACKGROUND
ISRCTN15872455.
van Eijsden-Besseling
Marjon D
MD
University Hosptial Maastricht, Maastricht, 6202 AZ, The Netherlands. Mvey@frev.am.nl
Staal
J Bart
JB
van Attekum
Antonius
A
de Bie
Rob A
RA
van den Heuvel
Wim J A
WJ
D000328:Adult; D005081:Exercise Therapy; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D053580:Muscle Strength; D018482:Muscle, Skeletal / Q000503:physiopathology*; D009140:Musculoskeletal Diseases / Q000209:etiology; D009426:Netherlands / Q000453:epidemiology; D009784:Occupational Diseases / Q000209:etiology / Q000534:rehabilitation*; D016273:Occupational Exposure / Q000009:adverse effects; D010809:Physical Fitness; D011187:Posture; D015995:Prevalence; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D013997:Time Factors; D034941:Upper Extremity / Q000473:pathology*; D014584:User-Computer Interface