Myofeedback training and intensive muscular strength training to decrease pain and improve work ability among female workers on long-term sick leave with neck pain: a randomized controlled trial.
The theoretical framework is that muscle tension in the neck is related to insufficient muscular rest and is a risk factor for chronic pain and reduced work ability. Promoting muscle strength and muscle rest may increase work ability and reduce neck pain.


OBJECTIVE
To test whether myofeedback training or intensive strength training leads to decreased pain and increased work ability in women on long-term sick leave.


METHODS
This is a randomized controlled trial of two 1-month interventions with myofeedback or muscular strength training in the home environment. Female human service organization workers (n = 60) on long-term (>60 days) sick leave and with chronic neck pain were followed with self-reported and laboratory-observed data of health, pain, muscular activation, and work ability, at baseline, immediately after the intervention and 3 months after baseline.


RESULTS
For both intervention groups, pain was lowered over time compared with the control group. Decreased pain and muscular activity was associated with increased self-rated work ability and with laboratory-observed work ability at 3-month follow-up. Decreased pain was also associated with increased self-rated work ability at 1-month follow-up. Muscular strength training was associated with increased self-rated work ability and mental health. Myofeedback was associated with increased observed work ability and self- rated vitality.


CONCLUSIONS
The two interventions showed positive results, suggesting that they could be developed for use in health care practice to address pain and work ability. The intensive muscular strength training program, which is both easy to conduct at home and easy to coach, was associated with increased work ability.
Dellve
Lotta
L
Occupational and Environmental Medicine, Sahlgrenska Academy, University of Gothenburg, Box 414, 405 30, Gothenburg, Sweden. lotta.dellve@amm.gu.se
Ahlstrom
Linda
L
Jonsson
Andreas
A
Sandsjö
Leif
L
Forsman
Mikael
M
Lindegård
Agneta
A
Ahlstrand
Christina
C
Kadefors
Roland
R
Hagberg
Mats
M
D000328:Adult; D001676:Biofeedback, Psychology; D004576:Electromyography; D005260:Female; D018737:Hand Strength / Q000502:physiology; D006304:Health Status; D006801:Humans; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000502:physiology; D019547:Neck Pain / Q000503:physiopathology / Q000534:rehabilitation*; D009784:Occupational Diseases / Q000503:physiopathology / Q000534:rehabilitation*; D009788:Occupational Therapy / Q000379:methods*; D012064:Relaxation Therapy; D055070:Resistance Training / Q000379:methods*; D018582:Sick Leave; D016896:Treatment Outcome
Scand J Soc Med. 1997 Sep;25(3):185-92
9360275
J Occup Rehabil. 2002 Jun;12(2):55-64
12014226
Cochrane Database Syst Rev. 2005 Jul 20;(3):CD004250
16034925
Scand J Public Health. 2001 Jun;29(2):104-12
11484862
Orthop Clin North Am. 1996 Oct;27(4):841-60
8823401
Acta Physiol Scand. 1992 Mar;144(3):387-94
1585821
Arthritis Rheum. 2008 Jan 15;59(1):84-91
18163419
Scand J Rheumatol. 2005 Jul-Aug;34(4):277-83
16195160
Scand J Work Environ Health. 1993 Aug;19(4):277-83
8235517
Exerc Sport Sci Rev. 1987;15:95-151
3297731
Scand J Work Environ Health. 2002 Jun;28(3):184-90
12109558
Scand J Public Health. 2006;34(1):17-25
16449040
Scand J Work Environ Health. 1997;23 Suppl 1:49-57
9247995
Arch Phys Med Rehabil. 2000 Aug;81(8):1051-8
10943754
Pain. 1992 Aug;50(2):133-149
1408309
J Appl Physiol (1985). 2008 Dec;105(6):1796-801
18948442
Eur J Appl Physiol. 2000 Oct;83(2-3):235-8
11104066
Ann Rheum Dis. 2004 Nov;63(11):1362-7
15479885
Stat Methods Med Res. 1999 Jun;8(2):135-60
10501650
J Strength Cond Res. 2010 Apr;24(4):1037-42
20300021
Med Sci Sports Exerc. 1990 Aug;22(4):417-28
2205777
J Electromyogr Kinesiol. 1995 Dec;5(4):197-226
20719652
Percept Mot Skills. 2009 Oct;109(2):500-16
20038004
J Occup Rehabil. 2007 Mar;17(1):137-52
17260162
Soc Psychiatry Psychiatr Epidemiol. 2001 Jun;36(6):310-6
11583462
Scand J Work Environ Health. 2010 Sep;36(5):404-12
20372766
Scand J Work Environ Health. 2005 Dec;31(6):438-49
16425585
Occup Environ Med. 2004 Jun;61(6):523-8
15150392
Spine (Phila Pa 1976). 2006 Dec 15;31(26):3045-51
17173002
Scand J Work Environ Health. 1997;23 Suppl 1:58-65
9247996
Eur Spine J. 2006 Jun;15(6):834-48
15999284
Ann Intern Med. 2001 Apr 17;134(8):663-94
11304107
Int Arch Occup Environ Health. 1997;69(6):423-32
9215929
Am J Ind Med. 1999 Sep;Suppl 1:21-3
10519773
Spine (Phila Pa 1976). 2008 Feb 15;33(4 Suppl):S123-52
18204386
J Occup Environ Med. 2006 Jun;48(6):591-8
16766923