title: The cost-effectiveness of a lifestyle physical activity intervention in addition to a work style intervention on recovery from neck and upper limb symptoms and pain reduction in computer workers.
abstract: OBJECTIVE
  To evaluate the cost-effectiveness of a work style (WS) intervention and a work style plus physical activity (WSPA) intervention in computer workers with neck and upper limb symptoms compared with usual care.
  
  
  METHODS
  An economic evaluation was conducted from an employer's perspective and alongside a randomised controlled trial in which 466 computer workers with neck and upper limb symptoms were randomised to a WS group (N = 152), a WSPA group (N = 156) or a usual care group (N=158). Total costs were compared to the effects on recovery and pain intensity. In the primary analyses, missing effect data were imputed using multiple imputation techniques.
  
  
  RESULTS
  Total costs during the 12-month intervention and follow-up period were €1907 (WS), €2811 (WSPA) and €2310 (usual care). Differences between groups were not statistically significant. Neither intervention was more effective than usual care in improving overall recovery. The WS intervention was more effective than usual care in reducing current pain, average pain and worst pain in the past 4 weeks, but the WSPA intervention was not. The acceptability curve showed that when a company is willing to pay approximately €900 for a 1-point reduction in average pain (scale from 0 to 10), the probability of cost-effectiveness compared to usual care is 95%. Similar results were observed for current and worst pain.
  
  
  CONCLUSIONS
  This study shows that the WS intervention was not cost-effective for improving recovery but was cost-effective for reducing pain intensity, although this reduction was not clinically significant. The WSPA intervention was not cost-effective compared with usual care. Trial registration number ISRCTN87019406.
authors.affiliation: Body@Work Research Center on Physical Activity, Work and Health, TNO-VUmc, Amsterdam, The Netherlands. claire.bernaards@tno.nl
authors.forename: Claire M
authors.initials: CM
authors.lastname: Bernaards
authors.forename: Judith E
authors.initials: JE
authors.lastname: Bosmans
authors.forename: Vincent H
authors.initials: VH
authors.lastname: Hildebrandt
authors.forename: Maurits W
authors.initials: MW
authors.lastname: van Tulder
authors.forename: Martijn W
authors.initials: MW
authors.lastname: Heymans
mesh_terms: D000041:Absenteeism; D000328:Adult; D003201:Computers; D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D012090:Cumulative Trauma Disorders / Q000191:economics / Q000534:rehabilitation*; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D019547:Neck Pain / Q000191:economics / Q000534:rehabilitation; D009784:Occupational Diseases / Q000191:economics / Q000534:rehabilitation*; D009786:Occupational Health Services / Q000191:economics; D040242:Risk Reduction Behavior; D016896:Treatment Outcome; D034941:Upper Extremity / Q000503:physiopathology