title: Safety, tolerability and effectiveness of an ergonomic intervention with chiropractic care for knowledge workers with upper-extremity musculoskeletal disorders: a prospective case series.
abstract: BACKGROUND
  One hundred and sixty million office workers (knowledge workers) in the U.S. and 2/3 of the developed countries use computers on a daily basis.
  
  
  OBJECTIVE
  Investigate the effectiveness of ergonomic and diversified chiropractic care for the reduction of pain, discomfort and impaired productivity in knowledge workers presenting with neck and upper extremity musculoskeletal complaints.
  
  
  METHODS
  A one-year prospective case series (n=5 applying ergonomic job task analyses and ongoing surveillance at baseline, 8 weeks, 16 weeks and one-year for musculoskeletal discomfort (CMDQ and VAS, quality of life (Rand SF-36, productivity and forward head posture (FHP).
  
  
  RESULTS
  CMDQ and VAS scores decreased by 45% (neck) and 80% (upper extremities); productivity increased from 65% to 100%; physical functioning, role physical and role emotional improved for 4 of 5 subjects; body pain and general health improved for 3 of 5. Average FHP changed from 1-inch (baseline) to 1/4-inch (16-weeks) to 1/2-inch (one year).
  
  
  CONCLUSIONS
  Effectiveness of this intervention for the reduction of risks depended upon the subject's adoption of safe workstyle behaviors and postures. A transtheoretical model (TTM) for behavior change is discussed as a possible methodology to enhance the adoption of safer work habits.
authors.affiliation: Ergonomics Institute, Life Chiropractic College West, Hayward, CA, USA.
authors.forename: Chuck
authors.initials: C
authors.lastname: Sherrod
authors.affiliation: Life Chiropractic College West, Hayward, CA, USA.
authors.forename: Dale
authors.initials: D
authors.lastname: Johnson
authors.affiliation: Life Chiropractic College West, Hayward, CA, USA.
authors.forename: Bruce
authors.initials: B
authors.lastname: Chester
mesh_terms: D000328:Adult; D002684:Chiropractic; D003201:Computers; D006804:Ergonomics / Q000379:methods*; D005260:Female; D006801:Humans; D007374:Interior Design and Furnishings / Q000592:standards; D008297:Male; D008875:Middle Aged; D026741:Physical Therapy Modalities; D011187:Posture / Q000502:physiology; D011446:Prospective Studies; D011788:Quality of Life; D013663:Teaching; D034941:Upper Extremity / Q000293:injuries*
keywords: Ergonomics job task analysis; behavior change; chiropractic care; transtheoretical model; upper extremity musculoskeletal disorder