title: Contribution of biopsychosocial risk factors to nonspecific neck pain in office workers: A path analysis model.
abstract: OBJECTIVE
  The etiology of nonspecific neck pain is widely accepted to be multifactorial. Each risk factor has not only direct effects on neck pain but may also exert effects indirectly through other risk factors. This study aimed to test this hypothesized model in office workers.
  
  
  METHODS
  A one-year prospective cohort study of 559 healthy office workers was conducted. At baseline, a self-administered questionnaire and standardized physical examination were employed to gather biopsychosocial data. Follow-up data were collected every month for the incidence of neck pain. A regression model was built to analyze factors predicting the onset of neck pain. Path analysis was performed to examine direct and indirect associations between identified risk factors and neck pain.
  
  
  RESULTS
  The onset of neck pain was predicted by female gender, having a history of neck pain, monitor position not being level with the eyes, and frequently perceived muscular tension, of which perceived muscular tension was the strongest effector on the onset of neck pain. Gender, history of neck pain, and monitor height had indirect effects on neck pain that were mediated through perceived muscular tension. History of neck pain was the most influential effector on perceived muscular tension.
  
  
  CONCLUSIONS
  The results of this study support the hypothesis that each risk factors may contribute to the development of neck pain both directly and indirectly. The combination of risk factors necessary to cause neck pain is likely occupation specific. Perceived muscular tension is hypothesized to be an early sign of musculoskeletal symptoms.
authors.affiliation: Department of Physical Therapy, Faculty of Allied Health Sciences, Chulalongkorn University.
authors.forename: Arpalak
authors.initials: A
authors.lastname: Paksaichol
authors.forename: Chaipat
authors.initials: C
authors.lastname: Lawsirirat
authors.forename: Prawit
authors.initials: P
authors.lastname: Janwantanakul
mesh_terms: D000328:Adult; D016288:Computer Terminals; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009129:Muscle Tonus; D019547:Neck Pain / Q000453:epidemiology / Q000209:etiology* / Q000523:psychology; D009784:Occupational Diseases / Q000453:epidemiology / Q000209:etiology* / Q000523:psychology; D009790:Occupations; D011446:Prospective Studies; D012044:Regression Analysis; D012307:Risk Factors; D057566:Self Report; D012737:Sex Factors; D013785:Thailand / Q000453:epidemiology; D016526:Workload; D017132:Workplace