A comparison of symptomatic and asymptomatic office workers performing monotonous keyboard work--1: neck and shoulder muscle recruitment patterns.

Work-related neck and upper limb disorders (WRNULD) are common problems among office workers who use computers intensively and maintain prolonged static postures. These disorders have often been attributed to result from sustained muscle activity in the neck-shoulder musculature. The present study examined whether symptomatic subjects exhibited the same muscle activity patterns as asymptomatic controls when they performed a prolonged computer task under the same conditions. Surface electromyography (EMG) of four major neck-shoulder muscles were compared between a Case Group (n=23) and a Control Group (n=20) of female office workers. The Case Group had higher activity in the right upper trapezius (UT) while the Control Group had more symmetrical muscle activity between left and right UT. The Case subjects could also be differentiated into "High Discomfort" and "Low Discomfort" sub-groups based on their discomfort scores. The High Discomfort Group had significantly higher right UT activity compared to the Low Discomfort and Control Groups. Results suggested that symptomatic individuals had altered muscle recruitment patterns that persisted throughout the sustained occupational task, while discomfort increased with time-at-task. These findings indicate that altered muscle recruitment patterns observed in the symptomatic subjects preceded the onset of task discomfort, and this finding may have important implications for the etiology of WRNULD.

[1]  H Johansson,et al.  Pathophysiological mechanisms involved in genesis and spread of muscular tension in occupational muscle pain and in chronic musculoskeletal pain syndromes: a hypothesis. , 1991, Medical hypotheses.

[2]  L. Punnett,et al.  Pathomechanisms of work-related musculoskeletal disorders: conceptual issues , 2002, Ergonomics.

[3]  R. Jennrich,et al.  EMG activity in neck and back muscles during selected static postures in adult males and females , 1997 .

[4]  Maarten J. IJzerman,et al.  Cervical Muscle Dysfunction in the Chronic Whiplash Associated Disorder Grade II (WAD-II) , 2000, Spine.

[5]  W. Kibler,et al.  The role of the scapula in athletic shoulder function. , 1998, The American journal of sports medicine.

[6]  Morten Wærsted,et al.  Human muscle activity related to non-biomechanical factors in the workplace , 2000, European Journal of Applied Physiology.

[7]  S. Mense,et al.  Nociception from skeletal muscle in relation to clinical muscle pain , 1993, Pain.

[8]  Bill Vicenzino,et al.  Development of motor system dysfunction following whiplash injury , 2003, PAIN®.

[9]  E. Culham,et al.  Functional anatomy of the shoulder complex. , 1993, Physical therapy.

[10]  A Aarås,et al.  Postural load during VDU work: a comparison between various work postures. , 1997, Ergonomics.

[11]  R H Westgaard,et al.  Work-related musculoskeletal complaints: some ergonomics challenges upon the start of a new century. , 2000, Applied ergonomics.

[12]  Gwendolen Jull,et al.  Deep Cervical Flexor Muscle Dysfunction in Whiplash , 2000 .

[13]  R H Westgaard,et al.  Trapezius muscle activity as a risk indicator for shoulder and neck pain in female service workers with low biomechanical exposure , 2001, Ergonomics.

[14]  D Rempel,et al.  Risk factors for musculoskeletal disorders among computer users. , 1999, Occupational medicine.

[15]  W. G. Allread,et al.  The Influence of Psychosocial Stress, Gender, and Personality on Mechanical Loading of the Lumbar Spine , 2000, Spine.

[16]  B. Jonsson,et al.  Standardised Nordic questionnaires for the analysis of musculoskeletal symptoms. , 1987, Applied ergonomics.

[17]  O. Sjaastad,et al.  Cervicogenic Headache: The Influence of Mental Load on Pain Level and EMG of Shoulder‐Neck and Facial Muscles , 1996, Headache.

[18]  G. Jull,et al.  Impairment in the cervical flexors: a comparison of whiplash and insidious onset neck pain patients. , 2004, Manual therapy.

[19]  J. P. Lund,et al.  The pain-adaptation model: a discussion of the relationship between chronic musculoskeletal pain and motor activity. , 1991, Canadian journal of physiology and pharmacology.

[20]  A. Bergmark Stability of the lumbar spine. A study in mechanical engineering. , 1989, Acta orthopaedica Scandinavica. Supplementum.

[21]  C. Oatis,et al.  Incidence of common postural abnormalities in the cervical, shoulder, and thoracic regions and their association with pain in two age groups of healthy subjects. , 1992, Physical therapy.

[22]  R. H. Westgaard,et al.  Individual and work-related risk factors associated with symptoms of musculoskeletal complaints , 1993, International archives of occupational and environmental health.

[23]  Annika Åström,et al.  Load pattern and pressure pain threshold in the upper trapezius muscle and psychosocial factors in medical secretaries with and without shoulder/neck disorders , 1997, International archives of occupational and environmental health.

[24]  Leon Straker,et al.  Mouse versus keyboard use: A comparison of shoulder muscle load , 1998 .

[25]  B Jonsson,et al.  Measurement and evaluation of local muscular strain in the shoulder during constrained work. , 1982, Journal of human ergology.

[26]  S. Kumar,et al.  Theories of musculoskeletal injury causation , 2001, Ergonomics.

[27]  G. Jull,et al.  Cervical Range of Motion Discriminates Between Asymptomatic Persons and Those With Whiplash , 2001, Spine.

[28]  L. Straker,et al.  A comparison of symptomatic and asymptomatic office workers performing monotonous keyboard work--2: neck and shoulder kinematics. , 2005, Manual therapy.

[29]  Maarten J. IJzerman,et al.  Cervical Muscle Dysfunction in Chronic Whiplash-Associated Disorder Grade 2: The Relevance of the Trauma , 2002, Spine.

[30]  D House,et al.  Anatomy and actions of the trapezius muscle. , 1994, Clinical biomechanics.

[31]  G. Jull,et al.  Further Clinical Clarification of the Muscle Dysfunction in Cervical Headache , 1999, Cephalalgia.

[32]  G. Jull,et al.  The effect of musculoskeletal pain on motor activity and control. , 2001, The journal of pain : official journal of the American Pain Society.

[33]  K. Hansen,et al.  Trapezius muscle load as a risk indicator for occupational shoulder-neck complaints , 1993, International archives of occupational and environmental health.

[34]  I Bradl,et al.  Surface EMG of shoulder and back muscles and posture analysis in secretaries typing at visual display units , 1999, International archives of occupational and environmental health.

[35]  B. Knave,et al.  Eye discomfort and work with visual display terminals. , 1994 .

[36]  L. Fine,et al.  Job task and psychosocial risk factors for work-related musculoskeletal disorders among newspaper employees. , 1994, Scandinavian journal of work, environment & health.

[37]  P. Hodges,et al.  Inefficient Muscular Stabilization of the Lumbar Spine Associated With Low Back Pain: A Motor Control Evaluation of Transversus Abdominis , 1996, Spine.

[38]  S J Linton,et al.  Neck and shoulder disorders in medical secretaries. Part II. Ergonomical work environment and symptom profile. , 2020, Scandinavian journal of rehabilitation medicine.

[39]  Gordon Waddell,et al.  The Back Pain Revolution , 1998 .

[40]  Etienne Grandjean Fitting the task to the man , 1969 .

[41]  L. Straker,et al.  A field comparison of neck and shoulder postures in symptomatic and asymptomatic office workers. , 2002, Applied ergonomics.

[42]  Toby Hall,et al.  Responses to mechanical stimulation of the upper limb in painful cervical radiculopathy. , 1996, The Australian journal of physiotherapy.

[43]  David G. Simons,et al.  Myofascial Pain and Dysfunction : The Trigger Point Manual , 1992 .

[44]  R Merletti,et al.  Myoelectric manifestations of sternocleidomastoid and anterior scalene muscle fatigue in chronic neck pain patients , 2003, Clinical Neurophysiology.

[45]  G. Németh,et al.  Effects of changes in sitting work posture on static neck and shoulder muscle activity. , 1986, Ergonomics.

[46]  Cognitive performance and muscle activation in workers with chronic shoulder myalgia , 2001, Ergonomics.

[47]  G. Allison,et al.  Altered patterns of abdominal muscle activation in patients with chronic low back pain. , 1997, The Australian journal of physiotherapy.

[48]  S J Linton,et al.  A review of psychological risk factors in back and neck pain. , 2000, Spine.

[49]  R Ortengren,et al.  Reproducibility and stability of normalized EMG measurements on musculus trapezius. , 1996, Ergonomics.

[50]  P Asterland,et al.  Muscular rest and gap frequency as EMG measures of physical exposure: the impact of work tasks and individual related , 2000, Ergonomics.

[51]  R H Westgaard,et al.  Mental Stress of Long Duration: EMG Activity, Perceived Tension, Fatigue, and Pain Development in Pain‐Free Subjects , 1997, Headache.