Top

International Archives of Occupational and Environmental Health

Published in:

01-10-2014 | Original Article

Changes in physical activity and heart rate variability in chronic neck–shoulder pain: monitoring during work and leisure time

Authors: David M. Hallman, Annika Hed Ekman, Eugene Lyskov

Published in: International Archives of Occupational and Environmental Health | Issue 7/2014

Abstract

Objectives

Neck–shoulder pain (NSP) is a common work-related musculoskeletal disorder with unclear mechanisms. Changes in physical activity and autonomic nervous system regulation may be involved in the pathogenesis of chronic NSP. The aim of the current study was to investigate autonomic regulation in relation to physical activity and perceived symptoms during work and leisure time among workers with chronic NSP (n = 29) as compared to a healthy control group (CON, n = 27).

Methods

Physical activity was objectively monitored for 7 days using accelerometry. Beat-to-beat heart rate was collected continuously for 72 h, with simultaneous momentary ratings of pain, stress, and fatigue. Duration of sitting/lying, standing and walking, number of steps, and energy expenditure were used as measures of physical activity. Heart rate variability (HRV) indices were extracted in time and frequency domains as reflecting autonomic regulation. Data were divided into work hours, leisure time, and sleep.

Results

The NSP group rated higher levels of stress and fatigue at work and leisure, and reduced sleep quality as compared to CON. Elevated heart rate and reduced HRV were found in NSP compared with CON, especially during sleep. The NSP group demonstrated a different pattern of physical activity than CON, with a lower activity level in leisure time. Higher physical activity was associated with increased HRV in both groups.

Conclusion

Changes in HRV reflected an autonomic imbalance in workers with chronic musculoskeletal pain. This can be explained by reduced physical activity in leisure time. Intervention studies aimed at increasing physical activity may shed further light on the association between autonomic regulation and physical activity in work-related NSP.

Åstrand PO, Rhyming I (1954) A nomogram for calculation of aerobic capacity from pulse rate during submaximal work. J Appl Physiol 7:215–221

Benarroch E (2006) Pain-autonomic interactions. Neurol Sci 27:s130–s133CrossRef

Blair SN, Morris JN (2009) Healthy hearts—and the universal benefits of being physically active: physical activity and health. Ann Epidemiol 19(4):253–256. doi:10.1016/j.annepidem.2009.01.019 CrossRef

Borg G (1998) Borg’s perceived exertion and pain scales. Human Kinetics, Champaign

Chouchou F, Pichot V, Perchet C, Legrain V, Garcia-Larrea L, Roche F, Bastuji H (2011) Autonomic pain responses during sleep: a study of heart rate variability. Eur J Pain 15(6):554–560. doi:10.1016/j.ejpain.2010.11.011 CrossRef

Clays E, De Bacquer D, Crasset V, Kittel F, de Smet P, Kornitzer M, Karasek R, De Backer G (2011) The perception of work stressors is related to reduced parasympathetic activity. Int Arch Occup Environ Health 84(2):185–191. doi:10.1007/s00420-010-0537-z CrossRef

Clays E, De Bacquer D, Van Herck K, De Backer G, Kittel F, Holtermann A (2012) Occupational and leisure time physical activity in contrasting relation to ambulatory blood pressure. BMC Public Health 12(1):1002CrossRef

Côté P, van der Velde G, Cassidy JD, Carroll LJ, Hogg-Johnson S, Holm LW, Carragee EJ, Haldeman S, Nordin M, Hurwitz EL, Guzman J, Peloso PM (2009) The burden and determinants of neck pain in workers: results of the bone and joint decade 2000–2010 task force on neck pain and its associated disorders. J Manip Physiol Ther 32(2, Supplement 1):S70–S86CrossRef

Fishbain DA, Cutler RB, Cole B, Lewis J, Smets E, Rosomoff HL, Steele Rosomoff R (2004) Are patients with chronic low back pain or chronic neck pain fatigued? Pain Med 5(2):187–195CrossRef

Gockel M, Lindholm H, Alaranta H, Viljanen A, Lindquist A, Lindholm T (1995) Cardiovascular functional disorder and stress among patients having neck–shoulder symptoms. Ann Rheum Dis 54(6):494–497. doi:10.1136/ard.54.6.494 CrossRef

Hagberg M, Vilhemsson R, Tornqvist EW, Toomingas A (2007) Incidence of self-reported reduced productivity owing to musculoskeletal symptoms: association with workplace and individual factors among computer users. Ergonomics 50(11):1820–1834. doi:10.1080/00140130701674539 CrossRef

Hallman DM, Lyskov E (2012) Autonomic regulation, physical activity and perceived stress in subjects with musculoskeletal pain: 24-hour ambulatory monitoring. Int J Psychophysiol 86:276–282. doi:10.1016/j.ijpsycho.2012.09.017 CrossRef

Hallman DM, Lindberg L-G, Arnetz BB, Lyskov E (2011) Effects of static contraction and cold stimulation on cardiovascular autonomic indices, trapezius blood flow and muscle activity in chronic neck–shoulder pain. Eur J Appl Physiol 111(8):1725–1735. doi:10.1007/s00421-010-1813-z CrossRef

Hamilton M, Healy G, Dunstan D, Zderic T, Owen N (2008) Too little exercise and too much sitting: inactivity physiology and the need for new recommendations on sedentary behavior. Current Cardiovasc Risk Rep 2(4):292–298. doi:10.1007/s12170-008-0054-8 CrossRef

Hansson EK, Hansson TH (2005) The costs for persons sick-listed more than one month because of low back or neck problems. A two-year prospective study of Swedish patients. Eur Spine J 14(4):337–345. doi:10.1007/s00586-004-0731-3 CrossRef

Hasenbring M, Marienfeld G, Kuhlendahl D, Soyka D (1994) Risk factors of chronicity in lumbar disc patients: a prospective investigation of biologic, psychologic, and social predictors of therapy outcome. Spine 19(24):2759–2765CrossRef

Hautala AJ, Karjalainen J, Kiviniemi AM, Kinnunen H, Mäkikallio TH, Huikuri HV, Tulppo MP (2010) Physical activity and heart rate variability measured simultaneously during waking hours. Am J Physiol Heart Circul Physiol 298(3):H874–H880. doi:10.1152/ajpheart.0 0856.2009CrossRef

Holtermann A, Burr H, Hansen J, Krause N, Søgaard K, Mortensen O (2012a) Occupational physical activity and mortality among Danish workers. Int Arch Occup Environ Health 85(3):305–310. doi:10.1007/s00420-011-0668-x CrossRef

Holtermann A, Hansen JV, Burr H, Søgaard K, Sjøgaard G (2012b) The health paradox of occupational and leisure-time physical activity. Br J Sports Med 46(4):291–295. doi:10.1136/bjsm.2010.079582 CrossRef

Holtermann A, Marott JL, Gyntelberg F, Søgaard K, Suadicani P, Mortensen OS, Prescott E, Schnohr P (2013) Does the benefit on survival from leisure time physical activity depend on physical activity at work? A prospective cohort study. PLoS ONE 8(1):e54548. doi:10.1371/journal.pone.0054548 CrossRef

Kalezic N, Åsell M, Kerschbaumer H, Lyskov E (2007) Physiological reactivity to functional tests in patients with chronic low back pain. J Musculoskelet Pain 15(1):29–40CrossRef

Kecklund G, Åkerstedt T (1992) The psychometric properties of the Karolinska Sleep Questionnaire. J Sleep Res 1(1):113CrossRef

Kjellberg A, Wadman C (2002) Subjektiv stress och dess samband med psykosociala arbetsförshållanden och besvär. En prövning av Stress-Energi-modellen. Arbete och hälsa, vol 12. National Institute of Working life, Stockholm

Larsson B, Søgaard K, Rosendal L (2007) Work related neck–shoulder pain: a review on magnitude, risk factors, biochemical characteristics, clinical picture and preventive interventions. Best Practice Res Clin Rheumatol 21(3):447–463CrossRef

Leeuw M, Goossens M, Linton S, Crombez G, Boersma K, Vlaeyen J (2007) The fear-avoidance model of musculoskeletal pain: current state of scientific evidence. J Behav Med 30(1):77–94CrossRef

Lundberg U (2006) Stress, subjective and objective health. Int J Soc Welf 15:S41–S48. doi:10.1111/j.1468-2397.2006.00443.x CrossRef

Malik M (1996) Task force of the European Society of Cardiology and The North American Society of pacing and electrophysiology. Heart rate variability: standards of measurement, physiological interpretation, and clinical use. Eur Heart J 93(5):1043–1065

Margolis RB, Chibnall JT, Tait RC (1988) Test–retest reliability of the pain drawing instrument. Pain 33(1):49–51. doi:10.1016/0304-3959(88)90202-3 CrossRef

Martinez-Lavin M (2007) Biology and therapy of fibromyalgia. Stress, the stress response system, and fibromyalgia. Arthritis Res Ther 9(4):216CrossRef

Martinez-Lavin M (2012) Fibromyalgia: when distress becomes (un)sympathetic pain. Pain Res Treat. doi:10.1155/2012/981565

Martínez-Lavín M, Hermosillo AG, Rosas M, Soto ME (1998) Circadian studies of autonomic nervous balance in patients with fibromyalgia: a heart rate variability analysis. Arthritis Rheum 41(11):1966–1971CrossRef

Melanson EL (2000) Resting heart rate variability in men varying in habitual physical activity. Med Sci Sports Exerc 32(11):1894–1901CrossRef

Mork PJ, Nilsson J, Lorås HW, Riva R, Lundberg U, Westgaard RH (2013) Heart rate variability in fibromyalgia patients and healthy controls during non-REM and REM sleep: a case–control study. Scand J Rheumatol 1–4. doi:10.3109/03009742.2012.755564

Nilsen KB, Sand T, Westgaard RH, Stovner LJ, White LR, Bang Leistad R, Helde G, Rø M (2007) Autonomic activation and pain in response to low-grade mental stress in fibromyalgia and shoulder/neck pain patients. Eur J Pain 11(7):743–755CrossRef

Passatore M, Roatta S (2006) Influence of sympathetic nervous system on sensorimotor function: whiplash associated disorders (WAD) as a model. Eur J Appl Physiol 98(5):423–449CrossRef

Rennie KL, Hemingway H, Kumari M, Brunner E, Malik M, Marmot M (2003) Effects of moderate and vigorous physical activity on heart rate variability in a British study of civil servants. Am J Epidemiol 158(2):135–143. doi:10.1093/aje/kwg120 CrossRef

Rezai M, Côté P, Cassidy J, Carroll L (2009) The association between prevalent neck pain and health-related quality of life: a cross-sectional analysis. Eur Spine J 18(3):371–381. doi:10.1007/s00586-008-0823-6 CrossRef

Ryan CG, Grant PM, Tigbe WW, Granat MH (2006) The validity and reliability of a novel activity monitor as a measure of walking. Br J Sports Med 40(9):779–784. doi:10.1136/bjsm.2006.027276 CrossRef

Ryan CG, Gray HG, Newton M, Granat MH (2010) The relationship between psychological distress and free-living physical activity in individuals with chronic low back pain. Man Ther 15(2):185–189CrossRef

Saalasti S (2003) Neural networks for heart rate time series analysis. University of Jyväskylä, Jyväskylä

Sjøgaard G, Lundberg U, Kadefors R (2000) The role of muscle activity and mental load in the development of pain and degenerative processes at the muscle cell level during computer work. Eur J Appl Physiol 83(2):99–105. doi:10.1007/s004210000285

Sjörs A, Larsson B, Dahlman J, Falkmer T, Gerdle B (2009) Physiological responses to low-force work and psychosocial stress in women with chronic trapezius myalgia. BMC Musculoskelet Disord 10(1):63CrossRef

Trinder J, Waloszek J, Woods M, Jordan A (2012) Sleep and cardiovascular regulation. Pflügers Archiv Eur J Physiol 463(1):161–168. doi:10.1007/s00424-011-1041-3 CrossRef

Ulrich-Lai YM, Herman JP (2009) Neural regulation of endocrine and autonomic stress responses. Nat Rev Neurosci 10 (6):397–409. http://www.nature.com/nrn/journal/v10/n6/suppinfo/nrn2647_S1.html

van Weering M, Vollenbroek-Hutten MMR, Kotte EM, Hermens HJ (2007) Daily physical activities of patients with chronic pain or fatigue versus asymptomatic controls. A systematic review. Clin Rehabil 21(11):1007–1023. doi:10.1177/0269215507078331 CrossRef

van Weering MGH, Vollenbroek-Hutten MMR, Tönis TM, Hermens HJ (2009) Daily physical activities in chronic lower back pain patients assessed with accelerometry. Eur J Pain 13(6):649–654CrossRef

Visser B, van Dieën JH (2006) Pathophysiology of upper extremity muscle disorders. J Electromyogr Kinesiol 16(1):1–16CrossRef

Warburton DER, Nicol CW, Bredin SSD (2006) Health benefits of physical activity: the evidence. CMAJ 174(6):801–809. doi:10.1503/cmaj.051351 CrossRef

Ware JE, Gandek B (1998) Overview of the SF-36 health survey and the international quality of life assessment (IQOLA) project. J Clin Epidemiol 51(11):903–912. doi:10.1016/s0895-4356(98)00081-x CrossRef

Wemme KM, Rosvall M (2005) Work related and non-work related stress in relation to low leisure time physical activity in a Swedish population. J Epidemiol Commun Health 59(5):377–379CrossRef

Title: Changes in physical activity and heart rate variability in chronic neck–shoulder pain: monitoring during work and leisure time
Authors: David M. Hallman
Annika Hed Ekman
Eugene Lyskov
Publication date: 01-10-2014
Publisher: Springer Berlin Heidelberg
Published in: International Archives of Occupational and Environmental Health / Issue 7/2014
Print ISSN: 0340-0131
Electronic ISSN: 1432-1246
DOI: https://doi.org/10.1007/s00420-013-0917-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Changes in physical activity and heart rate variability in chronic neck–shoulder pain: monitoring during work and leisure time

Abstract

Objectives

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 7/2014

Analysis of potential influence factors on background urinary benzene concentration among a non-smoking, non-occupationally exposed general population sample

Musculoskeletal symptoms and psychosocial work environment, among Swedish commercial pilots

Mortality gradient across the labour market core–periphery structure: a 13-year mortality follow-up study in north-eastern France

Assessment of liver function in two groups of outdoor workers exposed to arsenic

Considerations on the calculation of fractions of cardiovascular disease attributable to psychosocial work factors

Screening for bladder cancer with urinary tumor markers in chemical workers with exposure to aromatic amines