Top

Published in:

Open Access 27-09-2022 | Neck Pain

A Multi-component Intervention (NEXpro) Reduces Neck Pain-Related Work Productivity Loss: A Randomized Controlled Trial Among Swiss Office Workers

Authors: Andrea Martina Aegerter, Manja Deforth, Thomas Volken, Venerina Johnston, Hannu Luomajoki, Holger Dressel, Julia Dratva, Markus Josef Ernst, Oliver Distler, Beatrice Brunner, Gisela Sjøgaard, Markus Melloh, Achim Elfering, the NEXpro Collaboration Group

Published in: Journal of Occupational Rehabilitation | Issue 2/2023

Abstract

Purpose Neck pain is common among office workers and leads to work productivity loss. This study aimed to investigate the effect of a multi-component intervention on neck pain-related work productivity loss among Swiss office workers. Methods Office workers, aged 18–65 years, and without serious neck-related health problems were recruited from two organisations for our stepped-wedge cluster randomized controlled trial. The 12-week multi-component intervention included neck exercises, health-promotion information, and workplace ergonomics. The primary outcome of neck pain-related work productivity loss was measured using the Work Productivity and Activity Impairment Questionnaire and expressed as percentages of working time. In addition, we reported the weekly monetary value of neck pain-related work productivity loss. Data was analysed on an intention-to-treat basis using a generalized linear mixed-effects model. Results Data from 120 participants were analysed with 517 observations. At baseline, the mean age was 43.7 years (SD 9.8 years), 71.7% of participants were female (N = 86), about 80% (N = 95) reported mild to moderate neck pain, and neck pain-related work productivity loss was 12% of working time (absenteeism: 1.2%, presenteeism: 10.8%). We found an effect of our multi-component intervention on neck pain-related work productivity loss, with a marginal predicted mean reduction of 2.8 percentage points (b = −0.27; 95% CI: −0.54 to −0.001, p = 0.049). Weekly saved costs were Swiss Francs 27.40 per participant. Conclusions: Our study provides evidence for the effectiveness of a multi-component intervention to reduce neck pain-related work productivity loss with implications for employers, employees, and policy makers.

Trial Registration ClinicalTrials.gov, NCT04169646. Registered 15 November 2019—Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT04169646.

Available only for authorised users

Hoy D, March L, Woolf A, Blyth F, Brooks P, Smith E, et al. The global burden of neck pain: estimates from the global burden of disease 2010 study. Ann Rheum Dis. 2014;73(7):1309–15.PubMedCrossRef

Côté P, van der Velde G, Cassidy JD, Carroll LJ, Hogg-Johnson S, Holm LW, et al. 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. Spine (Phila Pa 1976). 2008;33(4 Suppl):S60–74.PubMedCrossRef

Carroll LJ, Hogg-Johnson S, van der Velde G, Haldeman S, Holm LW, Carragee EJ, et al. Course and prognostic factors for neck pain in the general population: results of the bone and joint decade 2000–2010 task force on neck pain and its associated disorders. Spine (Phila Pa 1976). 2008;33(4 Suppl):S75-82.PubMedCrossRef

Amstutz S, Monn C, Vanis M, Schwehr P, Kündig S, Bossart R, et al. Swiss survey in offices SBiB study (original: Schweizerische Befragung in Büros SBiB-Studie). Bern, Luzern: Eidgenössisches Volkswirtschaftsdepartement Staatssekretariat für Wirtschaft SECO, Hochschule Luzern; 2010.

van den Heuvel SG, Ijmker S, Blatter BM, de Korte EM. Loss of productivity due to neck/shoulder symptoms and hand/arm symptoms: results from the PROMO-study. J Occup Rehabil. 2007;17(3):370–82.PubMedPubMedCentralCrossRef

Wieser S, Tomonaga Y, Riguzzi M, Fischer B, Telser H, Pletscher M, et al. The costs of non-communicable diseases in Switzerland: final report (original: Die Kosten der nichtübertragbaren Krankheiten in der Schweiz: Schlussbericht). Winterthur: Zürcher Hochschule für Angewandte Wissenschaften, 2014.

Cancelliere C, Cassidy JD, Ammendolia C, Cote P. Are workplace health promotion programs effective at improving presenteeism in workers? A systematic review and best evidence synthesis of the literature. BMC Public Health. 2011;11:395.PubMedPubMedCentralCrossRef

Kuoppala J, Lamminpaa A, Husman P. Work health promotion, job well-being, and sickness absences-a systematic review and meta-analysis. J Occup Environ Med. 2008;50(11):1216–27.PubMedCrossRef

Laestadius JG, Ye J, Cai X, Ross S, Dimberg L, Klekner M. The proactive approach–is it worthwhile? A prospective controlled ergonomic intervention study in office workers. J Occup Environ Med. 2009;51(10):1116–24.PubMedCrossRef

10.

Shiri R, Martimo KP, Miranda H, Ketola R, Kaila-Kangas L, Liira H, et al. The effect of workplace intervention on pain and sickness absence caused by upper-extremity musculoskeletal disorders. Scand J Work Environ Health. 2011;37(2):120–8.PubMedCrossRef

11.

Odeen M, Magnussen LH, Maeland S, Larun L, Eriksen HR, Tveito TH. Systematic review of active workplace interventions to reduce sickness absence. Occup Med (London). 2013;63(1):7–16.CrossRef

12.

Chen X, Coombes BK, Sjogaard G, Jun D, O’Leary S, Johnston V. Workplace-based interventions for neck pain in office workers: systematic review and meta-analysis. Phys Ther. 2018;98(1):40–62.PubMedCrossRef

13.

Sjøgaard G, Christensen JR, Justesen JB, Murray M, Dalager T, Fredslund GH, et al. Exercise is more than medicine: the working age population’s well-being and productivity. J Sport Health Sci. 2016;5(2):159–65.PubMedPubMedCentralCrossRef

14.

Blangsted AK, Sogaard K, Hansen EA, Hannerz H, Sjogaard G. One-year randomized controlled trial with different physical-activity programs to reduce musculoskeletal symptoms in the neck and shoulders among office workers. Scand J Work Environ Health. 2008;34(1):55–65.PubMedCrossRef

15.

Andersen CH, Andersen LL, Gram B, Pedersen MT, Mortensen OS, Zebis MK, et al. Influence of frequency and duration of strength training for effective management of neck and shoulder pain: a randomised controlled trial. Br J Sports Med. 2012;46(14):1004–10.PubMedCrossRef

16.

Dalager T, Bredahl TGV, Pedersen MT, Boyle E, Andersen LL, Sjøgaard G. Does training frequency and supervision affect compliance, performance and muscular health? A cluster randomized controlled trial. Man Ther. 2015;20(5):657–65.PubMedCrossRef

17.

Pereira M, Comans T, Sjøgaard G, Straker L, Melloh M, O’Leary S, et al. The impact of workplace ergonomics and neck-specific exercise versus ergonomics and health promotion interventions on office worker productivity: a cluster-randomized trial. Scand J Work Environ Health. 2019;45(1):42–52.PubMedCrossRef

18.

Aegerter AM, Deforth M, Johnston V, Ernst MJ, Volken T, Luomajoki H, et al. On-site multi-component intervention to improve productivity and reduce the economic and personal burden of neck pain in Swiss office-workers (NEXpro): protocol for a cluster-randomized controlled trial. BMC Musculoskelet Disord. 2020;21(1):391.PubMedPubMedCentralCrossRef

19.

Wall T, Cooper CL, Brough P. The SAGE handbook of organizational wellbeing. London: SAGE Publications Ltd; 2021.CrossRef

20.

Haines TP, Hemming K. Stepped-wedge cluster-randomised trials: level of evidence, feasibility and reporting. J Physiother. 2018;64(1):63–6.PubMedCrossRef

21.

Johnston V, Chen X, Welch A, Sjøgaard G, Comans TA, McStea M, et al. A cluster-randomized trial of workplace ergonomics and neck-specific exercise versus ergonomics and health promotion for office workers to manage neck pain—a secondary outcome analysis. BMC Musculoskelet Disord. 2021;22(1):68.PubMedPubMedCentralCrossRef

22.

Campbell MK, Piaggio G, Elbourne DR, Altman DG. Consort 2010 statement: extension to cluster randomised trials. BMJ. 2012;345:e5661.PubMedCrossRef

23.

Haldeman S, Carroll L, Cassidy JD, Schubert J, Nygren A. The bone and joint decade 2000–2010 task force on neck pain and its associated disorders: executive summary. Spine (Phila Pa 1976). 2008;33(4 Suppl):S5–7.PubMedCrossRef

24.

Pereira MJ, Straker LM, Comans TA, Johnston V. Inter-rater reliability of an observation-based ergonomics assessment checklist for office workers. Ergonomics. 2016;59(12):1606–12.PubMedCrossRef

25.

Reilly MC, Zbrozek AS, Dukes EM. The validity and reproducibility of a work productivity and activity impairment instrument. Pharmacoeconomics. 1993;4(5):353–65.PubMedCrossRef

26.

Igic I, Semmer NK, Elfering A. Manual S-tool: online stress survey tool for companies (original: manual S-tool: online-Stressbefragungsinstrument für die Unternehmen). Bern, Lausanne: Gesundheitsförderung Schweiz; 2012.

27.

Baio G, Copas A, Ambler G, Hargreaves J, Beard E, Omar RZ. Sample size calculation for a stepped wedge trial. Trials. 2015;16:354.PubMedPubMedCentralCrossRef

28.

Barker D, McElduff P, D’Este C, Campbell MJ. Stepped wedge cluster randomised trials: a review of the statistical methodology used and available. BMC Med Res Methodol. 2016;16:69.PubMedPubMedCentralCrossRef

29.

Justesen JB, Sogaard K, Dalager T, Christensen JR, Sjogaard G. The effect of intelligent physical exercise training on sickness presenteeism and absenteeism among office workers. J Occup Environ Med. 2017;59(10):942–8.PubMedCrossRef

30.

Wu JJ, Lin C, Sun L, Goldblum O, Zbrozek A, Burge R, et al. Minimal clinically important difference (MCID) for work productivity and activity impairment (WPAI) questionnaire in psoriasis patients. J Eur Acad Dermatol Venereol. 2019;33(2):318–24.PubMedCrossRef

31.

Fleischmann R, Weinblatt ME, Schiff M, Khanna D, Maldonado MA, Nadkarni A, et al. Patient-reported outcomes from a two-year head-to-head comparison of subcutaneous abatacept and adalimumab for rheumatoid arthritis. Arthritis Care Res. 2016;68(7):907–13.CrossRef

32.

Aas RW, Tuntland H, Holte KA, Roe C, Lund T, Marklund S, et al. Workplace interventions for neck pain in workers. Cochrane Database Syst Rev. 2011;4:Cd008160.

33.

Bundesamt für Statistik BFS. Mean age of the working population (original: Durchschnittliches Alter der Erwerbsbevölkerung). 2020. https://www.bfs.admin.ch/bfs/de/home/statistiken/arbeit-erwerb/erwerbstaetigkeit-arbeitszeit/erwerbspersonen/durchschnittsalter-erwerbsbevoelkerung.html. Accessed 30 Jul 2021.

34.

Bundesamt für Statistik BFS. Education leven (original: Bildungsstand). 2020. https://www.bfs.admin.ch/bfs/de/home/statistiken/bildung-wissenschaft/bildungsindikatoren/themen/wirkung/bildungsstand.html. Accessed 09 Aug 2021.

35.

Robroek SJW, van Lenthe FJ, Burdorf A. The role of lifestyle, health, and work in educational inequalities in sick leave and productivity loss at work. Int Arch Occup Environ Health. 2013;86(6):619–27.PubMedCrossRef

36.

Pereira MJ, Coombes BK, Comans TA, Johnston V. The impact of onsite workplace health-enhancing physical activity interventions on worker productivity: a systematic review. Occup Environ Med. 2015;72(6):401.PubMedCrossRef

37.

Kunz CU, Jörgens S, Bretz F, Stallard N, Van Lancker K, Xi D, et al. Clinical trials impacted by the COVID-19 pandemic: adaptive designs to the rescue? Stat Biopharm Res. 2020;12(4):461–77.PubMedPubMedCentralCrossRef

38.

Aegerter AM, Deforth M, Sjøgaard G, Johnston V, Volken T, Luomajoki H, et al. No evidence for a decrease in physical activity among Swiss office workers during COVID-19: a longitudinal study. Front Psychol. 2021;12:190.CrossRef

39.

Aegerter AM, Deforth M, Johnston V, Sjøgaard G, Ernst MJ, Luomajoki H, et al. No evidence for an effect of the first COVID-19 lockdown on neck pain and neck disability among Swiss office workers. Vienna: Eurospine Congress; 2021.CrossRef

40.

Aegerter AM, Deforth M, Johnston V, Sjøgaard G, Luomajoki H, Volken T, et al. (2021, 11.11.). No evidence for an effect of the first COVID-19 lockdown on work stress conditions in office workers. 14th European Public Health Conference, Online.

41.

Aegerter AM, Johnston V, Melloh M, Elfering A. (2022, 11.02.). Does the home office workstation meet recommended guidelines in a sample of Swiss office workers? 7th International Conference "Work an Health", Online.

42.

Brunner B, Igic I, Keller AC, Wieser S. Who gains the most from improving working conditions? Health-related absenteeism and presenteeism due to stress at work. Eur J Health Econ. 2019;20(8):1165–80.PubMedPubMedCentralCrossRef

43.

Svedmark Å, Björklund M, Häger CK, Sommar JN, Wahlström J. Impact of workplace exposure and stress on neck pain and disabilities in women-a longitudinal follow-up after a rehabilitation intervention. Ann Work Expo Health. 2018;62(5):591–603.PubMedCrossRef

44.

Hagberg M, Vilhemsson R, Tornqvist EW, Toomingas A. Incidence of self-reported reduced productivity owing to musculoskeletal symptoms: association with workplace and individual factors among computer users. Ergonomics. 2007;50(11):1820–34.PubMedCrossRef

45.

Kotz D, Spigt M, Arts IC, Crutzen R, Viechtbauer W. Use of the stepped wedge design cannot be recommended: a critical appraisal and comparison with the classic cluster randomized controlled trial design. J Clin Epidemiol. 2012;65(12):1249–52.PubMedCrossRef

46.

Mdege ND, Man MS, Taylor nee Brown CA, Torgerson DJ. There are some circumstances where the stepped-wedge cluster randomized trial is preferable to the alternative: no randomized trial at all: Response to the commentary by Kotz and colleagues. J Clin Epidemiol. 2012;65(12):1253–4.PubMedCrossRef

47.

Holtermann A, Straker L, Lee IM, Stamatakis E, van der Beek AJ. Workplace physical activity promotion: why so many failures and few successes? The need for new thinking. Br J Sports Med. 2021;55(12):650.PubMedCrossRef

48.

Bundesamt für Gesundheit BAG. Effects of sport and exercise during work on health and productivity (original: Auswirkungen von Sport und Bewegung während der Arbeitszeit auf Gesundheit und Produktivität). Bern: Bundesamt für Gesundheit BAG; 2020.

49.

Takala E-P, Viikari-Juntura E, Moneta GB, Saarenmaa K, Kaivanto K. Seasonal variation in neck and shoulder symptoms. Scand J Work Environ Health. 1992;18(4):257–61.PubMedCrossRef

Title: A Multi-component Intervention (NEXpro) Reduces Neck Pain-Related Work Productivity Loss: A Randomized Controlled Trial Among Swiss Office Workers
Authors: Andrea Martina Aegerter
Manja Deforth
Thomas Volken
Venerina Johnston
Hannu Luomajoki
Holger Dressel
Julia Dratva
Markus Josef Ernst
Oliver Distler
Beatrice Brunner
Gisela Sjøgaard
Markus Melloh
Achim Elfering
the NEXpro Collaboration Group
Publication date: 27-09-2022
Publisher: Springer US
Keyword: Neck Pain
Published in: Journal of Occupational Rehabilitation / Issue 2/2023
Print ISSN: 1053-0487
Electronic ISSN: 1573-3688
DOI: https://doi.org/10.1007/s10926-022-10069-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

A Multi-component Intervention (NEXpro) Reduces Neck Pain-Related Work Productivity Loss: A Randomized Controlled Trial Among Swiss Office Workers

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 2/2023

Preventing Pain and Stress-Related Ill-Health in Employees: A 6-Months Follow-Up of a Psychosocial Program in a Cluster Randomized Controlled Trial

Disability Phenotypes and Job Accommodations Utilization Among People with Physical Disability

Integrative Prevention at Work: A Concept Analysis and Meta-Narrative Review

Differences in Modified-Return-to-Work by Immigration Characteristics Among a Cohort of Workers in British Columbia, Canada

Workplace Mental Health Disclosure, Sustainable Employability and Well-Being at Work: A Cross-Sectional Study Among Military Personnel with Mental Illness

Does Consulting an Occupational Medicine Specialist Decrease Time to Return to Work Among Total Knee Arthroplasty Patients? A 12-Month Prospective Multicenter Cohort Study