Dental workers including dental health students experience a high incidence of neck/shoulder symptoms. However, research into interventions has been scarce and largely focused on tools and technological modifications.
OBJECTIVE:
This study investigates the feasibility and benefits of a neck/shoulder exercise intervention on work posture and local symptoms in dental health students.
METHODS:
Twenty-three students participated in a 10-week resistance exercise program for 2 minutes daily, 5 days per week. Work posture (evaluated with the Rapid Upper Limb Assessment tool, RULA), muscle strength measures, self-rated symptom severity and function were collected. Feasibility of the intervention was determined with six items scored on a 5-point Likert scale.
RESULTS:
The exercise intervention improved: work posture score by 1.88 (95% CI 1.05–2.70, p < 0.01) points on the RULA; isometric maximal strength of neck flexor and extensor muscles by 17.2% (95% CI 6.9–27.6%, p < 0.01) and 23.2% (95% CI 10.2–36.3%, p < 0.01) respectively; and clinical performance (77%). Isometric strength of the shoulder muscles, and symptom severity at the neck/shoulder showed no improvement. Adherence to training was 77%.
CONCLUSION:
Ten weeks of exercise was feasible for dental health students, and likely beneficial with improvements in work posture and neck muscle strength.
Burgess-LimerickR. Issues associated with force and weight limits and associated threshold limit values in the physical handling work environment. In: Commission NOHaS, editor. Issues paper: Threshold limit values for Manual Tasks. National Standard Code of Practice on Manual Handling and Associated documents: National Occupational Health and Safety Commission; 2003.
2.
McAtamneyL, Nigel CorlettE. RULA: a survey method for the investigation of work-related upper limb disorders. Appl Ergon. 1993;24(2):91.
3.
PejcicN, PetrovicV, MarkovicD, MilicicB, DimitrijevicII, PerunovicN, et al.Assessment of risk factors and preventive measures and their relations to work-related musculoskeletal pain among dentists. Work. 2017;57(4):573.
4.
HayesM, CockrellD, SmithDR. A systematic review of musculoskeletal disorders among dental professionals. Int J Dent Hyg. 2009;7(3):159.
5.
MorseT, BruneauH, DussetschlegerJ. Musculoskeletal disorders of the neck and shoulder in the dental professions. Work. 2010;35(4):419.
6.
ThorntonLJ, BarrAE, Stuart-ButtleC, GaughanJP, WilsonER, JacksonAD, et al.Perceived musculoskeletal symptoms among dental students in the clinic work environment. Ergonomics. 2008;51(4):573.
7.
MoodleyR, NaidooS, WykJV. The prevalence of occupational health-related problems in dentistry: A review of the literature. J Occup Health. 2018;60(2):111.
8.
ChismarkA, AsherG, SteinM, TavocT, CurranA. Use of complementary and alternative medicine for work-related pain correlates with career satisfaction among dental hygienists. J Dent Hyg. 2011;85(4):273.
9.
HayesMJ, TaylorJA, SmithDR. Predictors of work-related musculoskeletal disorders among dental hygienists. Int J Dent Hyg. 2012;10(4):265.
10.
HayesMJ, SmithDR, CockrellD. An international review of musculoskeletal disorders in the dental hygiene profession. Int Dent J. 2010;60(5):343.
11.
SakzewskiL, Naser-ud-DinS. Work-related musculoskeletal disorders in dentists and orthodontists: a review of the literature. Work. 2014;48(1):37.
12.
SilvaA, SharplesP, JohnsonM. Studies comparing surrogate measures for head posture in individuals with and without neck pain. Physical Therapy Reviews. . 2010;15(1):12.
13.
FallaD, JullG, RussellT, VicenzinoB, HodgesP. Effect of neck exercise on sitting posture in patients with chronic neck pain. Phys Ther. 2007;87(4):408.
14.
PedersenMT, AndersenCH, ZebisMK, SjogaardG, AndersenLL. Implementation of specific strength training among industrial laboratory technicians: long-term effects on back, neck and upper extremity pain. BMC Musculoskelet Disord. 2013;14:287.
15.
RasottoC, BergaminM, SimonettiA, MasoS, BartolucciGB, ErmolaoA, et al.Tailored exercise program reduces symptoms of upper limb work-related musculoskeletal disorders in a group of metalworkers: A randomized controlled trial. Man Ther. 2015;20(1):56.
16.
AndersenCH, AndersenLL, GramB, PedersenMT, MortensenOS, ZebisMK, 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.
17.
BlangstedAK, SogaardK, HansenEA, HannerzH, SjogaardG. 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.
18.
CouryHJCG, MoreiraRFC, DiasNB. Evaluation of the effectiveness of workplace exercise in controlling neck, shoulder and low back pain: a systematic review. Revista Brasileira De Fisioterapia. 2009;13(6):461.
19.
FerrariS, MonticoneM. Efficacy of a multimodal rehabilitation program in a dental hygienist with upper quadrant disorders. Description of a case report with one-year follow-up. G Ital Med Lav Ergon. 2009;31(4):407.
20.
HortonSJ, WadeKJ. Exercise intervention for a musculoskeletal disorder in an oral health student: a case report. N Z Dent J. 2013;109(1):12.
21.
SkamagkiG, KingA, DuncanM, WahlinC. A systematic review on workplace interventions to manage chronic musculoskeletal conditions. Physiother Res Int. 2018:e1738.
22.
JakobsenMD, SundstrupE, BrandtM, JayK, AagaardP, AndersenLL. Effect of workplace- versus home-based physical exercise on musculoskeletal pain among healthcare workers: A cluster randomized controlled trial. Scand J Work Environ Health. 2015;41(2):153.
23.
AndersenLL, SaervollCA, MortensenOS, PoulsenOM, HannerzH, ZebisMK. Effectiveness of small daily amounts of progressive resistance training for frequent neck/shoulder pain: randomised controlled trial. Pain. 2011;152(2):440.
24.
SchulzKF, AltmanDG, MoherD. CONSORT 2010 statement: Updated guidelines for reporting parallel group randomised trials. J Pharmacol Pharmacother. 2010;1(2):100.
25.
McHughML. Interrater reliability: The kappa statistic. Biochem Med (Zagreb). 2012;22(3):276.
26.
JohnstonV, O’LearyS, ComansT, StrakerL, MellohM, KhanA, et al.A workplace exercise versus health promotion intervention to prevent and reduce the economic and personal burden of non-specific neck pain in office personnel: protocol of a cluster-randomised controlled trial. J Physiother. 2014;60(4):233; discussion 233.
27.
CraigCL, MarshallAL, SjostromM, BaumanAE, BoothML, AinsworthBE, et al.International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc. 2003;35(8):1381.
28.
RangulV, HolmenTL, KurtzeN, CuypersK, MidthjellK. Reliability and validity of two frequently used self-administered physical activity questionnaires in adolescents. BMC Med Res Methodol. 2008;8:47.
29.
PedersenMM, ZebisMK, LangbergH, PoulsenOM, MortensenOS, JensenJN, et al.Influence of self-efficacy on compliance to workplace exercise. Int J Behav Med. 2013;20(3):365.
30.
KamperSJ, OsteloRW, KnolDL, MaherCG, de VetHC, HancockMJ. Global Perceived Effect scales provided reliable assessments of health transition in people with musculoskeletal disorders, but ratings are strongly influenced by current status. J Clin Epidemiol. 2010;63(7):760.
31.
FinsenL, ChristensenH, BakkeM. Musculoskeletal disorders among dentists and variation in dental work. Appl Ergon. 1998;29(2):119.
32.
LeeMH, ParkSJ, KimJS. Effects of neck exercise on high-school students’ neck-shoulder posture. J Phys Ther Sci. 2013;25(5):571.
33.
CohenJ. A power primer. Psychological Bulletin. . 1992;112(1):155.
34.
CorrocherPA, PresotoCD, CamposJA, GarciaPP. The association between restorative pre-clinical activities and musculoskeletal disorders. Eur J Dent Educ. 2014;18(3):142.
35.
GarciaPP, CamposJA. Risk of musculoskeletal disorders in upper limbs in dental students: concordance of different methods for estimation of body angle. Indian J Dent Res. 2013;24(5):562.
36.
YlinenJ, TakalaEP, NykanenM, HakkinenA, MalkiaE, PohjolainenT, et al.Active neck muscle training in the treatment of chronic neck pain in women: a randomized controlled trial. JAMA. 2003;289(19):2509.
37.
FukunagaT, MiyataniM, TachiM, KouzakiM, KawakamiY, KanehisaH. Muscle volume is a major determinant of joint torque in humans. Acta Physiol Scand. . 2001;172(4):249.
38.
FaigenbaumAD, McFarlandJE. Criterion Repetition Maximum Testing. Strength and Conditioning Journal. 2014;36(1):88.
39.
VerhagenAP, Bierma-ZeinstraSMA, BurdorfA, StynesSM, de Vet HenricaCW, KoesBW. Conservative interventions for treating work-related complaints of the arm, neck or shoulder in adults. Cochrane Database of Systematic Reviews [Internet]. 2013;(12). Available from: http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD008742.pub2/abstract
40.
EvansR, BronfortG, MaiersM, SchulzC, HartvigsenJ. “I know it’s changed”: a mixed-methods study of the meaning of Global Perceived Effect in chronic neck pain patients. Eur Spine J. 2014;23(4):888.
41.
JordanJL, HoldenMA, MasonEEJ, FosterNE. Interventions to improve adherence to exercise for chronic musculoskeletal pain in adults. Cochrane Database Syst Rev. 2010;(1):Art. No.: CD005956.
