On-the-job resistance training helps prevent musculoskeletal disorders in the neck, arm, shoulder and hand: IWH review

November 12, 2015 (Toronto, Ontario)—Strong evidence suggests that implementing workplace-based resistance training can help prevent and manage musculoskeletal disorders (MSDs) of the upper extremity, which includes the neck, shoulder, arm, elbow, wrist and hand.

That’s one of the key findings coming out of a systematic review conducted by the Institute for Work & Health (IWH), published today as an open access paper in the Journal of Occupational and Environmental Medicine (doi:10.1136/oemed-2015-102992).

The systematic review also found moderate evidence that stretching exercise programs (including yoga), workstation forearm supports and vibration feedback on computer mouse use have a positive effect on preventing and managing MSDs of the upper extremity.

Employers should consider implementing these prevention measures if they’re suitable to the workplace, says Dwayne Van Eerd, an associate scientist at IWH and co-lead of the systematic review. Suitability to the workplace is important, because evidence-based practice should not only incorporate research findings such as these, but also incorporate the knowledge and experience of practitioners and end-users such as occupational health and safety professionals and workers.

Musculoskeletal disorders are a group of painful disorders affecting muscles, tendons, joints and nerves. They can affect all body parts, although the neck, back, arm, hand and shoulders are the most common areas. In Canada, MSDs account for 40 to 60 per cent of work-related injury claims involving time off work.

This systematic review is an update of an earlier IWH review published in 2010, which also focused on studies about workplace interventions to reduce upper extremity MSDs. This update synthesizes findings from 61 studies that the reviewers judged to be of medium or high quality.

The findings for resistance training were the strongest coming out of this latest review. Resistance training refers to exercises that cause the muscles to contract against an external resistance (e.g. dumbbells, rubber exercise tubing, own body weight, etc.) with the expectation of increases in muscle strength, tone, mass and/or endurance.

While the studies on the effectiveness of resistance programs varied in the level of detail provided, according to those that supplied specifics, the resistance programs ranged from 20 minutes to one hour per week, spread across one or multiple days per week, with and without the involvement of a physiotherapist, says Emma Irvin, head of IWH’s systematic review group and co-lead of the study.

The review also found moderate evidence that some programs have no effect on the prevention and management of MSDs. These include job stress management, electromagnetic biofeedback and workstation adjustments alone (i.e. with minimal worker involvement).

The finding about doing workstation adjustments alone not being effective is consistent across a number of our reviews, Irvin adds. When our stakeholders were presented with this finding, they concurred that workstation adjustments alone, without engaging the worker, cannot be expected to have a strong impact on upper extremity MSDs.

Based on these findings from the systematic review and on discussions about the findings with numerous stakeholder groups, the systematic review team makes these recommendations:

• Implementing a workplace-based resistance training exercise program can help prevent and manage upper extremity musculoskeletal symptoms and disorders.
• Workplaces should consider implementing stretching exercise programs (including yoga), workstation forearm supports and vibration feedback on mouse use, if applicable to the work context.
• Workplaces should consider seeking alternatives to job stress management, electromagnetic biofeedback and workstation adjustments alone (i.e. with minimal worker involvement).

The Institute thanks the University of Glasgow for providing the funding for the open-access paper.