Comparison of randomized and non-randomized controlled trials evidence regarding the effectiveness of workplace exercise on musculoskeletal pain control

Abstract

Evidence synthesized based on randomized controlled trials (RCT) results are recognized as the pinnacle of research excellence; however, the conduction of RCT in workplace environment is not always possible. This study comparatively reviewed evidence from RCT and non-RCT studies in which participants performed workplace exercise for musculoskeletal pain control. Up to February 2011, PubMed, MEDLINE, Embase, Cochrane, PEDro and Web of Science databases were searched. All trials that evaluated workplace exercise interventions for controlling musculoskeletal pain were included. The PEDro scale was used to rate the studies' quality, PRISMA and Cochrane recommendations were applied, and association between frequencies of effect size categories (small, moderate, large) from various outcomes by study type was tested (2x3 contingency table). The search yielded 10239 references in English, from which 21 RCT and 12 non-RCT were selected. Both groups of studies presented methodological flaws including descriptions of randomization, blinding of examiners and absence of intention-totreat analysis for the RCT, and further absence of controls and blind assessor for the non-RCTs. RCTs had significantly more moderate and large effect size reported in their results compared to non-RCTs (p=0.04). Considering the difficulties in randomizing participants in occupational settings, all studies would benefit from better describing pertinent methodological information.

Prevalence of musculoskeletal symptoms in hospital nurse technicians and licensed practical nurses: associations with demographic factors

“…Systematic reviews about the effects of exercise on musculoskeletal pain in active workers 29 , 31 found a protective effect in the occupational environment against lumbar and cervical pain in workers with heavy and sedentary activities, respectively. Martins and Marzialle 56 also identified benefits of therapeutic exercises for nursing workers with shoulder pain.…”

“…Two questionnaires were applied: the standardized Nordic Musculoskeletal Questionnaire (NMQ) and a questionnaire specifically designed for the present study that included 15 independent variables potentially related to the response variables of the NMQ 26 . In the customized questionnaire, personal, occupational, and health factors were included based on relevant, previously published epidemiological studies about risk factors 10 , 27 , 28 and on the authors' own experience 29 - 31 . The questions were structured as direct queries.…”

Move-It: A Cluster-Randomised Digital Worksite Exercise Intervention in China: Outcome and Process Evaluation

“…The study is limited by the small cluster size. The study was group randomised since individual-level randomised controlled trials are not always appropriate or feasible in the workplace setting [74]. The intervention itself was a pragmatic intervention that reflected real-world workplace interventions through accessibility to all employees with voluntary participation, rather than being offered to select groups with health risk factors.…”

Volitional Weight-Lifting in Rats Promotes Adaptation via Performance and Muscle Morphology prior to Gains in Muscle Mass

“…This is largely because of the methodological complexities that arise when investigating a human population. 34,35 Because of these complexities, investigators have worked to develop animal models of volitional resistance exercise. [6][7][8][9] The present investigation advances the research concerning volitional animal models of resistance exercise by demonstrating traininginduced adaptation by the assessment of reactive forces and the observation of distinct alterations at the muscle fiber level.…”

“…A multitude of reports and reviews exist in the scientific literature regarding exercise as an intervention to reduce work-related MSDs. 34,35 While resistance exercise in general appears to alleviate MSDs, novel insights into muscle adaptation and consensus on exercise prescription have been difficult to ascertain. This is largely because of the methodological complexities that arise when investigating a human population.…”