Effects of combining ergonomic interventions and motor control exercises on muscle activity and kinematics in people with work-related neck–shoulder pain



This study compared the effects of “Ergomotor” intervention and conventional physiotherapy, on influencing the motor control in the neck–shoulder region in people with work-related neck–shoulder pain (WRNSP).


101 patients (age range 20–54 years) diagnosed with chronic WRNSP were randomized into control (CO) group (n = 50) and Ergomotor (EM) group (n = 51). Each group received a 12-week intervention. Participants in CO group received treatment for pain relief and general exercises. EM group received individualized motor control training and advice of ergonomic modifications at their workplaces.


At post-intervention, EM group showed significant reduction of bilateral upper trapezius muscle activity during active neck movements (left: 40–35%, right: 35–27%) and functional tasks such as lifting a weight forward–backward (left: 31–21%, right: 22–14%) and upward–downward (left: 26–23%, right: 20–13%). Cervical erector spinae also showed significant decrease in muscle activity during some phases of the functional tasks (left: 13–6%, right: 10–2%). In contrast, CO group did not show such changes in muscle activity at post-intervention. EM group also showed significant increase in movement velocity and acceleration during active neck movements in all directions (from 18 to 31%), while CO group only showed significant increase in movement velocity in some directions. Both groups reported significant but similar reduction in pain scores, at post-intervention and 1-year follow-up.


The present results provided some evidence to support the positive and sustainable benefits of integrating motor control training into the workplace postures and motions.

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Cervical erector spinae




Disability of Arm, Shoulder and Hand questionnaire










Finite impulse response


Generalised estimating equations


Infinite impulse response


Inertial measurement units


Lower trapezius


Musculoskeletal disorders


Neck Disability Index


Repeated measures analysis of variance


Root mean square






Upper trapezius


Work-related neck–shoulder pain


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The authors would like to acknowledge the Health and Medical Research Fund for the financial support to this project. We would like to express our appreciation to the orthopaedic specialists—Prof. LK Hung, Dr. SW Law, and Dr. KK Wong, who helped to recruit suitable patients to join this study. We also want to thank the physiotherapists who have assisted to carry out the interventions for the Ergomotor group (Miss Rufina Lau) and for the control group (Miss Polina Yeung and Mr. Ted Wong). We would also like to thank the research staff including Jay Dai, Phoebe Xie, Viviane Hui, Sam Chong, and our technical advisor Mr. Man Cheung.

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Correspondence to Grace P. Y. Szeto.

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The authors declare no conflict of interest regarding the publication of this manuscript.

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Communicated by Bénédicte Schepens.

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Tsang, S.M.H., So, B.C.L., Lau, R.W.L. et al. Effects of combining ergonomic interventions and motor control exercises on muscle activity and kinematics in people with work-related neck–shoulder pain. Eur J Appl Physiol 118, 751–765 (2018). https://doi.org/10.1007/s00421-018-3802-6

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  • Ergonomics
  • Neck pain
  • Motor control
  • Electromyography
  • Kinematics