The present study aimed to investigate whether physiotherapy or Feldenkrais interventions resulted in a reduction of complaints from the neck and shoulders (prevalence, pain intensity, sick leave, and disability in leisure and work roles) in 97 female industrial workers (not on long-term sick leave). Range of motion of neck and shoulders, VO2, endurance score (i.e., summation of pain intensity ratings during a static shoulder flexion), cortical control according to the Feldenkrais methodology, and physiological capacity according to a dynamic endurance test of the shoulder flexors with simultaneous surface EMG were also recorded. The workers were randomized to: (1) physiotherapy group (PT-group; treatment according to the ergonomic program of the PTs of the occupational health care service), (2) Feldenkrais group (F-group; education according to the Feldenkrais methodology), or (3) control group (C-group; no intervention). Pre- and post-tests were made at one-year intervals. The two interventions lasted 16 weeks during paid working time. The F-group showed significant decreases in complaints from neck and shoulders and in disability during leisure time. The two other groups showed no change (PT-group) or worsening of complaints (C-group). The present study showed significant positive changes in complaints after the Feldenkrais intervention but not after the physiotherapy intervention. Possible mechanisms behind the effects in the F-group are discussed.
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Gerdle B, Brulin C, Elert J, Eliasson P, Granlund B-M. Effect of a general fitness program on musculoskeletal symptoms, clinical status, physiological capacity and perceived work-environment among home care personnel. J Occup Rehab 1995; 5: 1–16.
Kilbom Å, Hagberg M. Work-related musculoskeletal diseases-high risk jobs and risk factors (in swedish). Arbete & Hälsa 1990; 19: 1–45.
Kilbom Å. Intervention programmes for work-related neck and upper limb disorders: strategies and evaluation. Ergonomics 1988; 31: 735–747.
Beckerman H, Bouter LM, van der Heijden GJMG, De Bie RA, Koes BW. Efficacy of physiotherapy from musculoskeltal disorders: what can we learn from research? Br J Gen Prac 1993; 43: 73–77.
Feine JS, Lund JP. An assessment of the efficacy of physical therapy and physical modalities for the control of chronic musculoskeletal pain. Pain 1997; 71: 5–23.
Koes BW, Assendelft WJJ, van der Heijden GJMG, Bouter LM. Spinal manipulation for low back pain. An updated systematic review of randomized clinical trials. Spine 1996; 21: 2860–2871.
Wigeus-Hjelm E, Hagberg M. Prevention of musculoskeletal disorders in nursing aides. A randomized stury of physical training. In: Hagberg, M. Kilbom A. eds. Proceedings from the international scientific conference on prevention of work-related musculoskeletal disorders. Arbete & Hälsa 1992; 17: 338–340.
Dyrssen T, Svedenkrans M, Paasikivi J. Muskelträning vid besvär i nacke och skuldror effektiv behandling för att minska smärtan. Sjukgymnasten 1989; No. 10: 12–15.
Cady LD, Bischoff DP, O'Connell ER, Thomas PC, Allan JH. Strength and fitness and subsequent back injuries in fire fighters. J Occup Med 1979; 21: 269–272.
Battié MC. The reliability of physical factors as predictors of the occurrence of back pain reports. Göteborg. Medical Dissertation, 1989.
Gyntelberg F. One-year incidence of low back pain among male residents of Copenhagen aged 40–49. Danish Med Bull 1974; 21: 30–36.
Mostardi RA, Noe DA, Kovacik MW, Porterfield JA. Isokinetic lifting strength and occupational injury. Spine 1992; 17: 189–193.
Troup JDG, Foreman TK, Baxter CE, Brown D. The perception of back pain and the role of psychological tests of lifting capacity. Spine 1987; 12: 645–657.
Kellett KM, Kellett DA, Nordholm LA. Effects of an exercise program on sick leavel due to back pain. Phys Ther 1991; 71: 283–291.
Mayer T, Gatchel R, Kishino N. Objective assessment of spine function following industrial injury. Spine 1985; 10: 482–483.
Block AR. Multidisciplinary treatment of chronic low back pain: a review. Rehab Psych 1982; 27: 51–63.
Bono SF, Zasa ML. Chronic low back pain and therapy: a critical review and overview. Behav Ther 1988; 11: 189–198.
Hildebrandt J, Pfingsten M, Saur P, Jansen J. Prediction of success from a multidisciplinary treatment program for chronic low back pain. Spine 1997; 22: 990–1001.
Fordyce WE, Fowler RS, Lehmann JF, Delateur BJ, Sand PL, Treischmann RB. Operant conditioning in the treatment of chronic pain. Arch Phys Med Rehabil 1973; 54: 399–408.
Pfingsten M, Hildebrandt J, Leibing E, Franz C, Saur P. Effectiveness of a multimodal treatment program for chronic low-back pain. Pain 1997; 73: 177–185.
Lunblad I. Preliminary Report. SödertN-0304;lje. Företagshälsov N-0304;rden, Scania, 1995.
Hagberg M. Occupational musculoskeletal stress and disorders of the neck and shoulder: a review of possible pathophysiology. Int Arch Occup Environ Health 1984; 53: 269–278.
Holmström EB, Lindell J, Moritz U. Low back and neck/shoulder pain in construction workers; occupational workload and psychosocial risk factors. Part 2: Relationship to neck and shoulder pain. Spine 1992; 17: 672–677.
Armstrong TJ, Buckle P, Fine LJ, Hagberg M, Jonsson B, Kilbom Å, Kuorinka IA, Silverstein BA, Sjögaard G, Viikari-Juntura ERA. A conceptual model for work-related neck and upper-limb musculoskeletal. Scand J Work Environ Health 1993; 19: 73–84.
Gerdle B, Elert J, Henriksson-Larsén K. Muscular fatigue during repeated isokinetic shoulder forward flexions in young females. Eur J Appl Physiol 1989; 58: 666–673.
Elert J. The pattern of activation and relaxation during fatiguing isokinetic contractions in subjects with and without muscle pain. UmeÑ. Medical dissertation, 1991.
Elert J, Rantapää-Dahlqvist S, Henriksson-Larsén K, Lorentzon R, Gerdle B. Muscle performance, electromyography and fibre type composition in fibromyalgia and work-related myalgia. Scand J Rheumatol 1992; 21: 28–34.
Fredin Y, Elert J, Britschgi N, Vaher A, Gerdle B. A decreased ability to relax between repetitive muscle contractions in patients with chronic symptoms after whiplash trauma of the neck. J Musculoskel Pain 1997; 5: 55–70.
Elert J, Rantapää-Dahlqvist S-B, Almay B, Eisemann M. Muscle endurance, muscle tension and personality traits in patients with muscle or joint pain—a pilot study. J Rheumatol 1993; 20: 1550–1556.
Veiersted K, Westgaard R, Andersen P. Pattern of muscle activity during stereotyped work and its relation to muscle pain. Int Arch Occup Environ Health 1990; 62: 31–41.
Veiersted KB, Westgaard RH, Andersen P. Electromyographic evaluation of muscular work pattern as a predictor of trapezius myalgi. Scand J Work Environ Health 1993; 19: 284–290.
Lundblad I, Elert J, Gerdle B. Worsening of neck and shoulder complaints are correlated with frequency parameters of the EMGobtained one year earlier. Eur J Appl Physiol 1998; 79: 7–16.
Kuorinka I, Jonsson B, Kilbom A, Vinterberg H, Biering-Sörensen F, Andersson G, Jörgensen K. Standardised Nordic questionnaires for the analysis of musculoskeletal symptoms. Appl Ergon 1987; 18.3: 233–237.
Borg GAV. Psychophysical bases of perceived exertion. Med Sci Sports Exerc 1982; 14: 377–381.
Karlsson S, Erlandsson B, Gerdle B. A personal computer-based system for real-time analysis of surface EMG signals during static and dynamic contractions. J Electromyogr Kinesiol 1994; 4: 170–180.
Elert J, Gerdle B. The relation ship between contraction and relaxation during fatiguing isokinetic shoulder flexions. An electromyographic study. Eur J Appl Physiol 1989; 59: 303–309.
Ellis BK. Feldenkrais-physical therapy and research. A literature review. Sjukgymnasten, Vetenskapligt supplement 1995; 2: 34–41.
Grönholm J. The Feldenkrais method (in swedish). In: Grönholm J, ed. The Feldenkrais method (in Swedish), Falun: Natur & Kultur, 1996, pp 1–118.
Hanna T. The body of life. Alfred A Knopf, 1987.
Gutman GM, Herbert CP, Brown SR. Feldenkrais versus conventional exercises for the elderly. J Gerontology 1977; 32: 562–567.
Simons DG, Mense S. Understanding and measurement of muscle tone as related to clinical muscle pain. Pain 1998; 75: 1–17.
Manniche C, Hesselöe G, Bentzen L, Christensen I, Lundberg E. Clinical trial of intensive muscle training for chronic lowback pain. Lancet 1988; 31: 1473–1476.
Manniche C, Lundberg E, Christensen I, Bentzen L, Hesselöe G. Intense dynamic back exercises for chronic low back pain: A clinical trial. Pain 1991; 47: 53–63.
Risch SV, Norvell NK, Pollock L, Risch ED, Langer H, Fulton M, Graves JE, Leggett SH. Lumbar strengthening in chronic low back patients—physiological and psychological benefits. Spine 1993; 18: 232–238.
Horn S, Munafó M. Theories of pain. Pain. Theory, research and intervention. Buckingham. Open University Press, 1997.
Parenmark G, Engvall B, Malmkvist A-K. Ergonomic on-the-job training of assembly workers. Arm-neck-sholder complaints drastically reduced amongst beginners. Appl Ergonomics 1988; 19: 143–146.
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Lundblad, I., Elert, J. & Gerdle, B. Randomized Controlled Trial of Physiotherapy and Feldenkrais Interventions in Female Workers with Neck-Shoulder Complaints. J Occup Rehabil 9, 179–194 (1999). https://doi.org/10.1023/A:1021301801292