No difference between postural exercises and strength and fitness exercises for early, non-specific, work-related upper limb disorders in visual display unit workers: a randomised trial

Question

Are postural exercises delivered by Mensendieck/Cesar therapists more effective in decreasing pain, reducing disability and improving health-related quality of life in visual display unit workers with early non-specific work-related upper limb disorders than strength and fitness exercises delivered by physiotherapists?

Design

Randomised trial with concealed allocation and intention-to-treat analysis.

Participants

Eighty-eight (6 drop-outs) visual display unit workers with early nonspecific work-related upper limb disorders.

Intervention

One group received 10 weeks of postural exercises while the other group received 10 weeks of strength and fitness exercises.

Outcome measures

Pain was measured with a 10-cm visual analogue scale, disability was measured with the Disabilities of Arm, Shoulder and Hand questionnaire, and health-related quality of life was measured with the Short Form-36. Number of participants experiencing upper limb complaints was also collected. Outcome measures were collected at baseline and again at 3, 6, and 12 months.

Results

There was no significant difference in decrease in pain between the groups at 3 months (0.6 cm, 95% CI 0.0 to 1.2), 6 months (0.2, 95% CI –0.3 to 0.7), or at 12 months (0.1, 95% CI –0.6 to 0.8). Differences between the groups in upper limb complaints, disability, and healthrelated quality of life were also small and not significant at any measurement occasion.

Conclusion

Postural exercises did not result in a better outcome than strength and fitness exercises. However, 55% of visual display unit workers with early non-specific work-related upper limb disorders reported being free of complaints one year after both interventions were commenced.