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No difference between postural exercises and strength and fitness exercises for early, nonspecific, work-related upper limb disorders in visual display unit workers: a randomised trial
van Eijsden-Besseling MD, Staal JB, van Attekum A, de Bie RA, van den Heuvel WJA
Australian Journal of Physiotherapy 2008;54(2):95-101
clinical trial
7/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

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. TRIAL REGISTRATION: ISRCTN15872455.

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