7.1 Mongini et al. Effectiveness of
an educational and physical
programme in reducing headache,
neck and shoulder pain: a workplace
controlled trial. Cephalalgia 2008;
28, 541-552
Relaxation and Posture
Exercises Help to
Significantly Reduce
Headaches and Neck and
Shoulder
Pain
Italian researchers compared two
large groups of government
employees over an eight-month trial
period to determine the effects of
an educational and physical program
for office workers. One group
(175) was the control group that
had no interventions. The
other group (169) was the study
group that was asked to perform
relaxation and posture exercises
every two to three hours, reminded
to avoid excessive muscle
contractions of the neck and
shoulder area, and educated with a
short film, practical demonstration
and training. The two groups
used daily diaries to track
headaches, neck, and shoulder pain,
and the use of pain
medication.
At the end of the trial period, the
study group reported 41 percent
fewer headaches compared to the
control group that essentially
reported no change. The study
group reported 43 percent less neck
and shoulder pain compared to the
control group that reported a 5
percent reduction. The study
group reported a 51 percent
reduction in the use of pain
medication compared to the control
group that reported a 15 percent
cut. Finally, the study group
reported a reduced burden (impact
on activities of daily living) of
41 percent for headaches and 54
percent for neck and shoulder pain
compared to the control group that
reported a reduced burden of 2
percent for headaches and 4 percent
for neck and shoulder pain.
People with anxiety or depression
had better than average improvement
compared to others in the
study.
COMMENTS:
The education, training and
performance of the relaxation and
posture exercises were very
successful for the study
group. The key points to take
note of are a) the use of daily
dairies, b) red labels were placed
around the study group’s work
area as visual reminders, c) the
clinician leading the study
revisited the workplace to remind
the group of the procedures, d)
posture exercises were performed
every two to three hours, e) there
were two daily periods of ten to 15
minutes for quiet relaxation, f)
people with anxiety or depression
are typically more susceptible to
headache and neck and shoulder
pain, and when relieved of those
pains, feel much
better.
Australian
researchers measured 3-D
posture and muscle activity
in the neck and arms of 24
children age 10-12 while they
performed interactive tasks
such as reading from a book
or computer display, writing
on paper, and using a mouse
and keyboard to enter
data. The
display and reading heights
were varied in three test
positions; high, mid and low
level. The high display
caused extension, or backward
bending, of the upper
neck. The
low display (book-level)
increased forward bending of
the neck and caused the most
strain on muscles and
joints.
The mid-level display
promoted the most upright and
symmetrical posture and the
lowest muscle activity
compared to the high or low
display positions.
COMMENTS:
The researchers set out to study
children because a) data from the
Australian Bureau of Statistics
indicated that in 2006, 80% of
children aged 5 to 14 years used a
computer at home, b) the rapid
increase in computer use by
children over the past few years
"has outpaced the development of
knowledge about the ramifications
for the health of children,”
and c) children are physically and
behaviorally different from adults,
for example, children’s heads
are proportionately larger than
those of adults.
However, the results of this
research are in line with the
current research for all
humans.
Reading
materials must be positioned
approximately at eye level to avoid
either excessive forward or
backward bending of the neck.
