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Central adaptation of pain perception in response to rehabilitation of musculoskeletal pain: randomized controlled trial.

https://arctichealth.org/en/permalink/ahliterature120497
Source
Pain Physician. 2012 Sep-Oct;15(5):385-94
Publication Type
Article
Author
Lars L Andersen
Christoffer H Andersen
Emil Sundstrup
Markus D Jakobsen
Ole S Mortensen
Mette K Zebis
Author Affiliation
National Research Centre for the Working Environment, Copenhagen, Denmark. lla74@outlook.com
Source
Pain Physician. 2012 Sep-Oct;15(5):385-94
Language
English
Publication Type
Article
Keywords
Adaptation, physiological - physiology
Adult
Denmark
Double-Blind Method
Exercise Therapy - methods
Female
Follow-Up Studies
Humans
Male
Middle Aged
Muscle, Skeletal - physiopathology
Musculoskeletal Pain - physiopathology - psychology - rehabilitation
Pain Measurement
Pain Perception - physiology
Pain Threshold - physiology
Shoulder - physiopathology
Time Factors
Abstract
Understanding the mechanisms of long-standing musculoskeletal pain and adaptations in response to physical rehabilitation is important for developing optimal treatment strategies. The influence of central adaptations of pain perception in response to rehabilitation of musculoskeletal pain remains unclear.
To investigate the effect of neck/shoulder resistance training on pressure pain threshold (PPT) of the painful neck/shoulder muscles (upper trapezius) and a non-painful reference muscle of the leg (tibialis anterior) in adults with neck/shoulder pain.
Examiner-blinded, parallel-group randomized controlled trial with allocation concealment.
ISRCTN60264809 SETTING: Office workplaces in the capital of Denmark.
The study contained 198 adults with frequent neck/shoulder pain (174 women and 24 men, mean: age 43 years, duration of pain 186 days during the previous year, computer use 93% of work time) were randomly allocated to 10 weeks of specific resistance training for the neck/shoulder muscles for 2 or 12 minutes per day 5 times a week, or weekly information on general health (control group). Primary outcomes were changes in PPT of the painful neck/shoulder muscles (upper trapezius) and a distant non-painful reference muscle (tibialis anterior) at 10 weeks.
PPT of both the trained painful trapezius and the non-trained reference muscle of the leg increased more in the training groups compared with the control group (P
PubMed ID
22996850 View in PubMed
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The Danish national return-to-work program--aims, content, and design of the process and effect evaluation.

https://arctichealth.org/en/permalink/ahliterature127987
Source
Scand J Work Environ Health. 2012 Mar;38(2):120-33
Publication Type
Article
Date
Mar-2012
Author
Birgit Aust
Trine Helverskov
Maj Britt D Nielsen
Jakob Bue Bjorner
Reiner Rugulies
Karina Nielsen
Ole H Sørensen
Gry Grundtvig
Malene F Andersen
Jørgen V Hansen
Helle L Buchardt
Lisbeth Nielsen
Trine L Lund
Irene Andersen
Mogens H Andersen
Aksel S Clausen
Eskil Heinesen
Ole S Mortensen
John Ektor-Andersen
Palle Ørbæk
Glen Winzor
Ute Bültmann
Otto M Poulsen
Author Affiliation
National Research Centre for the Working Environment, Lersø Parkalle 105, DK-2100 Copenhagen, Denmark. bma@nrcwe.dk
Source
Scand J Work Environ Health. 2012 Mar;38(2):120-33
Date
Mar-2012
Language
English
Publication Type
Article
Keywords
Denmark
Female
Humans
Male
Occupational Health - economics - statistics & numerical data
Occupational Therapy - economics - statistics & numerical data
Organizational Innovation
Program Development
Program Evaluation
Questionnaires
Registries
Sick Leave - economics - statistics & numerical data
Work Capacity Evaluation
Abstract
The Danish national return-to-work (RTW) program aims to improve the management of municipal sickness benefit in Denmark. A study is currently ongoing to evaluate the RTW program. The purpose of this article is to describe the study protocol. The program includes 21 municipalities encompassing approximately 19 500 working-age adults on long-term sickness absence, regardless of reason for sickness absence or employment status. It consists of three core elements: (i) establishment of multidisciplinary RTW teams, (ii) introduction of standardized workability assessments and sickness absence management procedures, and (iii) a comprehensive training course for the RTW teams. The effect evaluation is based on a parallel group randomized trial and a stratified cluster controlled trial and focuses on register-based primary outcomes - duration of sickness absence and RTW - and questionnaire-based secondary outcomes such as health and workability. The process evaluation utilizes questionnaires, interviews, and municipal data. The effect evaluation tests whether participants in the intervention have a (i) shorter duration of full-time sickness absence, (ii) longer time until recurrent long-term sickness absence, (iii) faster full RTW, (iv) more positive development in health, workability, pain, and sleep; it also tests whether the program is cost-effective. The process evaluation investigates: (i) whether the expected target population is reached; (ii) if the program is implemented as intended; (iii) how the beneficiaries, the RTW teams, and the external stakeholders experience the program; and (iv) whether contextual factors influenced the implementation. The program has the potential to contribute markedly to lowering human and economic costs and increasing labor force supply. First results will be available in 2013. The trial registrations are ISRCTN43004323, and ISRCTN51445682.
PubMed ID
22245919 View in PubMed
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Does a history of physical exposures at work affect hand-grip strength in midlife? A retrospective cohort study in Denmark.

https://arctichealth.org/en/permalink/ahliterature113962
Source
Scand J Work Environ Health. 2013 Nov;39(6):599-608
Publication Type
Article
Date
Nov-2013
Author
Anne Møller
Susanne Reventlow
Åse Marie Hansen
Lars L Andersen
Volkert Siersma
Rikke Lund
Kirsten Avlund
Johan Hviid Andersen
Ole S Mortensen
Author Affiliation
Department of Occupational Medicine, Køge Sygehus, Lykkebæaekvej 1, DK-4600 Køge, Denmark. annemoller1972@gmail.com.
Source
Scand J Work Environ Health. 2013 Nov;39(6):599-608
Date
Nov-2013
Language
English
Publication Type
Article
Keywords
Cross-Sectional Studies
Denmark
Female
Hand - physiology
Hand Strength
Humans
Male
Middle Aged
Occupational Exposure
Abstract
The aim of this cohort study was to examine associations between physical exposures throughout working life and hand-grip strength (HGS) in midlife.
The Copenhagen Aging and Midlife Biobank (CAMB) provided data about employment and HGS for 3843 Danes. Individual job histories, including duration of employment in specific jobs, were assigned exposures from a job exposure matrix. Exposures were standardized to ton-years (lifting 1000 kg each day in one year), stand-years (standing/walking for six hours each day in one year) and kneel-years (kneeling for one hour each day in one year). The effects of exposure-years on HGS were analyzed as linear effects and cubic splines in multivariate regression models, adjusted for potential confounders.
Mean age was 59 years among both genders and HGS was 49.19 kg [standard deviation (SD) 8.42] and 30.61 kg (SD 5.49) among men and women, respectively. Among men, exposure to kneel-years was associated with higher HGS [>0.030 kg (P=0.007) per exposure-year]. Ton- and stand-years were not associated with HGS among either men or women in linear analyses. In spline regression analyses, associations between ton- and stand-years and HGS were non-linear and primarily positive among men. Among women, the associations were non-linear and, according to ton-years, primarily negatively associated with HGS but statistically insignificant.
A history of physical exposures at work explained only a minor part of the variation in HGS, though exposure to kneeling throughout working life was associated with a slightly higher HGS among men. Exposure to lifting and standing/walking was not associated with HGS.
PubMed ID
23665642 View in PubMed
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Occupational physical activity and mortality among Danish workers.

https://arctichealth.org/en/permalink/ahliterature133530
Source
Int Arch Occup Environ Health. 2012 Apr;85(3):305-10
Publication Type
Article
Date
Apr-2012
Author
Andreas Holtermann
Hermann Burr
Jørgen V Hansen
Niklas Krause
Karen Søgaard
Ole S Mortensen
Author Affiliation
National Research Centre for the Working Environment, Copenhagen, Denmark. aho@nrcwe.dk
Source
Int Arch Occup Environ Health. 2012 Apr;85(3):305-10
Date
Apr-2012
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Cause of Death
Denmark - epidemiology
Female
Humans
Male
Middle Aged
Motor Activity
Occupational Exposure - statistics & numerical data
Proportional Hazards Models
Sex Factors
Survival Rate
Young Adult
Abstract
The relationship between occupational physical activity (OPA) and mortality has mainly been studied among males and shows conflicting results. This study examines this relationship in a cohort of both male and female workers.
OPA was determined by 4 self-reported questions in a representative sample of 5,839 Danish workers aged 18-59 years at baseline. A 19-year follow-up on mortality was assessed by linkage with the national death registry. Gender-stratified Cox regression models were used to determine the effect of high OPA on all-cause mortality while controlling for age, BMI, smoking, alcohol consumption, doctor-diagnosed disease, influence at work, and social class.
Two hundred and sixty-two males (8.6%) and 174 females (6.2%) died during follow-up. Being in the highest quartile of OPA predicted an increased risk for all-cause mortality among male workers (HR: 1.79, CI: 1.19-2.70), but not among female workers (HR: 0.99, CI: 0.65-1.49) compared with workers in the lowest quartile of OPA. Among females, indications of a u-shaped relationship between occupational physical activity and all-cause mortality were found.
The findings indicate that high occupational physical activity increases the risk for all-cause mortality among male workers. Future studies need to further examine gender differences in the effects of OPA on mortality.
PubMed ID
21695437 View in PubMed
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Perceived psychological pressure at work, social class, and risk of stroke: a 30-year follow-up in Copenhagen male study.

https://arctichealth.org/en/permalink/ahliterature129472
Source
J Occup Environ Med. 2011 Dec;53(12):1388-95
Publication Type
Article
Date
Dec-2011
Author
Poul Suadicani
Lars L Andersen
Andreas Holtermann
Ole S Mortensen
Finn Gyntelberg
Author Affiliation
Epidemiological Research Unit, Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, Copenhagen, Denmark. PSUA0001@bbh.regionh.dk
Source
J Occup Environ Med. 2011 Dec;53(12):1388-95
Date
Dec-2011
Language
English
Publication Type
Article
Keywords
Adult
Denmark - epidemiology
Follow-Up Studies
Humans
Male
Middle Aged
Prevalence
Prospective Studies
Risk
Social Class
Stress, Psychological - epidemiology
Stroke - epidemiology
Workplace - psychology - statistics & numerical data
Abstract
Investigate if the association between perceived psychological work pressure and risk of stroke is modified by socioeconomic status.
Thirty-year follow-up of 4943 middle-aged men without cardiovascular disease.
In the higher social classes (I, II, and III), perceived regular exposure to psychological work pressure was common and a significant predictor of stroke; almost 10% of the stroke events could be attributed to this exposure in the higher social classes; among lower social classes (IV and V), perceived psychological pressure was no predictor at all.
Regular psychological work pressure is a highly prevalent and independent risk factor for stroke among men in higher social classes. In contrast, no association to stroke risk was found among low social class men.
PubMed ID
22104980 View in PubMed
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Prevalence and anatomical location of muscle tenderness in adults with nonspecific neck/shoulder pain.

https://arctichealth.org/en/permalink/ahliterature132796
Source
BMC Musculoskelet Disord. 2011;12:169
Publication Type
Article
Date
2011
Author
Lars L Andersen
Klaus Hansen
Ole S Mortensen
Mette K Zebis
Author Affiliation
National Research Centre for the Working Environment, Lersø Parkalle 105, DK 2100 Copenhagen Ø, Denmark. LLA@NRCWE.DK
Source
BMC Musculoskelet Disord. 2011;12:169
Date
2011
Language
English
Publication Type
Article
Keywords
Adult
Aged
Analysis of Variance
Denmark
Female
Humans
Male
Middle Aged
Neck - pathology - physiopathology
Neck Pain - diagnosis - epidemiology - pathology - physiopathology
Pain Measurement
Palpation
Physical Examination
Predictive value of tests
Prevalence
Regression Analysis
Risk assessment
Risk factors
Severity of Illness Index
Shoulder - pathology - physiopathology
Shoulder Pain - diagnosis - epidemiology - physiopathology
Abstract
Many adults experience bothersome neck/shoulder pain. While research and treatment strategies often focus on the upper trapezius, other neck/shoulder muscles may be affected as well. The aim of the present study is to evaluate the prevalence and anatomical location of muscle tenderness in adults with nonspecific neck/shoulder pain.
Clinical neck/shoulder examination at two large office workplaces in Copenhagen, Denmark. 174 women and 24 men (aged 25-65 years) with nonspecific neck/shoulder pain for a duration of at least 30 days during the previous year and a pain intensity of at least 2 on a modified VAS-scale of 0-10 participated. Exclusion criteria were traumatic injuries or other serious chronic disease. Using a standardized finger pressure of 2 kg, palpable tenderness were performed of eight anatomical neck/shoulder locations in the left and right side on a scale of 'no tenderness', 'some tenderness' and 'severe tenderness'.
In women, the levator scapulae, neck extensors and infraspinatus showed the highest prevalence of severe tenderness (18-30%). In comparison, the prevalence of severe tenderness in the upper trapezius, occipital border and supraspinatus was 13-19%. Severe tenderness of the medial deltoid was least prevalent (0-1%). In men, the prevalence of severe tenderness in the levator scapulae was 13-21%, and ranged between 0-8% in the remainder of the examined anatomical locations.
A high prevalence of tenderness exists in several anatomical locations of the neck/shoulder complex among adults with nonspecific neck/shoulder pain. Future research should focus on several neck/shoulder muscles, including the levator scapulae, neck extensors and infraspinatus, and not only the upper trapezius.
ISRCTN60264809.
Notes
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PubMed ID
21777478 View in PubMed
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A prospective cohort study on musculoskeletal risk factors for long-term sickness absence among healthcare workers in eldercare.

https://arctichealth.org/en/permalink/ahliterature130592
Source
Int Arch Occup Environ Health. 2012 Aug;85(6):615-22
Publication Type
Article
Date
Aug-2012
Author
Lars L Andersen
Thomas Clausen
Ole S Mortensen
Hermann Burr
Andreas Holtermann
Author Affiliation
National Research Centre for the Working Environment, Lersø Parkalle 105, 2100, Copenhagen, Denmark. lla@nrcwe.dk
Source
Int Arch Occup Environ Health. 2012 Aug;85(6):615-22
Date
Aug-2012
Language
English
Publication Type
Article
Keywords
Absenteeism
Adult
Aged
Back Pain - etiology
Cohort Studies
Denmark
Female
Geriatric Nursing
Health Personnel
Humans
Male
Middle Aged
Musculoskeletal Diseases - etiology
Neck Pain - etiology
Occupational Diseases
Proportional Hazards Models
Prospective Studies
Questionnaires
Risk factors
Sick Leave
Abstract
The socioeconomic burden of sickness absence from musculoskeletal disorders is considerable. However, knowledge about the risk of sickness absence from pain in different body regions among specific job groups is needed to more efficiently target preventative strategies. This study estimates the risk of long-term sickness absence (LTSA) from pain in different body regions among healthcare workers.
Prospective cohort study among 8,952 Danish healthcare workers responding to a questionnaire in 2004-2005 and followed for 1 year in a national register of social transfer payments (DREAM). Using Cox regression hazard ratio (HR) analysis controlled for age, gender, BMI, smoking, seniority, leisure physical activity and psychosocial working conditions, we modeled risk estimates of sub-chronic (1-30 days last year) and chronic pain (>30 days last year) in the low back, neck/shoulder and knees for onset of LTSA (receiving sickness absence compensation for at least eight consecutive weeks) during one-year follow-up.
At baseline, the prevalence of chronic pain was 23% (low back), 28% (neck/shoulder) and 12% (knees). During follow-up, the 12-month prevalence of LTSA was 6.3%. Chronic pains in the low back (HR 1.47 [95% CI 1.17-1.85]), neck/shoulder (HR 1.60 [95% CI 1.27-2.02]) and knees (HR 1.92 [95% CI 1.52-2.42]) were significant risk factors for LTSA. However, only chronic neck/shoulder (HR 1.41 [95% CI 1.09-1.82]) and knee pain (HR 1.69 [95% CI 1.32-2.16]) remained significant with mutual adjustment for all three musculoskeletal pain regions.
Musculoskeletal pain is a risk factor for LTSA among healthcare workers. Future research among healthcare workers in eldercare should include the management of neck/shoulder and knee pain in addition to the management of back pain.
PubMed ID
21986907 View in PubMed
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Protocol for work place adjusted intelligent physical exercise reducing musculoskeletal pain in shoulder and neck (VIMS): a cluster randomized controlled trial.

https://arctichealth.org/en/permalink/ahliterature141721
Source
BMC Musculoskelet Disord. 2010;11:173
Publication Type
Article
Date
2010
Author
Lars L Andersen
Mette K Zebis
Mogens T Pedersen
Kirsten K Roessler
Christoffer H Andersen
Mette M Pedersen
Helene Feveile
Ole S Mortensen
Gisela Sjøgaard
Author Affiliation
National Research Centre for the Working Environment, Lersø Parkalle 105, DK 2100 Copenhagen Ø, Denmark. lla@nrcwe.dk.
Source
BMC Musculoskelet Disord. 2010;11:173
Date
2010
Language
English
Publication Type
Article
Keywords
Adult
Clinical Protocols
Cluster analysis
Denmark - epidemiology
Exercise Therapy - methods
Female
Humans
Male
Middle Aged
Neck Pain - physiopathology - prevention & control - rehabilitation
Occupational Diseases - physiopathology - prevention & control - rehabilitation
Outcome Assessment (Health Care) - methods
Physical Fitness - physiology
Resistance Training - methods
Sedentary lifestyle
Shoulder Pain - physiopathology - prevention & control - rehabilitation
Teaching - methods
User-Computer Interface
Workplace
Abstract
Neck and shoulder complaints are common among employees in sedentary occupations characterized by intensive computer use. Specific strength training is a promising type of physical exercise for relieving neck and shoulder pain in office workers. However, the optimal combination of frequency and exercise duration, as well as the importance of exercise supervision, is unknown. The VIMS study investigates in a cluster randomized controlled design the effectiveness of different time wise combinations of specific strength training with identical accumulated volume, and the relevance of training supervision for safe and effective training.
A cluster randomized controlled trial of 20 weeks duration where employed office workers are randomized to 1 x 60 min, 3 x 20 min, 9 x 7 min per week of specific strength training with training supervision, to 3 x 20 min per week of specific strength training with a minimal amount of training supervision, or to a reference group without training. A questionnaire will be sent to 2000 employees in jobs characterized by intensive computer work. Employees with cardiovascular disease, trauma, hypertension, or serious chronic disease will be excluded. The main outcome measure is pain in the neck and shoulders at week 20.
The trial is registered at ClinicalTrials.gov, number NCT01027390.
Notes
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PubMed ID
20687940 View in PubMed
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Time trend analysis of return to work after stroke in Denmark 1996-2006.

https://arctichealth.org/en/permalink/ahliterature125329
Source
Int J Occup Med Environ Health. 2012 Jun;25(2):200-4
Publication Type
Article
Date
Jun-2012
Author
Harald Hannerz
Ole S Mortensen
Otto M Poulsen
Frank Humle
Betina Holbæk Pedersen
Lars L Andersen
Author Affiliation
National Research Centre for the Working Environment, Copenhagen, Denmark. hha@nrcwe.dk
Source
Int J Occup Med Environ Health. 2012 Jun;25(2):200-4
Date
Jun-2012
Language
English
Publication Type
Article
Keywords
Adult
Denmark - epidemiology
Employment - legislation & jurisprudence - statistics & numerical data
Female
Health Policy - legislation & jurisprudence
Humans
Male
Middle Aged
Prospective Studies
Stroke - epidemiology
Time Factors
Young Adult
Abstract
In the period 1997-2005, the Danish government initiated a series of legislative changes aimed at facilitating RTW (return to work) in the Danish population. In the present study, we investigated the odds of being gainfully occupied ca. two years after stroke as a function of onset calendar year, 1996-2006.
All previously employed 20-57 year-old stroke patients in Denmark 1996-2006 (N = 19985) were followed prospectively through national registers. The analysis was controlled for the type of stroke and a series of demographic, structural and occupational variables.
The odds for RTW increased significantly during the study period (P
PubMed ID
22492285 View in PubMed
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