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Analysis of the influence of workplace exercises on functional performance and symptomatology in upper limbs of university hospital workers: a randomized controlled trial

Abstract

Complaints of work-related musculoskeletal pain and discomfort may be related to a number of individual / personal, physical, biomechanical or psychosocial / organizational risk factors and preventive actions such as therapeutic exercises may interfere positively. Objective: To analyze the effects of the association of muscular strengthening workplace kinesiotherapy on postural and ergonomic education in the reduction of pain and musculoskeletal discomfort in the upper limbs and cervical region perceived by university hospital workers, compared to a control group and correlate the risk factors with the symptoms and function through the development of a assessment protocol. Methods: After sample size calculation 154 hospital workers with or without complaint of pain or discomfort in the upper limbs, without clinical diagnosis, will be invited to participate in this clinical trial. They will be recruited and randomly assigned to the group of workplace strengthening exercises or control group. The primary outcomes will be the pain perceived by the Numerical Pain Scale, the plane of scapula abduction isokinetic muscle strength of the upper limb and isometric handgrip bilateral. The discomfort, fatigue, work capacity and dysfunction will be evaluated by the questionnaires: Nordic Questionnaire, Restlessness Scale and Disability for Work, Patient specific functional scale (PSFS-Br), QuickDASH-Br, Neck Disability index-Br (NDI-Br), Global scale of change at baseline and after 12 weeks of individualized muscle strengthening performed in small groups. The Ergonomic Work Analysis of critical activities will be evaluated by indirect observation through the application of the QEC, RULA, REBA, RARME and HARM tools, after images recorded in videos and photos of the pre-intervention and after 12 weeks. All volunteers will receive specific ergonomic guidelines. Statistical analysis will be performed by intention to trait method. The independent samples t-test and ANOVA two way will be used to compare the groups after intervention. Clinical significance will be analyzed by minimal clinically important differences for the patient-related outcome measure scores and the Cohen index for the effect size calculation, with 95% confidence interval and p <0.05 through SPSS", 20.0. The correlation will be performed by Spearman coefficient and multivariate regression analysis. (AU)