THEWS Output 1 Needs Analysis Focus Group Manos Stefanakis Outcome 1 Coordinator
Neck pain
Neck pain prevalence
Neck pain epidemiology
Neck pain epidemiology
Neck pain epidemiology Office Workers
Chronic neck pain
Stretching exercises for neck pain RCT of 125 women with non-specific neck pain No significant difference in pain between a group of patients receiving manual therapy 2/week and a group doing stretches 5 times/week Neck and shoulder pain, disability index and neck stiffness decreased significantly more in manual therapy Low-cost stretching exercises can be recommended as an appropriate therapy intervention to relieve pain, at least in the short-term Ylinen et al. 2007 J Rehabil Med 39: 126 – 132
Strengthening exercises Strengthening exs improved the effect of manual therapy Results were maintained in the 2 years follow up
Motor control exercises Multicentre RCT (n=200 cervicogenic headache patients) Groups: Mobilization/manipulation group Exercise therapy group Combined mobilization/manipulation and exercise group Control group Groups 1- 3 had significantly reduced headache frequency and intensity 10% more patients experienced a complete reduction in headache frequency when treated with mobilization/ manipulation and exercise than those treated with the other approaches Jull et al. 2002 Spine 27 (17): 1835-43
Sick leave and return to work
Selection of exercises
Why don’t we ask the patients???
Why don’t we ask the patients??? After all they are the end user’s………….
Why don’t we ask the patients??? After all they are the end user’s…………. They should be able to tell you what they need…..
Thews needs analysis 4 focus groups with office workers Focus Focus in 3 countries group 1 group 2 Greece Greece Focus Focus group 3 group 4 Norway Cyprus
Focus groups • 8 office workers • 8 office workers • Both males and • Both males and females females Focus Focus group 1 group 2 Greece Greece Focus Focus group 3 group 4 Norway Cyprus • Chronic pain • 8 office workers patients • Both males and • 4 office workers females • All females
Aim and objectives The primary objective of the focus groups was to identify the needs of office employees with neck complains in relation to exercise for prevention and management of their neck problem.
Methodology “What is the biggest “What are the problem with your strategies you use to neck ” alleviate/relieve your problem” “How is this problem “And more importantly affecting your work and your life” are there any exercises you use to relieve your “What do you think is complaints ?” causing/affecting your neck problem”
“What is the biggest problem with your neck” Most of the participants Headaches were present in some identified neck pain as their main of the cases especially after problem prolonged hours in front of the computer Muscle tightness, muscle spasm Neck tightness and stiffness and muscle soreness was another frequently mentioned complain especially in rotation was a common problem Arm and upper extremity Severity of the complaints varied problems were not a significant problem in Cyprus and Greece across the year and most of the participants reported episodic Few of the participants appearance of their neck problem mentioned some forearm pain Complaints depended on the due to the desk pressure on the forearm muscles time spend in their desk and cold weather and intensity tended to Muscle tightness and occasional be less on holidays and days with muscle pain was reported in the less workload area of upper trapezius and between the shoulder blades
“How is this problem affecting your work and your life” Some of the participants reported that Participants would spend more time their neck problem was significant working in their desk if they didn’t have enough to affect their work the pain All of them agreed that it affects their Interruption of sleep was frequent productivity Difficulty with driving especially Others reported lack of concentration reversing the car Stress, anxiety and fatigue was caused Absence from work was rare in the by the neck pain which frequently led Cyprus and Greece to headaches In Norway a significant number of In Norway some of the participants working time and productivity were lost were on a varied percentage of sick Some participants in Norway reported leave or reduced duties they had significant problems with Some of them were also using the house duties and they were frequently “Green prescription” in the past using the help of other family members for these tasks Frequent tension with other colleagues
Associated pain
“What do you think is causing/affecting your neck problem” Poor sitting habits Talking on the phone and typing at the same time provokes pain due to Desk ergonomics the need for neck side flexion to hold short desk the phone relatively high chair Other provocative factors mentioned forward head posture were the number of pillows during slumped sitting night sleep, the condition of their placement and height of the mattress, air condition at work computer screen Psychological stress makes the Long hours at the office in front of problem worse and can provoke the computer increased neck muscle tension complaints More than 50% of them felt that Blind typing was considered exercise was helpful and they stated important as “you don’t have to flex they feel remission of their symptoms your neck ” when they exercise regularly
“What are the strategies you use to alleviate/relieve your problem” Massage e.g self - massage of the upper trapezius Frequent interruption of sitting Long walks around the building or outside Hot shower in the morning Medication (pain killers, pain soothing creams and NSAIDs) Change of chair/desk Stress management
“Are there any exercises you use to relieve your complaints?” Simple ROM exercises (“moving the neck/head around”) Stretching exercises Aerobic exercises Exercises for back extensors and generally postural exercises
Strengths of the focus groups Same methodology across all There were also secondary or groups explanatory questions to gain further clarifications Predefined script with All of these were prepared in explanatory directions regarding the objectives of the participant’s native the activity language In addition the script 3 different countries contained the relevant Males and females questions phrased in the Chronic and less chronic same “open ended way” for all groups
Conclusions Overall the objectives of the activity were achieved as several important conclusions were confirmed by the replies of the participants Specifically the activity identified a gap in the guidance of office workers with neck discomfort in appropriate exercises and stress management strategies for prevention or management of their complaint especially in the workplace These results provide some preliminary support for the importance of the THEWS project
Thank you
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