Needs Analysis Focus Group Manos Stefanakis Outcome 1 Coordinator - - PowerPoint PPT Presentation

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

Focus group 1 Greece Focus group 2 Greece Focus group 3 Norway Focus group 4 Cyprus

4 focus groups with office workers in 3 countries

Focus groups

• 8 office workers
• Both males and

females

• Chronic pain

patients

• 4 office workers
• All females
• 8 office workers
• Both males and

females

• 8 office workers
• Both males and

females

Focus group 1 Greece Focus group 2 Greece Focus group 4 Cyprus Focus group 3 Norway

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 problem with your neck” “How is this problem affecting your work and your life” “What do you think is causing/affecting your neck problem” “What are the strategies you use to alleviate/relieve your problem” “And more importantly are there any exercises you use to relieve your complaints?”

“What is the biggest problem with your neck”

 Most of the participants identified neck pain as their main problem  Muscle tightness, muscle spasm and muscle soreness was another frequently mentioned complain  Arm and upper extremity problems were not a significant problem in Cyprus and Greece  Few of the participants mentioned some forearm pain due to the desk pressure on the forearm muscles  Muscle tightness and occasional muscle pain was reported in the area of upper trapezius and between the shoulder blades  Headaches were present in some

• f the cases especially after

prolonged hours in front of the computer  Neck tightness and stiffness especially in rotation was a common problem  Severity of the complaints varied across the year and most of the participants reported episodic appearance of their neck problem  Complaints depended on the time spend in their desk and cold weather and intensity tended to be less on holidays and days with less workload

“How is this problem affecting your work and your life”

 Some of the participants reported that their neck problem was significant enough to affect their work  All of them agreed that it affects their productivity  Others reported lack of concentration  Stress, anxiety and fatigue was caused by the neck pain which frequently led to headaches  In Norway some of the participants were on a varied percentage of sick leave or reduced duties  Some of them were also using the “Green prescription” in the past  Frequent tension with other colleagues  Participants would spend more time working in their desk if they didn’t have the pain  Interruption of sleep was frequent  Difficulty with driving especially reversing the car  Absence from work was rare in the Cyprus and Greece  In Norway a significant number of working time and productivity were lost  Some participants in Norway reported they had significant problems with house duties and they were frequently using the help of other family members for these tasks

Associated pain

“What do you think is causing/affecting your neck problem”

 Poor sitting habits  Desk ergonomics  short desk  relatively high chair  forward head posture  slumped sitting  placement and height of the computer screen  Long hours at the office in front of the computer increased neck complaints  Blind typing was considered important as “you don’t have to flex your neck”  Talking on the phone and typing at the same time provokes pain due to the need for neck side flexion to hold the phone  Other provocative factors mentioned were the number of pillows during night sleep, the condition of their mattress, air condition at work  Psychological stress makes the problem worse and can provoke muscle tension  More than 50% of them felt that exercise was helpful and they stated they feel remission of their symptoms 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 groups  Predefined script with explanatory directions regarding the objectives of the activity  In addition the script contained the relevant questions phrased in the same “open ended way” for all groups  There were also secondary or explanatory questions to gain further clarifications  All of these were prepared in the participant’s native language  3 different countries  Males and females  Chronic and less chronic

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

• ffice 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