The effects of workplace stressors on muscle activity in the neck-shoulder and forearm muscles during computer work: a systematic review and meta-analysis

A J Van Der Beek,J T Dennerlein,B M Blatter,J L Bruno Garza,M A Huysmans,B H W Eijckelhof,J H Van Dieën

doi:10.1007/s00421-013-2602-2

Abstract

Workplace stressors have been indicated to play a role in the development of neck and upper extremity pain possibly through an increase of sustained (low-level) muscle activity. The aim of this review was to study the effects of workplace stressors on muscle activity in the neck-shoulder and forearm muscles. An additional aim was to find out whether the muscles of the neck-shoulder and the forearm are affected differently by different types of workplace stressors. A systematic literature search was conducted on studies investigating the relation between simulated or realistic workplace stressors and neck-shoulder and forearm muscle activity. For studies meeting the inclusion criteria, a risk of bias assessment was performed and data were extracted for synthesis. Results were pooled when possible and otherwise described. Twenty-eight articles met the inclusion criteria, reporting data of 25 different studies. Except for one field study, all included studies were laboratory studies. Data of 19 articles could be included in the meta-analysis and revealed a statistically significant, medium increase in neck-shoulder and forearm muscle activity as a result of workplace stressors. In subgroup analyses, we found an equal effect of different stressor types (i.e. cognitive/emotional stress, work pace, and precision) on muscle activity in both body regions. In conclusion, simulated workplace stressors result in an increase in neck-shoulder and forearm muscle activity. No indications were found that different types of stressors affect these body regions differently. These conclusions are fully based on laboratory studies, since field studies on this topic are currently lacking.Electronic supplementary materialThe online version of this article (doi:10.1007/s00421-013-2602-2) contains supplementary material, which is available to authorized users.

Highlights

BackgroundComputer work has become a key element in daily work for many people and is still growing
We found an equal effect of different stressor types on muscle activity in both body regions
The final set of 28 included articles consisted of 27 laboratory studies and 1 field study

Summary

Introduction

BackgroundComputer work has become a key element in daily work for many people and is still growing. Neck and upper extremity pain has serious consequences for the individual involved and is associated with high costs for societies and employers, due to productivity loss and medical consumption. One category of risk factors for neck and upper extremity pain is workplace stress (Bongers et al 2002; 2006), which is common in computer work. The etiological mechanisms of workplace stressors are not yet understood, but one of the mechanisms proposed is that these stressors increase sustained (low-level) muscle activity (Bongers et al 2006) which in turn may lead to injury via overexertion. Muscle activity may be affected indirectly through a changed work style due to these stressors (e.g. increased work pace, high forces on the keyboard and mouse, and more awkward and sustained postures) (Harrington and Feuerstein 2010). Muscle activity may be affected directly without any change in posture or movement (Bloemsaat et al 2005; Waersted 2000; Waersted and Westgaard 1996) due to increased arousal or due to more specific psychogenic mechanisms

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