Effect of Individually Tailored Biopsychosocial Workplace Interventions on Chronic Musculoskeletal Pain and Stress Among Laboratory Technicians: Randomized Controlled Trial

Background: Chronic musculoskeletal pain is prevalent among laboratory technicians andwork-related stress may aggravate the problem.Objectives: This study investigated the effect of a multifaceted worksite intervention on painand stress among laboratory technicians with chronic musculoskeletal pain using individuallytailored physical and cognitive elements.Study Design: This trial uses a single-blind randomized controlled design with allocationconcealment in a 2-armed parallel group format among laboratory technicians. The trial“Implementation of physical exercise at the Workplace (IRMA09) – Laboratory technicians“was registered at ClinicalTrials.gov prior to participant enrolment.Setting: The study was conducted at the head division of a large private pharmaceuticalcompany’s research and development department in Denmark. The study duration was March2014 (baseline) to July 2014 (follow-up).Methods: Participants (n = 112) were allocated to receive either physical, cognitive, andmindfulness group-based training (PCMT group) or a reference group (REF) for 10 weeks at theworksite. PCMT consisted of 4 major elements: 1) resistance training individually tailored to thepain affected area, 2) motor control training, 3) mindfulness, and 4) cognitive and behavioraltherapy/education. Participants of the REF group were encouraged to follow ongoing companyhealth initiatives. The predefined primary outcome measure was pain intensity (VAS scale 0 –10) in average of the regions: neck, shoulder, lower and upper back, elbow, and hand at 10week follow-up. The secondary outcome measure was stress assessed by Cohen´s perceivedstress questionnaire. In addition, an explorative dose-response analysis was performed on theadherence to PCMT with pain and stress, respectively, as outcome measures.Results: A significant (P < 0.0001) treatment by time interaction in pain intensity was observedwith a between-group difference at follow-up of -1.0 (95%CI: -1.4 to -0.6). No significanteffect on stress was observed (treatment by time P = 0.16). Exploratory analyses for each bodyregion separately showed significant pain reductions of the neck, shoulders, upper back andlower back, as well as a tendency for hand pain.Within the PCMT group, general linear models adjusted for age, baseline pain, and stress levelsshowed significant associations for the change in pain with the number of physical-cognitivetraining sessions per week (-0.60 [95%CI -0.95 to -0.25]) and the number of mindfulnesssessions (0.15 [95%CI 0.02 to 0.18]). No such associations were found with the change in stressas outcome.Limitations: Limitations of behavioral interventions include the inability to blind participantsto which intervention they receive. Self-reported outcomes are a limitation as they may beinfluenced by placebo effects and outcome expectations