THEWS Output 1Needs 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 of 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 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