A test of two training interventions to prevent work-related musculoskeletal disorders of the upper extremity

Appl Ergon. 2002 Jul;33(4):337-47. doi: 10.1016/s0003-6870(02)00006-6.


We investigated, on behalf of a large electronics manufacturer, two types of worker training interventions for their efficacy in preventing unnecessary muscle tension and the symptoms of work-related musculoskeletal disorders. The first intervention, Muscle Learning Therapy (MLT), used electromyographic (sEMG) feedback and operant conditioning to decrease muscle tension during complex work tasks. The second intervention used adult learning and cognitive behavioral techniques in small group discussion to advance the worker's capabilities for symptom and stress management and problem-solving. Workers were randomly assigned to a control group or one of the two treatment conditions. Prior to training, baseline data were collected using symptom diaries and sEMG recordings of the trapezius and forearm muscles of the left and right arms. The training interventions were conducted for 6 weeks with reinforcement training provided at 18 and 32 weeks post-baseline. Follow-up data were collected after the initial 6-week training period and at 32 weeks, prior to the reinforcement training. Symptom outcomes demonstrated significant differences at 6 weeks, increasing in severity for the control group and declining modestly for the educational group, with little change for the MLT group. These differences were not maintained at further follow-up. The MLT group was consistently effective in reducing muscle tension in the trapezius areas after 6 and 32 weeks, and was partially effective for the forearms. Further testing is recommended of these training interventions, especially with the inclusion of strategic, periodic reinforcement of the worker's learning.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Arm / physiology*
  • Arm / physiopathology
  • Biofeedback, Psychology
  • California
  • Cognitive Behavioral Therapy
  • Data Collection
  • Electromyography / statistics & numerical data*
  • Female
  • Humans
  • Inservice Training / organization & administration*
  • Male
  • Muscle Contraction
  • Musculoskeletal Diseases / physiopathology
  • Musculoskeletal Diseases / prevention & control*
  • Occupational Diseases / physiopathology
  • Occupational Diseases / prevention & control*
  • Outcome Assessment, Health Care