No difference between postural exercises and strength and fitness exercises for early, non-specific, work-related upper limb disorders in visual display unit workers: a randomised trial

Aust J Physiother. 2008;54(2):95-101. doi: 10.1016/s0004-9514(08)70042-4.


Question: Are postural exercises delivered by Mensendieck/Cesar therapists more effective in decreasing pain, reducing disability and improving health-related quality of life in visual display unit workers with early non-specific work-related upper limb disorders than strength and fitness exercises delivered by physiotherapists?

Design: Randomised trial with concealed allocation and intention-to-treat analysis.

Participants: Eighty-eight (6 drop-outs) visual display unit workers with early non-specific work-related upper limb disorders.

Intervention: One group received 10 weeks of postural exercises while the other group received 10 weeks of strength and fitness exercises.

Outcome measures: Pain was measured with a 10-cm visual analogue scale, disability was measured with the Disabilities of Arm, Shoulder and Hand questionnaire, and health-related quality of life was measured with the Short Form-36. Number of participants experiencing upper limb complaints was also collected. Outcome measures were collected at baseline and again at 3, 6, and 12 months.

Results: There was no significant difference in decrease in pain between the groups at 3 months (0.6 cm, 95% CI 0.0 to 1.2), 6 months (0.2, 95% CI -0.3 to 0.7), or at 12 months (0.1, 95% CI -0.6 to 0.8). Differences between the groups in upper limb complaints, disability, and health related quality of life were also small and not significant at any measurement occasion.

Conclusion: Postural exercises did not result in a better outcome than strength and fitness exercises. However, 55% of visual display unit workers with early non-specific work-related upper limb disorders reported being free of complaints one year after both interventions were commenced.

Trial registration: ISRCTN15872455.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Exercise Therapy*
  • Female
  • Health Status Indicators
  • Humans
  • Male
  • Muscle Strength*
  • Muscle, Skeletal / physiopathology*
  • Musculoskeletal Diseases / etiology
  • Netherlands / epidemiology
  • Occupational Diseases / etiology
  • Occupational Diseases / rehabilitation*
  • Occupational Exposure / adverse effects
  • Physical Fitness*
  • Posture*
  • Prevalence
  • Prospective Studies
  • Surveys and Questionnaires
  • Time Factors
  • Upper Extremity / pathology*
  • User-Computer Interface*

Associated data

  • ISRCTN/ISRCTN15872455