Effects on musculoskeletal pain, work ability and sickness absence in a 1-year randomised controlled trial among cleaners

Abstract

Background: Only a few workplace initiatives among cleaners have been reported, even though they constitute a job group in great need of health promotion. The purpose of this trial was to evaluate the effect of either physical coordination training or cognitive behavioural training on musculoskeletal pain, work ability and sickness absence among cleaners.

Methods: A cluster-randomised controlled trial was conducted among 294 female cleaners allocated to either physical coordination training (PCT), cognitive behavioural training (CBTr) or a reference group (REF). Questionnaires about musculoskeletal pain and work ability were completed at baseline and after one year's intervention. Sickness absence data were obtained from the managers' records. Analyses were performed according to the intention-to-treat-principle (ITT).

Results: No overall reduction in musculoskeletal pain, work ability or sickness absence from either PCT or CBTr compared with REF was found in conservative ITT analyses. However, explorative analyses revealed a treatment effect for musculoskeletal pain of the PCT. People with chronic neck/shoulder pain at baseline were more frequently non-chronic at follow-up after PCT compared with REF (p = 0.05).

Conclusions: The PCT intervention appeared effective for reducing chronic neck/shoulder pain among the female cleaners. It is recommended that future interventions among similar high-risk job groups focus on the implementation aspects of the interventions to maximise outcomes more distal from the intervention such as work ability and sickness absence.

Trial registration: ISRCTN: ISRCTN96241850.

Figure 1

Flow of participants during the study indicating recruitment, randomisation and drop-out. Yr = year, FU = follow-up, Empl. = employment.

Figure 2

Change in pain status (neck/shoulder). Frequency of participants who changed their pain status in the neck/shoulders (i.e. from chronic pain at baseline to non-chronic pain at follow-up and vice versa) in the three intervention groups. * = significant difference between intervention groups (physical coordination training or cognitive behavioural training) and reference group at p < 0.05 in Fisher's exact test, n = number of participants.

Figure 3

Change in pain status (low back). Frequency of participants who changed their pain status in the low back (i.e. from chronic pain at baseline to non-chronic pain at follow-up and vice versa) in the three intervention groups. There was no significant difference between intervention groups (physical coordination training or cognitive behavioural training) and reference group from Fisher's exact test, n = number of participants.