Online exercise added to ergonomic advice for reducing habitual upper body postures: A randomized trial.

BACKGROUND: Online learning during the COVID-19 pandemic is associated with unfavorable habitual upper body postures. OBJECTIVE: This study explored whether adding a remedial exercise routine to an ergonomic advice intervention, delivered remotely, is helpful for reducing habitual postures of the neck, shoulders, and upper back. DESIGN: Pragmatic randomized controlled trial. METHODS: 42 male adolescent students, initially selected with a forward head posture, were randomized to one of two intervention groups: ergonomic advice alone or exercise + ergonomic advice. Outcome measures were specific postural angles of, measured by a photogrammetric profile technique using a bespoke app before and after the 8-week intervention period. RESULTS: During online learning, most students used mobile phones (76%), while 35% used a table-chair-computer arrangement. At 8-week follow-up, a statistically significant reduction of forward head, shoulder protraction, and thoracic kyphosis angles was found in both groups (P < 0.001). However, the effect was significantly greater in the exercise + ergonomic advice group (P < 0.001): forward head, shoulder protraction, and thoracic kyphosis angles reduced by some 9, 6, and 5° respectively, compared with 4° for head and 2° for shoulder and thoracic angles for the ergonomic advice alone group. CONCLUSION: The results show that, a remedial online exercise routine is a beneficial addition to an ergonomic advice program for improving unfavorable habitual upper body postures. The impact of this intervention may extend beyond postural issues related just to online learning at home.

Home schooling during the COVID-19 pandemic: A randomized controlled trial of online exercise and ergonomics advice protocols on upper body symptoms.

BACKGROUND: Understanding of students' musculoskeletal health under home-schooling during the COVID-19 pandemic is limited. OBJECTIVES: (1) To investigate the prevalence and severity of musculoskeletal symptoms in home-schooled adolescents during the COVID-19 pandemic. (2) To evaluate the effect of an online exercise + ergonomics advice protocol on symptoms, compared with ergonomics advice alone. DESIGN: Cross-sectional symptom survey identifying eligible participants, followed by a pragmatic randomized controlled trial. SETTING: Online classes. PARTICIPANTS: Survey: 354 students (mean 16.6 years). TRIAL: 188 students with upper body musculoskeletal symptoms. INTERVENTIONS: Randomization to three groups (physical therapy exercises + ergonomics postural advice, ergonomics postural advice alone, nonintervention control) stratified by the site of symptoms (neck, shoulder, upper back). Interventions were orally delivered online (via WhatsApp) supplemented with written/illustrative material. Follow-up occurred at 8 weeks. OUTCOME MEASURES: Survey: prevalence of symptoms (Nordic Questionnaire). TRIAL: primary outcome = change in intensity of upper body symptoms (visual analogue scale); secondary outcome = number of participants reporting improvement in upper body symptoms. RESULTS: The 12-month prevalence of musculoskeletal disorders in the survey was 38% neck, 28% shoulder, and 35% upper back, with mean pain intensity of 3.6, 3.9, and 3.8, respectively, on 0-10 visual analogue scale: Two-thirds reported symptoms in multiple anatomical regions. In the trial, there was no statistically significant difference between the exercise + ergonomics group and ergonomics alone group on the primary outcome, yet both groups showed reduced symptom intensity compared with control (p < .001). More participants in the exercise + ergonomics group reported improvement than in the ergonomics advice alone group (p < .02). CONCLUSIONS: The prevalence of musculoskeletal symptoms was relatively high in home-schooled adolescents. Symptoms can be reduced by ergonomics advice with or without exercises, but the effect is enhanced by the addition of physical therapy exercises. The latter approach may be considered for improving schoolchildren's musculoskeletal health in the usual classroom setting.