Occupational Health, Posture, Work Related Musculoskeletal Disorders
Conditions
Keywords
musculoskeletal symptoms, working posture, Manual Material Handlers, Postural Awareness, Long-term Follow-up, ergonomic intervention, Blue-Collar Workers
Brief summary
Background: Musculoskeletal disorders are common occupational health problems among industrial workers, particularly manual material handlers involved in repetitive lifting and physical tasks. Ergonomic education and postural awareness interventions are frequently used to prevent these disorders, but long-term follow-up data regarding their effectiveness remain limited. Purpose: The main objective of this study was to evaluate the 12-month effectiveness of an intensive ergonomic education and postural awareness program on musculoskeletal symptoms, ergonomic risk levels, handling posture, and knowledge levels among manual material handlers. Methods: In this randomized controlled trial, participants were randomly allocated into two groups: an Intervention Group and a Control Group. The Intervention Group received comprehensive theoretical and practical ergonomic education focused on safe material handling and postural awareness, followed by regular follow-ups and reminders. The Control Group received baseline assessments without ongoing postural reinforcement. Outcome measures-including musculoskeletal symptom severity, ergonomic posture risk, and ergonomic knowledge-were evaluated at baseline, 3rd, 6th, 9th, and 12th months.
Detailed description
Study Design and Setting: This study was conducted as a single-blind, randomized controlled trial to evaluate the long-term effectiveness of an ergonomic education and postural awareness intervention program among manual material handlers. Assessments and follow-up protocols were carried out over a 12-month period. Participant Allocation: Eligible industrial workers were randomly assigned into two groups: the Intervention Group and the Control Group. Randomization was performed to ensure balanced distribution between groups. Intervention Group Protocol: Participants in the Intervention Group underwent a multi-faceted ergonomic education program comprising: Comprehensive theoretical and practical ergonomic education covering body mechanics, safe manual material handling, and postural awareness. On-site feedback and workstation evaluations tailored to baseline ergonomic posture risk assessments. Periodic follow-ups and educational reminders throughout the 12-month study period to maintain compliance, exercise habits, and behavioral reinforcement. Control Group Protocol: Participants in the Control Group received standard baseline ergonomic evaluations and basic informational materials regarding ergonomics without ongoing post-assessment reminders or guided postural feedback. Follow-up Timeline: Both groups were prospectively evaluated at five specific time points: Baseline (0 months), 3rd month, 6th month, 9th month, and 12th month. Outcome parameters included ergonomic posture risk levels, musculoskeletal symptoms, ergonomic knowledge, and long-term adherence.
Interventions
BEHAVIORALExperiential Learning-Based Ergonomic Training Program
An interactive 8-hour ergonomic training program based on Kolb's Experiential Learning Theory, including situation-based scenarios, role-playing, peer-interactive games, and practical motor-skill training for a 10-exercise home exercise program.
BEHAVIORALTraditional Ergonomic Seminar Education
A standard 6-hour classroom-based traditional ergonomic education seminar covering the exact same core ergonomic curriculum and 10-exercise home exercise program, delivered through didactic lectures, slide presentations, and question-and-answer sessions without interactive practical group exercises.
Sponsors
Okan University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
SINGLE (Outcomes Assessor)
Masking description
To minimize outcome assessment bias, the primary evaluator was masked to group allocations during all physical and observational data collections. For observational risk assessments (e.g., REBA), scoring and posture evaluations were completed independently prior to checking participant identification and group assignment records.
Intervention model description
Participants were randomly allocated into three parallel groups: Experiential Learning Group (ELG): Received an interactive, experience-based ergonomic education program specifically designed to prevent work-related musculoskeletal disorders and mitigate ergonomic risks. Seminar Group (SG): Received standard classroom-based traditional seminar education covering the exact same core ergonomic content and principles as the ELG. Control Group (CG): Received baseline assessments only without educational intervention during the study period. All three groups were prospectively evaluated at Baseline, 3rd, 6th, 9th, and 12th months.
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
Yes
Inclusion criteria
* Having performed manual material handling tasks for at least the last 12 months. * Having worked at least 30 hours per week in tasks requiring the use of upper extremities and hands. * Voluntarily participating in the study and signing the informed consent form.
Exclusion criteria
* Having received training in musculoskeletal disorders (MSDs) or ergonomics within the last 6 months. * Having received medical treatment for MSDs within the last 6 months. * Using medications that may affect muscle tone or balance. * Having a congenital or acquired physical disability that causes functional limitation. * Having a Body Mass Index less than 20 kg/m² or greater than 35 kg/m². * Having joint restriction in the extremities or spine. * Having a neurological or rheumatic disease. * Having a score of 30 or higher on the Beck Depression Inventory.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change from Baseline in Rapid Entire Body Assessment (REBA) Score | Baseline, Post-intervention 3rd month, 6th month, 9th month, and 12th month | REBA is an observational tool used to assess ergonomic risk levels related to working postures. It evaluates body posture (trunk, neck, legs, upper arms, lower arms, and wrists), load/force, and coupling. Total scores range from 1 to 15, with higher scores indicating higher ergonomic risk levels. |
| Change from Baseline in Ergonomics Score (EP) derived from Dutch Musculoskeletal Questionnaire Short Form (DMQ-SF) | Baseline, Post-intervention 3rd month, 6th month, 9th month, and 12th month | The Ergonomics Score (EP) evaluates exposure to physical working conditions and postural risk factors based on 8 questions (24 statements) of the DMQ-SF. Raw scores are normalized to a 0-100 scale using Min-Max Normalization: EP = ((Raw Score - 24) / 24) \* 100. Higher scores represent greater exposure to ergonomic risk factors. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change from Baseline in Musculoskeletal Knowledge Score (MKS) | Baseline, Immediately Post-intervention, 3rd month, 6th month, 9th month, and 12th month | A 30-item multiple-choice test designed according to NIOSH and CCOHS guidelines to evaluate theoretical knowledge regarding musculoskeletal anatomy, ergonomics, and risk prevention strategies. Total raw scores (range: 0 to 30) are converted to a 0-100 scale using the formula: MKS = (Number of Correct Answers / 30) \* 100. Higher scores indicate a higher level of theoretical knowledge. |
Contacts
STUDY_DIRECTORNezire Köse, PhD, PT
Hacettepe University Faculty of Physical Therapy and Rehabilitation
Outcome results
None listed