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Specific strength training is shown to relieve neck pain in office workers. The purpose of this study is to evaluate the effectiveness of specific strength training in women with severe neck pain and to analyze the dose-response relationship between training adherence and pain reduction. One hundred eighteen untrained women with severe neck pain (>30 mm VAS pain) were included from a larger study, in which the subjects were randomized to 20-week specific strength training for the neck/shoulders or to a control group. In the intention-to-treat analysis, the training group experienced greater pain relief than the control group (p < 0.01). Participants who adhered "per protocol" decreased pain by 35 mm VAS (95% confidence interval: -26 to -44) from baseline to follow-up corresponding to a 70% reduction. In the dose-response analyses, participants with medium and high training adherence showed better pain relief than the control group and those with low adherence (p < 0.0001). The decrease from baseline in the medium and high adherence groups was 37 mm VAS (28-46 mm) and 33 mm VAS (24-43 mm), respectively. Specific strength training reduces pain intensity in women with severe neck pain, and 1-2 training sessions per week for 20 weeks (∼30 training sessions) seems sufficient for optimal pain relief.

The aim of this study was to investigate the effectiveness of a worksite intervention using kettlebell training to improve postural reactions to perturbation and jump performance. This single-blind randomized controlled trial involved 40 adults (n = 40) from occupations with a high prevalence of musculoskeletal pain and discomfort (mean age 44 years, body mass index 23 kg·m, 85% women). A blinded examiner took measures at baseline and follow-up. Participants were randomly assigned to a training group-doing kettlebell swings 3 times a week for 8 weeks-or to a control group. The outcome measures were postural reactions to sudden perturbation and maximal countermovement jump height. Compared with the control group, the training group had a significant decreased stopping time after perturbation (-109 ms, 95% confidence interval [-196 to -21]). Jump height increased significantly in the training group (1.5 cm, 95% confidence interval [0.5 to 2.5]), but this was nonsignificantly different from control. Kettlebell training improves postural reactions to sudden perturbation. Future studies should investigate whether kettlebell training can reduce the risk of low back injury in occupations with manual material handling or patient handling where sudden perturbations often occur.

The purpose of this study was to investigate the dose-response of strength training for relieving musculoskeletal pain in female office workers. The relation between the dose of training in terms of total training volume (sets × repetitions × load reported in training diaries) during a 16-week strength training program and changes in pain (calculated as pain index, 0-100%, from self-reported intensities and durations of pain in the upper body and low back) was determined by regression analysis. The women were part of a randomized controlled trial with specific strength training (SRT), all-round physical exercise (APE), and a reference group (REF). Results showed that pain index in SRT and APE decreased significantly from baseline to follow-up (-25%/-22%) compared with changes in REF (-15%). In the dose-response analysis within the SRT group (n = 125), the total volume of training (mean 18.056 kg, SD = 13.798) was negatively correlated with changes in pain index (β = -0.16, p = 0.045), and there was a significant dose-response relationship between training volume per session and change in pain index (β = -0.20, p = 0.034). In contrast, training attendance (mean 1.69 sessions per week, SD = 0.8) was not significantly related to the change in pain index. In conclusion, achieving higher accumulated training volumes was important for reducing musculoskeletal pain in female office workers. The training volume per session should be optimized by securing a load at 10-15 repetition maximum and adhering to principles of progressive overload.

The purpose of this study was to evaluate if different types, body positions, and levels of progression of functional coordination exercises can provide sufficiently high levels of muscle activity to improve strength of the neck, shoulder, and trunk muscles. Nine untrained women were familiarized with 7 functional coordination exercises 12 times during 4 weeks before testing. Surface electromyographic (EMG) activity was obtained from rectus abdominus, erector spinae, obliquus externus, and trapezius during the exercises with 2-4 levels of progression. Electromyography was normalized to the maximal EMG activity during maximal voluntary contractions, and a p value < 0.05 was considered significant. All recorded muscles reached sufficiently high levels of activity during the coordination exercises for strength gain (>60% of maximal EMG activity). Type of exercise played a significant role for the attained muscle activity. Body position during the exercises was important for the activity of the erector spinae, and level of progression was important for the activity of the trapezius. The findings indicate that depending on type, body position, and level of progression, functional coordination training can be performed with a muscle activity sufficient for strength gain. Functional coordination training may therefore be a good choice for prevention or rehabilitation of musculoskeletal pain or injury in the neck, shoulder, or trunk muscles.

A slower reflex response to sudden trunk loading (SL) has been shown to increase future risk of low back injuries in healthy subjects, and specific readiness training can improve the response to SL among healthy subjects. The purpose of the study was to investigate the effect of recreational soccer training on the reaction to SL among untrained healthy women. Thirty-six healthy, untrained, Danish women (age 19-45 years) were randomly assigned to a soccer group (SO, n = 19) and a running group (RU, n = 17). In addition, an untrained control group (CON, n = 10) was recruited. Training was performed for 1 hour twice a week (mean heart rate of 165 b.min-1 in SO and 164 b.min-1 in RU) for 16 weeks. Test of reactions to sudden unexpected trunk loading was performed before and after the training period. Furthermore, time-motion analysis of the soccer training was performed for 9 subjects. Group assignment was blinded to the test personnel. Physical education students organized the training. During 1 hour of soccer training, the total number of sudden moves including sudden loading of the upper body (e.g. turns, stops, throw-ins, headers, and shoulder tackles) was 192 (63). In SO, time elapsed until stopping of the forward movement of the trunk (stopping time) decreased (p < 0.05) by 15% and distance moved after unexpected SL decreased (p < 0.05) by 24% compared with no changes in RU and CON. In conclusion, football training includes a high number of sudden loadings of the upper body and can improve the reflex response to SL. The faster reflex response indicates that soccer training can reduce the risk of low back injuries.