Importance of Frequency and Intensity of Strength Training for Reduced Musculoskeletal Pain in the Back, Neck–Shoulder, and Arm–Hand Among Physical Therapists

Click name to view affiliation

Yasmín Ezzatvar
Search for other papers by Yasmín Ezzatvar in
Current site
Google Scholar
PubMed
Close
,
Joaquín Calatayud
Search for other papers by Joaquín Calatayud in
Current site
Google Scholar
PubMed
Close
,
Lars L. Andersen
Search for other papers by Lars L. Andersen in
Current site
Google Scholar
PubMed
Close
, and
José Casaña
Search for other papers by José Casaña in
Current site
Google Scholar
PubMed
Close
Restricted access

Background: Musculoskeletal pain (MP) is common among health care professionals, including physical therapists (PTs). The physically demanding nature of their work might contribute to increase MP rates. Strength training has a positive effect on musculoskeletal health and MP. However, no studies have evaluated the association of strength training during leisure time on MP among PTs. This study aims to analyze the association between frequency and intensity of strength training during leisure time and MP in the back, neck–shoulder, and arm–hand among PTs. Methods: Data on MP and intensity and frequency of strength training were obtained using a questionnaire responded by 1006 PTs. The odds for having lower level of MP as a function of intensity or frequency of the strength training were estimated using binary logistic regression. Results: High-intensity strength training showed strong associations with lower intensity of MP in neck–shoulder (odds ratio = 5.08; 95% confidence interval, 1.36–18.92), arm–hand (odds ratio = 5.22; 95% confidence interval, 1.11–24.51), and back (odds ratio = 5.22; 95% confidence interval, 1.41–19.28). However, frequency and lower intensities were not significantly associated with MP in any body part. Conclusions: High-intensity strength training is strongly associated with lower levels of MP in arm–hand, neck–shoulder, and back, whereas no association was found with frequency or lower intensities.

Ezzatvar, Calatayud, and Casaña are with the Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Valencia, Spain. Calatayud and Andersen are with the National Research Centre for the Working Environment, Copenhagen, Denmark. Andersen is also with the Sport Sciences, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark.

Calatayud (joaquin.calatayud@uv.es) is corresponding author.

Supplementary Materials

    • Supplementary Material (PDF 195 KB)
  • Collapse
  • Expand
  • 1.

    Vos T, Flaxman AD, Naghavi M, et al. Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380(9859):21632196. PubMed ID: 23245607 doi:10.1016/S0140-6736(12)61729-2

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 2.

    Hurwitz EL, Randhawa K, Yu H, Côté P, Haldeman S. The global spine care initiative: a summary of the global burden of low back and neck pain studies. Eur Spine J. 2018;27(suppl 6):796801. PubMed ID: 29480409 doi:10.1007/s00586-017-5432-9

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 3.

    Anderson SP, Oakman J. Allied health professionals and work-related musculoskeletal disorders: a systematic review. Saf Health Work. 2016;7(4):259267. PubMed ID: 27924228 doi:10.1016/j.shaw.2016.04.001

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 4.

    Eurostat. Healthcare personnel statistics—dentists, pharmacists and physiotherapists—statistics explained. 2018. https://ec.europa.eu/eurostat/statistics-explained/index.php?title=Healthcare_personnel_statistics_-_dentists,_pharmacists_and_physiotherapists#Healthcare_personnel. Accessed January 31, 2019.

    • Search Google Scholar
    • Export Citation
  • 5.

    Vieira ER, Schneider P, Guidera C, Gadotti IC, Brunt D. Work-related musculoskeletal disorders among physical therapists: a systematic review. J Back Musculoskelet Rehabil. 2016;29(3):417428. PubMed ID: 26577282 doi:10.3233/BMR-150649

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6.

    Dankel SJ, Loenneke JP, Loprinzi PD. Determining the importance of meeting muscle-strengthening activity guidelines: is the behavior or the outcome of the behavior (strength) a more important determinant of all-cause mortality? Mayo Clinic Proc. 2016;91(2):166174. PubMed ID: 26723715 doi:10.1016/j.mayocp.2015.10.017

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 7.

    Kraschnewski JL, Sciamanna CN, Poger JM, et al. Is strength training associated with mortality benefits? A 15 year cohort study of US older adults. Prev Med. 2016;87:121127. PubMed ID: 26921660 doi:10.1016/j.ypmed.2016.02.038

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 8.

    Ruiz JR, Sui X, Lobelo F, et al. Association between muscular strength and mortality in men: prospective cohort study. BMJ. 2008;337:a439. PubMed ID: 18595904 doi:10.1136/bmj.a439

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9.

    Shiroma EJ, Cook NR, Manson JE, et al. Strength training and the risk of type 2 diabetes and cardiovascular disease. Med Sci Sports Exerc. 2017;49(1):4046. PubMed ID: 27580152 doi:10.1249/MSS.0000000000001063

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10.

    Andersen LL, Behm DG, Maffiuletti NA, Schoenfeld BJ. High-intensity physical training in the treatment of chronic diseases and disorders. BioMed Res Int. 2014;2014:927304. PubMed ID: 24895628 doi:10.1155/2014/927304

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11.

    Zebis MK, Andersen LL, Pedersen MT, et al. Implementation of neck/shoulder exercises for pain relief among industrial workers: a randomized controlled trial. BMC Musculoskelet Disord. 2011;12(1):205. doi:10.1186/1471-2474-12-205

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12.

    Jakobsen MD, Sundstrup E, Brandt M, Jay K, Aagaard P, Andersen LL. Effect of workplace- versus home-based physical exercise on musculoskeletal pain among healthcare workers: a cluster randomized controlled trial. Scand J Work Environ Health. 2015;41(2):153163. PubMed ID: 25596848 doi:10.5271/sjweh.3479

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13.

    Blangsted AK, Sogaard K, Hansen EA, Hannerz H, Sjogaard G. One-year randomized controlled trial with different physical-activity programs to reduce musculoskeletal symptoms in the neck and shoulders among office workers. Scand J Work Environ Health. 2008;34(1):5565. PubMed ID: 18427699 doi:10.5271/sjweh.1192

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14.

    Garber CE, Blissmer B, Deschenes MR, et al. American College of Sports Medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. Med Sci Sports Exerc. 2011;43(7):13341359. PubMed ID: 21694556 doi:10.1249/MSS.0b013e318213fefb

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15.

    von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. PLoS Med. 2007;4(10):e296. PubMed ID: 17941714 doi:10.1371/journal.pmed.0040296

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 16.

    Kuorinka I, Jonsson B, Kilbom A, et al. Standardised Nordic questionnaires for the analysis of musculoskeletal symptoms. Appl Ergon. 1987;18(3):233237. PubMed ID: 15676628 doi:10.1016/0003-6870(87)90010-X

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17.

    Ohlsson K, Attewell R, Johnsson B, Ahlm A, Skerfving S. An assessment of neck and upper extremity disorders by questionnaire and clinical examinationErgonomics. 1994;37(5):891897. PubMed ID: 8206057 doi:10.1080/00140139408963698

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 18.

    Chen H, Cohen P, Chen S. How big is a big odds ratio? Interpreting the magnitudes of odds ratios in epidemiological studies. Commun Stat Simul Comput. 2010;39(4):860864. doi:10.1080/03610911003650383

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 19.

    Schoenfeld BJ, Peterson MD, Ogborn D, Contreras B, Sonmez GT. Effects of low- vs high-load resistance training on muscle strength and hypertrophy in well-trained men. J Strength Cond Res. 2015;29(10):29542963. PubMed ID: 25853914 doi:10.1519/JSC.0000000000000958

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 20.

    Jenkins ND, Miramonti AA, Hill EC, et al. Greater neural adaptations following high- vs low-load resistance training. Front Physiol. 2017;8:331. PubMed ID: 28611677 doi:10.3389/fphys.2017.00331

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 21.

    Sveaas SH, Bilberg A, Berg IJ, et al. High intensity exercise for 3 months reduces disease activity in axial spondyloarthritis (axSpA): a multicentre randomised trial of 100 patients. Br J Sports Med. 2020;54(5):292297. PubMed ID: 30745314 doi:10.1136/bjsports-2018-099943

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 22.

    Kristensen J, Franklyn-Miller A. Resistance training in musculoskeletal rehabilitation: a systematic review. Br J Sports Med. 2012;46(10):719726. PubMed ID: 21791457 doi:10.1136/bjsm.2010.079376

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 23.

    Ciolac EG, Rodrigues-da-Silva JM. Resistance training as a tool for preventing and treating musculoskeletal disorders. Sports Med. 2016;46(9):12391248. PubMed ID: 26914266 doi:10.1007/s40279-016-0507-z

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 24.

    Gram B, Andersen C, Zebis MK, et al. Effect of training supervision on effectiveness of strength training for reducing neck/shoulder pain and headache in office workers: cluster randomized controlled trial. BioMed Res Int. 2014;2014:693013. PubMed ID: 24701581 doi:10.1155/2014/693013

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 25.

    Andersen CH, Andersen LL, Gram B, et al. Influence of frequency and duration of strength training for effective management of neck and shoulder pain: a randomised controlled trial. Br J Sports Med. 2012;46(14):10041010. PubMed ID: 22753863 doi:10.1136/bjsports-2011-090813

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 26.

    Saric J, Lisica D, Orlic I, et al. Resistance training frequencies of 3 and 6 times per week produce similar muscular adaptations in resistance-trained men. J Strength Cond Res. 2019;33(suppl 1):S122S129. PubMed ID: 30363041 doi:10.1519/JSC.0000000000002909

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 27.

    Grgic J, Schoenfeld BJ, Davies TB, Lazinica B, Krieger JW, Pedisic Z. Effect of resistance training frequency on gains in muscular strength: a systematic review and meta-analysis. Sports Med. 2018;48(5):12071220. PubMed ID: 29470825 doi:10.1007/s40279-018-0872-x

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 28.

    Fiuza-Luces C, Santos-Lozano A, Joyner M, et al. Exercise benefits in cardiovascular disease: beyond attenuation of traditional risk factors. Nat Rev Cardiol. 2018;15(12):731743. PubMed ID: 30115967 doi:10.1038/s41569-018-0065-1

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 29.

    Andersen LL, Andersen CH, Zebis MK, Nielsen PK, Søgaard K, Sjogaard G. Effect of physical training on function of chronically painful muscles: a randomized controlled trial. J Appl Physiol. 2008;105(6):17961801. PubMed ID: 18948442 doi:10.1152/japplphysiol.91057.2008

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 30.

    Gross A, Forget M, St George K, et al. Patient education for neck pain. Cochrane Database Syst Rev. 2012;(3):CD005106.

  • 31.

    O’Riordan C, Clifford A, Van De Ven P, Nelson J. Chronic neck pain and exercise interventions: frequency, intensity, time, and type principle. Arch Phys Med Rehabil. 2014;95(95):770783. doi:10.1016/j.apmr.2013.11.015

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 32.

    Rice D, Nijs J, Kosek E, et al. Exercise-induced hypoalgesia in pain-free and chronic pain populations: state of the art and future directions. J Pain. 2019;20(11):12491266. PubMed ID: 30904519 doi:10.1016/j.jpain.2019.03.005

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 33.

    Watkins LR, Milligan ED, Maier SF. Glial proinflammatory cytokines mediate exaggerated pain states: implications for clinical pain. Adv Exp Med Biol. 2003;521:121. PubMed ID: 12617561

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 34.

    Calle MC, Fernandez ML. Effects of resistance training on the inflammatory response. Nutr Res Pract. 2010:4(4):259269. PubMed ID: 20827340 doi:10.4162/nrp.2010.4.4.259

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 35.

    Kimura K, Obuchi S, Arai T, et al. The influence of short-term strength training on health-related quality of life and executive cognitive function. J Physiol Anthropol. 2010;29(3):95101. PubMed ID: 20558967 doi:10.2114/jpa2.29.95

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 36.

    Gabriel DA, Kamen G, Frost G. Neural adaptations to resistive exercise. Sports Med. 2006;36(2):133149. PubMed ID: 16464122 doi:10.2165/00007256-200636020-00004

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 37.

    Damas F, Phillips S, Vechin FC, Ugrinowitsch C. A review of resistance training-induced changes in skeletal muscle protein synthesis and their contribution to hypertrophy. Sports Med. 2015;45(6):801807. PubMed ID: 25739559 doi:10.1007/s40279-015-0320-0

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 38.

    Phillips SM, Tipton KD, Aarsland A, Wolf S, Wolfe RR. Mixed muscle protein synthesis and breakdown after resistance exercise in humans. Am J Physiol. 1997;273(1, pt 1):E99E107. PubMed ID: 9252485

    • PubMed
    • Search Google Scholar
    • Export Citation
All Time Past Year Past 30 Days
Abstract Views 3013 477 38
Full Text Views 79 23 10
PDF Downloads 59 13 0