Time Course and Risk Profile of Work-Related Neck Disability: A Longitudinal Latent Class Growth Analysis
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Coombes, Brooke K
Thomas, Lucy
Johnston, Venerina
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Abstract
OBJECTIVE: Given the economic burden of work-related neck pain and disability, it is important to understand its time course and associated risk factors to direct better management strategies. This study aimed to identify the 1-year trajectories of work-related neck disability in a high-risk occupation group such as sonography and to investigate which baseline biopsychosocial factors are associated with the identified trajectories. METHODS: A longitudinal study was conducted among 92 sonographers with neck disability assessed at 3 time points-baseline, 6 months, and 12 months-using the Neck Disability Index. Baseline biopsychosocial measures included individual characteristics (demographics and physical activity levels), work-related physical and psychosocial factors (eg, ergonomic risk, workplace social support, job satisfaction), general psychological features (depression, anxiety, pain catastrophizing, and fear-avoidance beliefs), and quantitative sensory testing of somatosensory function (cold and pressure pain thresholds at neck and tibialis anterior, and temporal summation). RESULTS: Two distinct trajectories of neck disability were identified, including a "low-resolving disability" trajectory showing slow improvement toward no disability (64.8%) and a "moderate-fluctuating disability" trajectory characterized by persistent moderate disability with a small fluctuation across time (35.2%). The trajectory of moderate-fluctuating disability was associated with more severe symptoms, lower vigorous physical activity, higher ergonomic risk, remote cold hyperalgesia, widespread mechanical hyperalgesia, heightened pain facilitation, and several psychosocial factors such as anxiety, depression, lower job satisfaction and lower workplace social support at baseline. CONCLUSION: Over one-third of sonographers were at risk of developing a moderate-fluctuating disability trajectory. This unfavorable trajectory was associated with low physical activity level, poor ergonomics, psychosocial distress and central sensitization at baseline. IMPACT: This study has important implications for the management of neck disability in workers. Addressing modifiable factors including low vigorous physical activity, poor ergonomics, anxiety, depression, and lack of workplace social support may improve the trajectory of work-related neck disability.
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Physical Therapy
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© 2022 American Physical Therapy Association. Published by Oxford University Press. This is a pre-copy-editing, author-produced PDF of an article accepted for publication in Physical Therapy following peer review. The definitive publisher-authenticated version Time Course and Risk Profile of Work-Related Neck Disability: A Longitudinal Latent Class Growth Analysis, Physical Therapy, 2022 is available online at: https://doi.org/10.1093/ptj/pzac050.
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Subject
Rehabilitation
Allied health and rehabilitation science
Biopsychosocial Risk
Central Sensitization
Disability Trajectory
Neck Pain
Prospective Study
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Xie, Y; Coombes, BK; Thomas, L; Johnston, V, Time Course and Risk Profile of Work-Related Neck Disability: A Longitudinal Latent Class Growth Analysis, Physical Therapy, 2022