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Stress and daily physical activity in chronic neck-shoulder pain
Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.
Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Arbetshälsovetenskap. Högskolan i Gävle, Centrum för belastningsskadeforskning.ORCID-id: 0000-0002-2741-1868
2013 (engelsk)Konferansepaper, Oral presentation with published abstract (Fagfellevurdert)
Abstract [en]

Aims Chronic work-related stress is a risk factor for the development of chronic musculo-skeletal pain and cardiovascular disease. The link between stress and chronic diseases is probably mediated by the autonomic nervous system (ANS) and the hypothalamus-pituatary-adrenal (HPA) axis; however the character and level of deviations in these regulatory systems have  not been sufficiently examined in persons with neck-shoulder pain (NSP).

Physical activity has shown a wide range of benefits extending to musculoskeletal health (1), while inactive behavior may contribute to chronic muscle pain (2). The development of NSP is associated with perceived stress (3) and altered regulation of physiological stress systems, mainly with increased sympathetic and/or reduced parasympathetic activation (4, 5). The role of daily physical activity in the development and maintenance of NSP is still largely unknown. Therefore, we investigated daily physical activity, autonomic regulation and symptoms among persons with chronic NSP and healthy controls, by using long-term ambulatory monitoring in daily life.

Methods In field studies, we investigated the relations between autonomic regulation, patterning of physical activity and stress perception in persons with chronic NSP (trapezius myalgia or tension neck syndrome, exhausted syndrome with somatic pain component) and symptom-free controls. Physical activity was objectively monitored by accelerometry or inclinometry, whereas heart rate variability (HRV) as an indicator of ANS regulation were recorded in parallel with  self- ratings of pain, stress and fatigue during several working days. Results Subjects with muscle pain showed relatively higher perceived stress and increased fatigue levels. Sleep quality was lower in patients in comparison with controls. Daily physical activity in chronic NSP was characterized by a different activity pattern than the control group. Particularly, lower activity levels and more time lying in the evening were observed. Increased heart rate and diminished HRV were observed in NSP as compared to controls. Correlations revealed a negative relationship between hour-to-hour changes in physical activity and HRV. Between subjects, physical activity was positively associated to HRV.

Conclusion The groups with chronic NSP showed reduced physical activity, especially in the evening. Higher heart rate and reduced HRV reflected chronic stress in terms of autonomic imbalance among those with NSP. Positive correlations between physical activity and HRV indicate a reduced parasympathetic activation in individuals with lower levels of physical activity in daily life. We suggest that chronic stress and physical activity might be important factors in chronic NSP. Interventions with increasing daily physical activity are warranted.

References

1.         Powell KE, Paluch AE, Blair SN. Physical Activity for Health: What Kind? How Much? How Intense? On Top of What? Annu Rev Public Health. 2011;32(1):349-65.

2.         van Weering M, Vollenbroek-Hutten MMR, Kotte EM, Hermens HJ. Daily physical activities of patients with chronic pain or fatigue versus asymptomatic controls. A systematic review. Clin Rehabil. 2007;21(11):1007-23.

3.         Bongers P, Ijmker S, van den Heuvel S, Blatter B. Epidemiology of work related neck and upper limb problems: Psychosocial and personal risk factors (Part I) and effective interventions from a bio behavioural perspective (Part II). J Occup Rehabil. 2006;16(3):272-95.

4.         Hallman DM, Lindberg L-G, Arnetz BB, Lyskov E. Effects of static contraction and cold stimulation on cardiovascular autonomic indices, trapezius blood flow and muscle activity in chronic neck–shoulder pain. Eur J Appl Physiol. 2011;111(8):1725-35.

5.         Gockel M, Lindholm H, Alaranta H, Viljanen A, Lindquist A, Lindholm T. Cardiovascular functional disorder and stress among patients having neck-shoulder symptoms. Ann Rheum Dis. 1995;54(6):494-7.

 

sted, utgiver, år, opplag, sider
2013.
HSV kategori
Identifikatorer
URN: urn:nbn:se:hig:diva-15199OAI: oai:DiVA.org:hig-15199DiVA, id: diva2:647413
Konferanse
PREMUS2013 - Eight International Conference on Prevention of Work-Related Musculoskeletal Disorders, KR Busan, 8-11 Jul 2013
Prosjekter
MONATilgjengelig fra: 2013-09-11 Laget: 2013-09-11 Sist oppdatert: 2018-03-13bibliografisk kontrollert

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