自我肩頸矯正與牽拉運動對職場上背部肌肉骨骼不適之成效探討：一項隨機對照試驗

The Effect of Self-shoulder and Neck Correction and Stretching Exercise on Musculoskeletal Discomfort of the Upper Back in the Workplace: A Randomized Controlled Trial

目的：探討自我肩頸矯正與牽拉運動是否能改善職場上背部肌肉骨骼不適的狀況。方法：招募60位某苗栗縣區域醫院醫護與行政人員，採隨機分配分為兩組。實驗組在家中執行每次約5分鐘、每天1次，共12周的自我肩頸矯正與牽拉運動。兩組皆接受1次衛教課程。於實驗前與12周後各接受一次評估，評估包括：視覺類比量表、壓力疼痛閾值、頭部前傾姿勢、Apley摸背測試、頸部失能量表等。結果：分析資料時納入29位實驗組及26位控制組，兩組受試者在視覺類比量表、頭部前傾姿勢、頸部失能總分於實驗後皆有顯著進步(p<0.05)，實驗組的頭部前傾姿勢之直尺測量進步顯著多於控制組(p<0.05)，且僅有實驗組在實驗後疼痛頻率與左側枕骨下肌壓力疼痛閾值有顯著下降(p<0.05)，控制組則無顯著前後差異。結論：本研究所設計的自我肩頸矯正與牽拉運動能改善職場頭部前傾姿勢、上背部疼痛頻率、枕骨下肌壓力疼痛閾值的狀況。建議醫院職場可參考此項運動，以改善醫護與行政同仁職場上背部肌肉骨骼不適的發生。

Objectives. To explore whether a set of self-shoulder and neck correction and stretching exercises can improve back musculoskeletal discomfort in the workplace.
Methods. 60 medical and administrative staff from a regional hospital in Miaoli County were recruited, and randomly assigned into two groups. The experimental group performed a self-administered neck and shoulder corrective exercise lasting 5 minutes once daily for 12 weeks in their homes. Both groups received a single health education session. Pre- and post-assessments were conducted at baseline and after 12 weeks, which included visual analog scale scores, pressure pain threshold, forward head posture assessment, Apley scratch test, and neck disability index.
Results. Data analysis included 29 participants from the experimental group and 26 from the control group. Both groups exhibited significant improvements (p<0.05) in visual analog scale scores, forward head posture, and neck disability index after the intervention. The experimental group demonstrated significantly greater improvement in direct measurement of forward head posture (p<0.05) compared to the control group. Furthermore, only the experimental group showed significant reductions (p<0.05) in pain frequency and pressure pain threshold of the left suboccipital muscles post-intervention, while no significant differences were observed in the control group.
Conclusion. The self-shoulder and neck correction and stretching exercises designed in this study can improve forward head posture, upper back pain frequency, and suboccipital muscle pressure pain threshold in the workplace. It is recommended that hospitals consider implementing this exercise program to improve the well-being of healthcare and administrative staff and reduce musculoskeletal discomfort in the workplace.