Document Type : Original Article



Background: Prevalence of work‑related musculoskeletal disorders (WMSDs) is high among
computer users. The study investigates the effect of three ergonomic interventions on the
incidence of musculoskeletal disorders among the staff of Isfahan Province Gas Company,
including training, sport, and installation of software. Materials and Methods: The study was
performed in the summer of 2013 on 75 (52 men, 23 women) Isfahan Province Gas Company
employees in three phases (phase 1: Evaluation of present situation, phase 2: Performing
interventions, and phase 3: Re‑evaluation). Participants were divided into three groups (training,
exercise, and software). The Nordic Musculoskeletal Questionnaire (NMQ) and rapid upper
limb assessment (RULA) were used. Data collected were analyzed using SPSS software and
McNemar test, t‑test, and Chi‑square test. Results: Based on the evaluations, there was a
decrease in musculoskeletal symptoms among the trained group participants after they received
the training. McNemar test showed that the lower rate of pain in low back, neck, knee, and
wrist was significant (P < 0.05). The results obtained from the RULA method for evaluation
of posture showed an average 25 points decrease in the right side of the body and 20 points
decrease in the left side of the body in the group subjected to training. Based on t‑test, the
decrease was significant. Conclusion: The study demonstrated that majority of the participants
accepted interventions, which indicates that most of the people were unsatisfied with the work
settings and seeking improvement at the workplace. Overall, the findings show that training,
chair adjustment, and arrangement in workplace could decrease musculoskeletal disorders.


1. Bernaards CM, Ariens GA, Hildebrandt VH. The (cost‑)
effectiveness of a lifestyle physical activity intervention in addition
to a work style intervention on the recovery from neck and upper
limb symptoms in computer workers. BMC Musculoskelet Disord.
2006;7 (80).
2. Rempel D, Tittiranonda P, Burastero S, Hudes M, So Y. Effect of
keyboard key‑switch design on hand pain. J Occup Environ Med.
1999;41 (2):111‑9.
3. poorghsemi A. Summary of Computer Applications in Ergonomics
and introduction to some modeling software. Articles Collections
of National Ergonomics Conference in Tehran manufacturing.
4. Gerr F, Marcus M, Monteilh C. Epidemiology of musculoskeletal
disorders among computer users: Lesson learned from the role
of posture and keyboard use. Journal of Electromyography and
Kinesiology. 2004;14:25‑31.
5. Brewer S, Van.Eerd D, Amick.III BC, Irvin E, Daum K, Gerr F,
et al. Workplace interventions to prevent musculoskeletal and visual
symptoms and disorders among computer users: A systematic
review. J Occup Rehab. 2006;16 (3).
6. Janwantanakul P, Pensri P, Jiamjarasrangsri W, Sinsongsook T.
Prevalence of self‑reported musculoskeletal symptoms among
office workers. Occup Med (Lond). 2008;58:436‑8.
7. Juul‑Kristensen B, Sogaard K, Stroyer J, Jensen C. Computer
users’ risk factors for developing shoulder, elbow and back
symptoms. Scand J Work Environ Health. 2004;30:390‑8.
8. Manchikanti L. Epidemiology of low back pain. Pain Physician.
9. Ortiz‑Hernández L, Tamez‑González S, Martínez‑Alcántara S,
Méndez‑Ramírez I. Computer use increases the risk of
musculoskeletal disorders among newspaper office workers. Arch
Med Res. 2003;34:331‑41.
10. Lis AM, Black KM, Korn H, Nordin M. Association between sitting
and occupational LBP. Eur Spine J. 2007;16:283‑98.
11. Akrouf QAS, Crawford JO, Al‑Shatti AS, Kamel MI. Musculoskeletal
disorders among bank office workers in Kuwait. Eastern
Mediterranean Health Journal. 2010;6.
12. Jensen C, Finsen L, Søgaard K, Christensen H. Musculoskeletal
symptoms and duration of computer and mouse use. International
Journal of Industrial Ergonomics. 2002;30 (4):265‑75.
13. Spyropoulos P, Papathanasiou G, Georgoudis G, Chronopoulos E,
Koutis H, Koumoutsou F. Prevalence of low back pain in Greek
public office workers. Pain Physician. 2007;10:651‑9.
14. Yip YB, Ho SC, Chan SG. Socio‑psychological stressors as risk
factors for low back pain in Chinese middle‑aged women. J Adv
Nurs. 2001;36:409‑16.
15. Rugulies R, Krause N. Effort‑reward imbalance and incidence of low
back and neck injuries in San Francisco transit operators. Occup
Environ Med. 2008;65:525‑33.
16. Cho C‑Y, Hwang Y‑S, Cherng R‑J. Musculoskeletal Symptoms
and Associated Risk Factors Among Office Workers With High
Workload Computer Use. Journal of Manipulative and Physiological
Therapeutics. 2012;35 (7):534‑40.
17. Kennedy CA, Amick BC, Dennerlein JT, Brewer S,
Catli S, Williams R, et al. Systematic Review of the Role of
Occupational Health and Safety Interventions in the Prevention
of Upper Extremity Musculoskeletal Symptoms, Signs, Disorders,
Injuries, Claims and Lost Time. 2010;20 (2):127‑62.
18. Andersen LL, Christensen KB, Holtermann A, Poulsen OM,
Sjøgaard G, Pedersen MT, et al. Effect of physical exercise
interventions on musculoskeletal pain in all body regions among
office workers: A one‑year randomized controlled trial. Manual
Therapy. 2010;15 (1):100‑4.
19. Korinka I, Jonsson B, Kilbom A, Vinterberg H, Biering‑Sorensen F,
Andersson G, et al. Standardized nordic questionnaires for the
analysis of musculoskeletal symptoms. Applied Ergonomics.
1987;18 (3):233‑7.
20. McAtamney L, Corlett E, Rula N. A survey method for the
investigation of work‑related upper limb disorders. Applied
Ergonomics. 1993;24 (2):91‑9.
21. Kennedy CA, Amick BC, Dennerlein JT, Brewer S, Catli S, Williams R,
et al. Systematic Review of the Role of Occupational Health and Safety
Interventions in the Prevention of Upper Extremity Musculoskeletal
Symptoms, Signs, Disorders, Injuries, Claims and Lost Time. Journal
of Occupational Rehabilitation 2010;20 (2):127‑62.
22. Taieb‑Maimon M, Cwikel J, Shapira B, Orenstein I. The effectiveness
of a training method using self‑modeling webcam photos for
reducing musculoskeletal risk among office workers using
computers. Applied Ergonomics. 2012;43 (2):376‑85.
23. Kim S‑L, Lee J‑E. Development of an intervention to prevent
work‑related musculoskeletal disorders among hospital nurses
based on the participatory approach Applied ergonomics.
2010;41 (3):454‑60.
24. Mesbah F, Choobineh A, Tozihian Ms, Peyman J, Naghibalhosseini F,
Shidmosavi M, et al. Ergonomic intervention effect in reducing
musculoskeletal disorders in staff of Shiraz Medical School. Iran
occupational health. 2012;9 (1).
25. Ketola R, Toivonen R, Hakkanen M, Luukkonen R, Takala E,
Viikari‑Juntura E, et al. Effects of ergonomic intervention in
work with video display units. Scand JWork Environ Health.
2002;28 (1):18‑24.
26. Bohr P. Efficacy of office ergonomics education. J Occup Rehab.
2000;10 (4):243–55.
27. Stetler CB, Burns M, Sander‑Buscemi K. Use of evidence for
prevention of work‑related musculoskeletal injuries. Journal of
Orthop Nurs. 2003;22 (1):32‑41.
28. Robertson M, Amick BC, DeRango K, Rooneyd T, Bazzanid L,
Harriste R, et al. The effects of an office ergonomics training
and chair intervention on worker knowledge, behavior and
musculoskeletal risk. Applied ergonomics. 2009;40:124‑35.
29. Habibi E, Soury S, Hasanzadeh A. Precise Evaluation of
Anthropometric 2D Software Processing of Hand in Comparison
with Direct Method. J Med Sign Sens. 2012;3 (195):256‑61.30. Habibi E, Zare M, Amini NR, Pourabdian S, Rismanchian M.
Macroergonomic conditions and job satisfaction among employees
of an industry. Int J Env Health Eng. 2012;1:34.
31. Habibi E, Pourabdian S, Atabaki AK, Hoseini M. Evaluation of
workrelated psychosocial and ergonomics factors in relation to
low back discomfort in emergency unit nurses. Int J Prev Med.
32. Habibi E, Zare M, Haghi A, Habibi P, Hassanzadeh A. Assessment
of physical risk factors among artisans using occupational repetitive
actions and Nordic questionnaire. Int J Env Health Eng. 2013;2:14.
33. Azmoon H, Dehghan H, Akbari J, Soury S. The Relationship between
Thermal Comfort and Light Intensity with Sleep Quality and Eye
Tiredness in Shift Work Nurses. Journal of Environmental and Public
Health. 2013;2013:5.