Effects of using a device for self-measurement of cervical ROM on neck pain of computer user.

[Purpose] The purpose of this study was to investigate the effects of using a device for the self-measurement of cervical range of motion on neck pain experienced by a computer user. [Subject] A 39-year-old male subject with neck pain caused by working on a computer was selected for the study. [Methods] The instrument was developed for the study, and that the instrument is used to self-measure cervical range of movement. The subject was trained in self-measurement procedures and a self-exercise program for two months, and pain was controlled through self-assessment and a program. The pressure pain threshold for the upper trapezius muscle, and cervical ranges of motion were measured prior to and after the 2-month period of pain control.
[Results] At the conclusion of self-measurement and the self-exercise program, the pressure pain threshold was higher than the initial pressure pain threshold, and all cervical ranges of motion increased compared to the initial cervical ranges of motion.
[Conclusion] This result shows that the self-management device for cervical ROM is an effective tool for pain management for computer users with cervical pain.

INTRODUCTION

Computers are a necessity in modern society’s industries, where most work is performed by using computers1). Typically, employees of an enterprise use their individual computer to perform work, and the daily time spent by office workers on using computers is increasing greatly1). Health problems related to computer use are generally referred to as ‘computer-related diseases’ or ‘visual display terminal (VDT) syndrome’. VDT syndrome is a term that refers to the various symptoms that occur in a person when computer peripheral devices such as the monitor, keyboard, and mouse are being used for a long time1, 2). VDT syndrome includes musculoskeletal pain and symptoms in the neck or shoulder, wrist, waist and pelvis, fatigue and irritation of the eyes, and psychoneurotic symptoms1, 2). Diseases of the musculoskeletal system that are related to VDT syndrome are divided into forward head posture (turtleneck) syndrome, lumbar disc degeneration, carpal tunnel syndrome, and myofascial pain syndrome1,2,3). Therefore, self-management of VDT syndrome symptoms are needed so that a person can monitor and correct their musculoskeletal conditions by themselves.. To date, the development and application of tools for self-management of these musculoskeletal conditions has not been reported. The purpose of this study was to investigate the effects of the self-measurement device for cervical range of motion (ROM) on neck pain experienced by a computer user.

SUBJECT AND METHODS

A 39-year-old male subject with neck pain caused by working on a computer was selected for this study. The subject complained of neck pain over the past year and currently experiences restrictions on all ROMs of the neck. His score was 7 on the visual analogue scale for pain. The purpose and methods of the study were explained to the participant prior to his inclusion in the study, and he provided informed consent according to the principles of the Declaration of Helsinki. Prior to the present experiment, our laboratory conducted a preliminary study for the development of a self-evaluation method for neck pain. The independent variables were: electromyograms, muscle lengths, cervical ROMs, pain assessment questionnaire, muscle strength, and muscle relaxation ratios, whereas the dependent variable was neck pain. Analysis was performed to determine all correlations between the individual independent variables and the dependent variable. According to the analysis results, the cervical extension angle and the cervical lateral (dominant side) ROM angle showed high negative correlation exceeding 80% with neck pain score. Among many factors, the measured values of the two cervical joint ROMs were selected as factors that respond most sensitively to changes in pain. Based on the foregoing, an instrument for self-measuring cervical ROM was developed. This instrument was made by using a tilt sensor and an accelerometer sensor. The tilt sensor can be used for the measurement of actual values of anterior/posterior motions. If two sensors are used in linkage with each other for neck motions, highly reliable measured values can be obtained. The accelerometer sensor allows for the measurement of acceleration values, total amount of motion, and the amount of activity through mathematical transformation formulas. In particular, distinguished motions can be calculated on the X, Y, and Z planes. Based on the results of recent studies, this sensor can be also used as a small assessment instrument for motion analysis. This instrument is in the form of a helmet so that users can wear it to measure their own ROMs and identify the results. The prototype in this study can measure neck motions using an electronic measuring device, and it places a display device in front of the patient’s field of view so that the patient can identify the measured values first-hand. Red and green visual effects are applied so that the user can identify the degree of restriction on his ROM immediately. The subject periodically assessed his ROM after working for a long time by using the self-measurement instrument for cervical ROM and implemented the self-exercise program based on the results of assessment. The exercise program applied in this study was designed so that the amount of exercise increases as the ROM assessment index decreases, and vice versa. The subject was trained in self-measurement and the self-exercise program for two months, and pain was controlled through self-assessment and a program. The pressure pain threshold for the upper trapezius muscle, and cervical ROMs were measured prior to and after the 2-month period of pain control, and a comparison was made between the initial and post-pain-controlling period values. The pressure pain threshold was measured by using an argolometer and cervical ROMs were measured during cervical ROM.

RESULTS

At the conclusion of self-measurement and the self-exercise program, the pressure pain threshold (3.5 lb) was higher than the initial threshold prior to the program (1.5 lb). In addition, all cervical ROMs increased compared to the initial ROMs prior to the program (Table 1).

Table 1.

Comparison of the pre-program and post-program active cervical ranges of motion

Cervical ROM	Degrees
	Pre-programl	Self-program
Flexion	52	58
Extension	42	50
Right lateral flexion	40	47
Left lateral flexion	39	45
Right rotation	54	62
Left rotation	52	60

DISCUSSION

According to a survey conducted by the Korea Internet & Security Agency about the actual state of computer use, the rate of computer use in children aged 3–5 years is 51.4%. Children in this age group use their computer 4.7 hours per week, and the age at which their computer use begins is 3.2 years4). Upon reviewing the rates of internet use by people according to age, it was found that teenage youths, and young adults in their 20s use computers the most frequently4). Students used computers for 3 hours and 8 minutes each day, whereas at-risk adolescents used computers for 4 hours and 49 minutes each day. The proportion of time spent on different types of tasks during computer use were as follows—gaming: 28.4%; study-related use: 17.0%; data searching: 19.9%4). Computer-related diseases occur when slight fatigue has accumulated continuously over a long period, leading to the development of injury-associated symptoms. It causes fatal damage and pain to the musculoskeletal system when time spent working on a computer has accumulated5). Computer-related disease is a process of cumulative traumatic damage, where preventable, reversible degeneration of the musculoskeletal system changes to irreversible degeneration, because of the damage that occurs due to repeated stress6, 7). In the case of preventable, reversible degeneration, pain can be sufficiently relieved by self-exercise or musculoskeletal system management methods1, 7). However, in the case of irreversible degeneration, pain is not easily relieved even after treatment at a hospital, because the pain and degeneration is permanent7). The purpose of this study was not only to create the self-measurement device and management tool based on scientific evidence, but also to manage the musculoskeletal care program for constant long-term management and communication with a health specialist to ensure precise evaluations. Therefore, this study suggested that the device and program for regular self-measurement of cervical ROM for computer users with cervical pain are very effective for pain management.