Skip to main content

Advertisement

Log in

Muscle Learning Therapy—Efficacy of a Biofeedback Based Protocol in Treating Work-Related Upper Extremity Disorders

  • Published:
Journal of Occupational Rehabilitation Aims and scope Submit manuscript

Abstract

Work-related upper extremity disorders (WRUEDs) continue to present significant treatment and financial challenges to providers, employers, and insurers. This retrospective study reviews outcomes for 309 subjects who, between 1995 and 1999, were referred through the workers' compensation system for treatment of computer keyboard- and mouse-related WRUED injuries. The mean length of time from the recorded date of injury to the date of intake was 12.9 months. Subjects were offered a 12-visit course in muscle learning therapy (MLT). MLT is an operant conditioning program which uses surface electromyography (sEMG) to train injured workers to control their muscles during work activities. Patient response to therapy was obtained by a therapist-administered questionnaire during Visit 8 of 12. A group of 309 subjects, who had failed to respond to a previous course of therapy (typically physical therapy), reported significant improvements of pain in the neck, thorax, and upper extremities. Ninety six percent reported that they felt “more in control,” 86% reported feeling “better overall,” and 81% reported either “working the same and feeling better” or “working and accomplishing more.” This study provides preliminary support for this approach and provides justification for controlled clinical trials in the future.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

REFERENCES

  1. Ramazzini B. Diseases of workers (Translated by Wright WC). Chicago: University of Chicago Press, 1713 and 1940, pp. 421-425.

    Google Scholar 

  2. Armstrong TJ, Fine LJ, Goldstein SA, Lifshitz YR, Silverstein BA. Ergonomics considerations in hand and wrist tendinitis. J Hand Surg 1987; 12a: 830-837.

    Google Scholar 

  3. National Research Council. Work-related musculoskeletal disorders: A review of the evidence. Washington, DC: National Academy Press, 1998, pp. 1-27.

    Google Scholar 

  4. Veiersted KB, Westgaard RH, Andersen P. Pattern of muscle activity during stereotyped work and its relation to muscle pain. Int Arch Occup Environ Health 1990; 62: 31-41.

    Google Scholar 

  5. Sauter SL, Swanson NG. An ecological model of musculo-skeletal disorders in office work. In: Moon SD, Sauter SL, eds. Beyond biomechanics: Psychosocial aspects of musculoskeletal disorders in office work. Bristol, PA: Taylor and Francis, 1996, pp. 3-21.

    Google Scholar 

  6. Gerr F, Marcus M, Ortiz DJ. Methodological limitations in the study of video display terminal use and upper extremity musculoskeletal disorders. Am J Ind Med 1996; 29: 649-656.

    Google Scholar 

  7. Stevens JC, Beard CM, O'Fallon WM, Kurland LT. Conditions associated with carpal tunnel syndrome. Mayo Clin Proc 1992; 67: 541-548.

    Google Scholar 

  8. Nathan PA, Keniston RC, Myers LD, Meadows KD. Obesity as a risk factor for slowing of sensory conduction of the median nerve in industry. J Occ Med 1992; 34: 370-383.

    Google Scholar 

  9. Green AG, Briggs CA. Anthropometric dimensions and overuse injury among Australian keyboard operators. J Occ Med 1989; 31: 747-750.

    Google Scholar 

  10. Feuerstein M. Workstyle: Definition, empirical support, and implications for prevention, evaluation, and rehabilitation of occupational upper-extremity disorders. In: Moon SD, Sauter SL, eds. Beyond biomechanics: Psychosocial aspects of musculoskeletal disorders in office work. Bristol, PA: Taylor and Francis, 1996, pp. 177-206.

    Google Scholar 

  11. Feuerstein M, Armstrong T, Hickey P, Lincoln A. Computer keyboard force and upper extremity symptoms. J Occup Med 1997; 39: 1144-1153.

    Google Scholar 

  12. Veiersted KB, Westgaard RH, Andersen P. Electromyographic evaluation of muscular work pattern as a predictor of trapezius myalgia. Scand J Work Environ Health 1993; 19: 284-290.

    Google Scholar 

  13. Sandsjo L, Melin B, Rissen D, Dohns I, Lundberg U. Trapezius muscle activity, neck and shoulder pain, and subjective experiences during monotonous work in women. Eur J Appl Physiol 2000; 83: 235-238.

    Google Scholar 

  14. Haufler AJ, Feuerstein M, Huang GD. Job stress, upper extremity pain and functional limitations in symptomatic computer users. Am J Ind Med 2000; 38: 507-515.

    Google Scholar 

  15. Faucett J, Remel D. VDT-related musculoskeletal symptoms: Interactions between work posture and psychosocial work factors. Am J Ind Med 1994; 26: 597-612.

    Google Scholar 

  16. Albin T, Hebaus M, Ley CA. Office ergonomics clinic results at thirty months. J Occup Environ Med 1997; 39: 1031.

    Google Scholar 

  17. Middaugh SJ, Kee WG. Advances in electromyographic monitoring and biofeedback in the treatment of chronic cervical and low back pain. In: Eisenberg MG, Grisesiak RC, eds. Advances in clinical rehabilitation, Vol. 1. New York: Springer-Verlag, 1987, pp. 137-172.

    Google Scholar 

  18. Flor H, Birbaumer N. Comparison of the efficacy of electromyographic biofeedback, cognitive behavioral therapy, and conservative medical interventions in the treatment of chronic musculoskeletal pain. J Consult and Clin Psych 1993; 61: 653-658.

    Google Scholar 

  19. Ettare DL, Ettare RC. Muscle learning therapy:Atreatment protocol. In: Cram J, ed. ClinicalEMGfor surface recordings, Vol. 2. Nevada City: Clinical Resources, 1990, pp. 197-233.

    Google Scholar 

  20. Kasman GS, Cram JR, Wolf SL. Clinical applications in surface electromyography: Chronic musculoskeletal pain. Gaithersburg: Aspen, 1998, pp. 141-191.

    Google Scholar 

  21. Hubbard DR, Berkoff GM. Myofascial trigger points show spontaneous needle EMG activity. Spine 1993; 18: 1803-1807.

    Google Scholar 

  22. McNulty WH, Gervitz RN, Hubbard DR, Berkoff GM. Needle electromyographic evaluation of trigger point response to a psychological stressor. Psychophysiology 1994; 31: 313-316.

    Google Scholar 

  23. Pransky G, Katy B, Himmelstein J, Mundt K, Morgan W, Feuerstein M, Koyamatsu K, Hill-Fotouhi C. Work-related upper-extremity disorders: Prospective evaluation of clinical and functional outcomes. J Occup Environ Med 1999; 41: 884-892.

    Google Scholar 

  24. Feuerstein M, Callan-Harris S, Jickey P, Dyer D, ArmbrusterW, Carosella AM. Multidisciplinary rehabilitation of chronic work-related upper extremity disorders. J Occup Med 1993; 35: 396-403.

    Google Scholar 

  25. Rempel DM, Harrison RJ, Barnhart S. Work-related cumulative trauma disorders of the upper extremity. JAMA 1992; 267: 838-842.

    Google Scholar 

  26. Lundberg U. Stress responses in low-status jobs and their relationship to health risks: Musculoskeletal disorders. Ann N Y Acad Sci 1999; 896: 162-172.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Nord, S., Ettare, D., Drew, D. et al. Muscle Learning Therapy—Efficacy of a Biofeedback Based Protocol in Treating Work-Related Upper Extremity Disorders. J Occup Rehabil 11, 23–31 (2001). https://doi.org/10.1023/A:1016600107571

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1016600107571

Navigation