The impact of visually demanding near work on neck/shoulder discomfort and trapezius muscle activity : Laboratory studies

Sammanfattning: Introduction: Musculoskeletal discomfort in the neck and shoulders is common among workers performing visually demanding near work, e.g., on a computer screen, and sustained low-level muscle activity during such work can lead to work-related pain. The relationships between visual demands and muscle activity and discomfort in the neck/shoulder region are at present unclear. Aim: The aims of this thesis were to determine whether neck/shoulder discomfort and trapezius muscle activity increases during visually demanding experimental near work, and to investigate whether eye-lens accommodation is a mediating mechanism behind increased trapezius muscle activity. Methods: The four papers included are based on two experiments with different visually demanding near work tasks (duration 5 and 7 min). Trial lenses of different diopters were used to manipulate the visual demands (i.e., induce more or less accommodation) and thereby create different viewing conditions. Monocular viewing, which does not require active convergence, was used to examine the isolated effect of accommodation. Eye-lens accommodation and trapezius muscle activity were measured continuously during the visual tasks, and in one experiment the participants rated their eye and neck/shoulder discomfort at baseline and after each visual task. Results: Neck/shoulder discomfort and trapezius muscle activity increased during the visually demanding near work and participants experiencing a greater increase in eye discomfort (compared with baseline) also developed more neck/shoulder discomfort with time. There were no significant differences in muscle activity among the viewing conditions, and no effect of isolated accommodation response within the monocular viewing conditions. Conclusion: These findings indicate that accommodation per se is unlikely to mediate trapezius muscle activity. Instead, the increase in trapezius muscle activity observed here may be due to a combination of high visual attention and enhanced requirement for eye-neck (head) stabilisation. Since these results suggest that neck/shoulder discomfort may aggravate with time when the visual demands are high, it is important to provide good visual conditions in connection with visually demanding occupations.