Outcomes of Participatory Ergonomics and Self-management in Commercial Clam Farmers with Chronic Low Back Pain: A Feasibility Study

ABSTRACT

Purpose: Participatory ergonomics engages workers in the development of strategies to reduce workplace-related pain, offering a flexible and practical option to create individualized context-specific strategies. This paper describes the outcomes of a feasibility study using a participatory approach for self-management of low back pain in clam farmers. Methods: A within-subject time-control design with repeated baseline and post-intervention assessment was used. After refining individual and team-based strategies, stakeholder interviews, and rapid prototyping, workers selected three strategies to use for 8 weeks. Frequency and ease of use for strategies are described. Pre-post paired t-tests were used for analysis of pain-related disability, difficulty and pain with work tasks, pain-related fear, self-efficacy, and coping. Analysis of improvements exceeding published and individual variability was calculated. Results: Participants chose both team and individual strategies, most using strategies 5 days a week >50% of the time. Significant improvements in pain-related disability, pain during specific tasks, pain-related anxiety, and coping were seen after 8 weeks of implementing strategies. No changes in task difficulty, fear, self-efficacy and average resting pain were reported. Pain improvements > MDC₉₅ were reported by 74% with 56–64% > personalized MDC₉₅ for lifting tasks. Conclusions: Pain-related disability, work activity pain ratings and related pain anxiety and coping improved beyond individual variability in this feasibility study. Multiple strategies allowed workers to choose relevant self-management options. Introduction of work-related changes in the workplace, visual demonstration, review of team videos and reminders were helpful. Further studies of this approach are needed.

KEYWORDS:

• Low back pain
• self-management
• participatory ergonomics
• clam farmers

Acknowledgments

We acknowledge the assistance and support of Rose Cantwell and the Cedar Key Aquaculture Association.

Disclosure statement

No potential conflict of interest was reported by the authors.

Ethics approval and Trial registration

Study was approved by the University of Florida IRB201702245 and registered as a Clinical Trial NCT03524378

Additional information

Funding

This study was supported by the Centers for Disease Control and Prevention, National Institute Occupational Safety and Health, Southeastern Coastal Center for Agricultural Health and Safety under grant# National Institute for Occupational Safety and Health 6 U54OHOH011230-05-02; University of Florida College of Public Health and Health Professions Dean’s Office (internal funding); and research survey support by the University of Florida Clinical and Translational Science Institute supported in part by National Institute of Health National Center for Advancing Translational Sciences Redcap NCATS grant ULTR0000064. This content is solely the responsibility of the authors and does not represent the official views of the National Institutes of Health. .