On-site multi-component intervention to improve productivity and reduce the economic and personal burden of neck pain in Swiss office-workers (NEXpro): protocol for a cluster-randomized controlled trial

Workstation ergonomics: Participants’ workstation ergonomics will be assessed using an observation-based ergonomics assessment checklist for office-workers adapted to Swiss guidelines [36]. Based on the initial assessment, best practice ergonomics will be applied individually using existing infrastructure [23]. Topics will include for example the adjustment of the chair, desk, and monitor.

Health promotion: Participants will attend health promotion information group workshops for approximately 1 h per week for 12 weeks. Content will include: attitudes to health and elements of success (including sleep); basic anatomical knowledge; behaviour change towards success; common workplace mental health issues; conflict management and resilience in the workplace; job stress and how to deal with it; keeping active (sit less, move more); keeping up the momentum and motivation; practical healthy eating; role of digital media; self-esteem; stress and relaxation workshop; and text-neck and how to avoid it [23, 37]. ‘Text-neck’ describes mechanical exposures on the neck, including static loading, non-neutral postures, and repetitive motions, associates with viewing portable devices over prolonged periods of time. The topics were selected in consultation with the organisations and on the basis of previous studies [23].

Neck exercise: Participants will receive an individual progressive exercise programme aimed at conditioning the muscles of the neck and shoulder girdle. The exercises will be performed in groups (maximum of 12 per group) at the workplace in a dedicated room, for approximately 1 h (3 × 20 minutes) per week; once per week supervised by a physiotherapist, a human movement scientist, or a health scientist, and twice per week self-administrated. A standard sequence of exercises will be prescribed to all participants, but their implementation and progression will be within the specific capabilities of the individual considering potential age- and gender-specific requirements. Participants will perform shoulder girdle exercises (bilateral shoulder shrugs; bilateral scapular raise; bilateral incline shoulder external rotation in squat position; bilateral shoulder extension; shoulder row; bench dips; incline push-ups), progressing from un-resisted to resisted utilising variable resistance bands, and neck exercises (using the hand to apply resistance during neck flexion, extension and rotation) [38, 39]. Training load for each individual will be based on their one-repetition maximum (1-RM) that will be assessed during physical examination of the neck and regularly re-evaluated [40, 41]. Training sessions will start with ten repetitions at 50% of 1-RM warm-ups, followed by two to three sets of 10–15 repetitions of exercise at 60–80% of 1-RM corresponding to 10-RM. Adequate breaks will be taken between sets to avoid overexertion. Warm-up exercises (bilateral shoulder circling; upper body rotation) once each for 20 s, and cool-down exercises (lateral neck stretch; neck extensor stretch; seated side stretch; self-massage of shoulder and neck with spiky ball) for three times 20 s will complete the program [20, 42].

Adherence to intervention: Workshop session attendance will be recorded as an indication of adherence to health promotion. Adherence to neck exercises will be recorded with the Physitrack® app (London, United Kingdom). Participants will maintain a record of exercise frequency, intensity, time, and type (F.I.T.T principles) [43]. A detailed instruction of each exercise technique (video), load intensity, and details regarding the number of sets and repetitions are recorded for each participant on the app enabled on their smartphone, tablet, or desk-top computer. Training reminder and feedback will be provided by the app.