Postural Awareness and Musculoskeletal Complaints

Recep Tayyip Erdogan University212 enrolled

Overview

Musculoskeletal complaints are common among working adults and reflect demographic, occupational, ergonomic, and lifestyle-related influences. Whether postural awareness is associated with musculoskeletal complaints beyond these factors remains unclear. This study examined whether postural awareness was independently associated with the number of symptomatic body regions and regional musculoskeletal complaints among working adults. In this cross-sectional study, 212 working adults completed the Postural Awareness Scale (PAS), Cornell Musculoskeletal Discomfort Questionnaire, International Physical Activity Questionnaire, and questionnaires assessing demographic characteristics, occupational factors, perceived workplace ergonomics, and regular exercise. The primary outcome was the number of symptomatic body regions. Hierarchical Poisson regression with robust standard errors was used to assess the association between postural awareness and the primary outcome after sequential covariate adjustment. Generalized Poisson regression was performed as a sensitivity analysis. Prespecified robust logistic regression models examined neck, upper-back, lower-back, and shoulder complaints, with Holm correction for multiple comparisons.

The present study investigated the association between postural awareness and musculoskeletal complaints in working adults across predominantly sitting, mixed, and predominantly standing working conditions. The primary hypothesis was that higher postural awareness would be associated with a lower number of symptomatic body regions after sequential adjustment for demographic characteristics, occupational factors, perceived workplace ergonomics, regular exercise, and physical activity. We additionally hypothesized that higher postural awareness would be associated with lower odds of complaints in the prespecified neck, upper-back, lower-back, and shoulder regions. Data were collected through face-to-face interviews. Demographic and occupational variables included age, sex, height, body weight, educational level, predominant working condition, duration in the current working arrangement, daily and weekly working hours, regular exercise participation, and perceived workplace ergonomics. Predominant working condition was self-reported and classified into three mutually exclusive categories: predominantly sitting, mixed sitting and standing, and predominantly standing. Participants were asked to indicate the posture in which they spent more than 50% of their working day. The mixed category represented participants who alternated between sitting and standing, with neither posture accounting for more than 50% of the working day. Perceived workplace ergonomics was assessed by asking participants whether they considered their workplace to be ergonomically appropriate and categorized as ergonomic, partially ergonomic, or non-ergonomic. Because this variable reflected participants' subjective appraisal rather than an objective ergonomic assessment, it is referred to as perceived workplace ergonomics throughout the study. Regular exercise was defined as engaging in planned exercise at least three days per week, for at least 30 minutes per session, over the preceding three months. Analyses were performed using IBM SPSS Statistics for Windows, version 29.0 (IBM Corp., Armonk, NY, USA).

Eligibility

Sex: ALLMin age: 18 YearsMax age: 65 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * Adults aged ≥18 years who were currently employed * Had maintained the same predominant working pattern for at least six months * Worked at least six hours per day * Were able to understand and complete the Turkish-language questionnaires. Exclusion Criteria: * an inflammatory disease, fibromyalgia or another chronic widespread pain disorder, a neurological disorder, major musculoskeletal surgery during the preceding six months * acute musculoskeletal trauma * continuous use of analgesics, muscle relaxants, or systemic corticosteroids * pregnancy * professional-level sports participation * a diagnosed severe postural deformity.

Outcomes

Primary Outcomes

Musculoskeletal complaints

Musculoskeletal complaints during the preceding working week were assessed using the validated Turkish version of the Cornell Musculoskeletal Discomfort Questionnaire (CMDQ). The CMDQ assesses the frequency, severity, and work interference associated with musculoskeletal discomfort across different anatomical regions. The Turkish version has demonstrated satisfactory construct validity and test-retest reliability in working adults. For each anatomical region, the weighted CMDQ score was calculated as the product of the frequency, discomfort-severity, and work-interference scores. Higher weighted scores indicate more frequent or severe discomfort and greater interference with work. A regional complaint was defined a priori as a weighted CMDQ score greater than zero. The primary outcome was the numbe

Time frame: At baseline

Postural awareness

Postural awareness was assessed using the validated Turkish version of the Postural Awareness Scale (PAS). The original PAS was developed to assess two related dimensions: ease or familiarity with postural awareness and the need for attention regulation to achieve postural awareness. The resulting Turkish PAS comprises 11 items rated on a seven-point Likert scale and has demonstrated satisfactory internal consistency and test-retest reliability among Turkish office workers. After reverse-scoring the relevant items, item scores were summed to obtain a total score ranging from 11 to 77. Higher scores indicate greater self-reported postural awareness. The total PAS score was analysed as a continuous variable. For clinical and statistical interpretability, regression estimates were reported per 10-point increase in the PAS score.