Changes in physical activity and heart rate variability in chronic neck–shoulder pain: monitoring during work and leisure time

• Published in: International archives of occupational and environmental health 2014-10, Vol.87 (7), p.735-744
• Main Authors: Hallman, David M., Ekman, Annika Hed, Lyskov, Eugene
• Format: Article
• Language: English
• Subjects: Accelerometry; Adult; Autonomic Nervous System - physiopathology; Biological and medical sciences; Cardiac dysrhythmias; Cardiology. Vascular system; Chronic Pain - epidemiology; Chronic Pain - physiopathology; Chronic Pain - psychology; Daily physical activity; Diseases of striated muscles. Neuromuscular diseases; Diseases of the osteoarticular system; Earth and Environmental Science; Environment; Environmental Health; Exercise; Exercise - physiology; Fatigue; Female; Health Status; Heart; Heart rate; Heart Rate - physiology; Heart rate variability; Humans; Leisure Activities; Male; Medical sciences; Mental Health; Middle Aged; Miscellaneous. Osteoarticular involvement in other diseases; Monitoring, Ambulatory; Musculoskeletal diseases; Neck Pain - epidemiology; Neck Pain - physiopathology; Neck Pain - psychology; Neurology; Occupational health; Occupational Medicine/Industrial Medicine; Original Article; Pain; Perceived stress; Rehabilitation; Shoulder Pain - epidemiology; Shoulder Pain - physiopathology; Shoulder Pain - psychology; Sleep; Stress, Psychological - epidemiology; Stress, Psychological - psychology; Sympathetic; Trapezius myalgia; Work
• ISSN: 0340-0131; 1432-1246; 1432-1246
• DOI: 10.1007/s00420-013-0917-2

Objectives Neck–shoulder pain (NSP) is a common work-related musculoskeletal disorder with unclear mechanisms. Changes in physical activity and autonomic nervous system regulation may be involved in the pathogenesis of chronic NSP. The aim of the current study was to investigate autonomic regulation in relation to physical activity and perceived symptoms during work and leisure time among workers with chronic NSP ( n  = 29) as compared to a healthy control group (CON, n  = 27). Methods Physical activity was objectively monitored for 7 days using accelerometry. Beat-to-beat heart rate was collected continuously for 72 h, with simultaneous momentary ratings of pain, stress, and fatigue. Duration of sitting/lying, standing and walking, number of steps, and energy expenditure were used as measures of physical activity. Heart rate variability (HRV) indices were extracted in time and frequency domains as reflecting autonomic regulation. Data were divided into work hours, leisure time, and sleep. Results The NSP group rated higher levels of stress and fatigue at work and leisure, and reduced sleep quality as compared to CON. Elevated heart rate and reduced HRV were found in NSP compared with CON, especially during sleep. The NSP group demonstrated a different pattern of physical activity than CON, with a lower activity level in leisure time. Higher physical activity was associated with increased HRV in both groups. Conclusion Changes in HRV reflected an autonomic imbalance in workers with chronic musculoskeletal pain. This can be explained by reduced physical activity in leisure time. Intervention studies aimed at increasing physical activity may shed further light on the association between autonomic regulation and physical activity in work-related NSP.