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Background: A high prevalence of MSP among dental care professionals is well documented in the international literature and recent Danish data shows multisite musculoskeletal pain (MMP) as highly prevalent. Dental work involves risk factors such as bent neck and back as well as static postures. Ergonomic work techniques and exercise training are both well-known means to successfully reduce and prevent pain, but few interventions have combined ergonomics and exercise among dental care workers. The purpose of the present randomized controlled study was to evaluate the effect on prevalence of MMP of a physical exercise training app in addition to an ergonomic course among the Danish Dental care profession.

Method: The study was designed as a two-armed cluster randomized controlled trial. Both groups had a 3-week course “Good ergonomics” based on existing knowledge as well as a synthesis of a systematic literature search. Focus points were Patient positioning, Standing work and Seated work. After the course the clinics were randomized into control and intervention clinics. The control group continued with Good Ergonomics while the intervention group had with free access to the Intelligent Physical Exercise Training (IPET) app, a weekly 50-minute training program individually tailored to work exposure, capacity, pain pattern and health profile. Elastic bands were handed out to intervention participants for training in work or leisure time. Primary outcome was MMP defined as pain in more than one body region with an intensity of 3 or more within the last 7 days. Secondary outcome was pain intensity within the last 7 days.

Results: Baseline survey was answered by 240 participants, who consented to participate in the study. At follow-up 192 participants responded. At baseline, 237 (98.75%) of the study sample have had MSP in minimum 1 of 12 anatomical regions, and 7 days MMP prevalence was 55%. At follow-up the intension to treat analysis showed a significant difference between groups in 7 days MMP with a prevalence in the intervention group of 33,1%, and in the control group of 49,6%. The intervention group also showed a trend to a larger reduction in pain intensity but significant difference was only found for right shoulder and low back pain intensity.

Discussion: Intention to treat analysis showed a significant effect of the intervention combining IPET with Good ergonomics with a larger reduction of MMP and a larger decrease in pain intensity for the right shoulder and the lowback compared to the control group, who received only Good Ergonomics. This is the first study showing an effect of IPET in an app version, however the results of a decrease in pain is similar to earlier studies using IPET with other kind of deliveries (14).

Conclusion: The combination of IPET with Good ergonomics showed a significant effect with a larger reduction of MMP and a larger decrease in pain intensity for the right shoulder and the low back compared to the control group, who received only Good Ergonomics. While Good Ergonomics may prevent some of the work-related load induced by static postures and awkward postures, the addition of IPET may be needed for an improvement in the MMP condition.