The burden and determinants of neck pain in workers: results of the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders. Effect of cushioned insoles on impact forces during running.
STUDY DESIGN Systematic review and best evidence synthesis . OBJECTIVES To describe the prevalence and incidence of  neck pain and disability in workers ; to identify risk factors for neck pain in workers ; to propose an etiological diagram ; and to make recommendations for future research . SUMMARY OF BACKGROUND DATA Previous review s of the etiology of neck pain in workers relied on cross-sectional evidence . Recently published cohorts and r and omized trials warrant a re- analysis of this body of research . METHODS We systematic ally search ed Medline for literature published from 1980 - 2006 . Retrieved articles were review ed for relevance . Relevant articles were critically appraised . Articles judged to have adequate internal validity were included in our best evidence synthesis . RESULTS One hundred and nine papers on the burden and determinants of neck pain in workers were scientifically admissible . The annual prevalence of neck pain varied from 27.1 % in Norway to 47.8 % in Québec , Canada . Each year , between 11 % and 14.1 % of workers were limited in their activities because of neck pain . Risk factors associated with neck pain in workers include age , previous musculoskeletal pain , high quantitative job dem and s , low social support at work , job insecurity , low physical capacity , poor computer workstation design and work posture , sedentary work position , repetitive work and precision work . We found preliminary evidence that gender , occupation , headaches , emotional problems , smoking , poor job satisfaction , awkward work postures , poor physical work environment , and workers ' ethnicity may be associated with neck pain . There is evidence that interventions aim ed at modifying workstations and worker posture are not effective in reducing the incidence of neck pain in workers . CONCLUSION Neck disorders are a significant source of pain and activity limitations in workers . Most neck pain results from complex relationships between individual and workplace risk factors . No prevention strategies have been shown to reduce the incidence of neck pain in workers BACKGROUND The use of cushioned or shock-absorbing insoles has been suggested as a mechanism to reduce the impact forces associated with running , thereby protecting against overuse injuries . The purpose of this study was to determine whether the use of cushioned insoles reduced impact forces during running in healthy subjects . METHODS Sixteen recreational runners ( 9 females and 7 males ) ran at a self-selected pace for five trials with and without the use of cushioned insoles . During each trial , ground reaction forces , tibial accelerations , lower-extremity kinematics , and subject-perceived comfort were recorded . All variables were tested with the level of statistical significance set at alpha = .05 . RESULTS The use of cushioned insoles result ed in significant reductions in mean vertical ground reaction force peak impact ( 6.8 % ) and ground reaction force loading rate ( 8.3 % ) , as well as peak tibial acceleration ( 15.8 % ) . Spectral analysis of the tibial acceleration data in the frequency range associated with impact accelerations ( 12 - 25 Hz ) revealed no change in the predominant frequency or the power of the predominant frequency . The knee flexion angle at initial contact and perceived comfort were similar for the two conditions . CONCLUSIONS This study demonstrates the effectiveness of one type of cushioned insole in reducing peak impact force and tibial acceleration at initial foot-ground contact during running . The impact reduction observed was independent of knee kinematic adjustments or changes in perceived comfort . Further study is required to determine whether the reduction in loading that accompanied the use of the cushioned insoles can affect the incidence of running-related injuries
A moderate level of evidence was found in support of using cushioned material s in reducing discomfort/fatigue among st and ing workers .
A limited level of evidence exists in favour of using insoles over anti-fatigue mats .
This systematic review up date s the current state of evidence on the effectiveness of softer flooring and cushioned shoe insoles on reducing  musculoskeletal discomfort amongst workers who are required to st and for prolonged periods to work and the impact of factors such as age and gender on the outcomes .