Objectives I-Preventive is a digital preventive tool for musculoskeletal disorders (MSDs) in computer workers. We sought to determine its impact on pain in computer workers with upper limb MSDs and visual discomfort. Methods We conducted a pilot cluster randomised trial in 2 different sites of a tyre factory in France. We randomised 200 employees to either an intervention group (I-Preventive) or control group, each comprising symptomatic and asymptomatic employees. The workers were followed up for 5 months. The main outcome was overall recovery from symptoms following 1 month's intervention based on Nordic-style and eyestrain questionnaires. Results We included 185/200 workers: 96 in the intervention group (mean age 41.8±1.4 years; 88.5% males) and 79 in the control group (mean age 42.9±12.0 years; 94.5% males). The most painful areas (numerical scale ≥2) were the neck (40.0%), upper back (18.8%) and shoulders (15.7%). For the most painful anatomical area, the Nordic score significantly decreased after 1 month in the intervention group (p=0.038); no change was observed in the control group (p=0.59). After 1 month's use, the intervention group reported less pain in the painful area and less visual discomfort symptoms (p=0.02). Adherence to the I-Preventive program was 60%. Conclusions I-Preventive is effective in the short term on musculoskeletal symptoms and visual discomfort by promoting active breaks and eyestrain treatment. This easy-to-use digital tool allows each worker to focus on areas of their choice via personalised, easy exercises that can be performed in the workplace. Trial registration number NCT02350244; Pre-results.

To describe barriers to physical activity (PA) in type 2 diabetes patients and their general practitioners (GPs), looking for practitioner’s influence on PA practice of their patients. We conducted a cross-sectional study on GPs (n = 48) and their type 2 diabetes patients (n = 369) measuring respectively barriers to prescribe and practice PA using a self-assessment questionnaire: barriers to physical activity in diabetes (BAPAD). Statistical analysis was performed accounting hierarchical data structure. Similar practitioner’s patients were considered a cluster sharing common patterns. The higher the patient’s BAPAD score, the higher the barriers to PA, the higher the risk to declare practicing no PA (p<0.001), low frequency and low duration of PA (p<0.001). A high patient’s BAPAD score was also associated with a higher risk to have HbA_1c ≥7% (53 mmol/mol) (p = 0.001). The intra-class correlation coefficient between type 2 diabetes patients and GPs was 34%, indicating a high cluster effect. A high GP’s BAPAD score, regarding the PA prescription, is predictive of a high BAPAD score with their patients, regarding their practice (p = 0.03). Type 2 diabetes patients with lower BAPAD score, thus lower barriers to physical activity, have a higher PA level and a better glycemic control. An important and deleterious cluster effect between GPs and their patients is demonstrated: the higher the GP’s BAPAD score, the higher the type 2 diabetes patients’ BAPAD score. This important cluster effect might designate GPs as a relevant lever for future interventions regarding patient’s education towards PA and type 2 diabetes management.

Background: Creatine supplementation is widely used to enhance exercise performance, mainly resistance training adaptations, yet its differential effects on upper- and lower-body strength and muscular power remain unclear across populations. Objective: This systematic review and meta-analysis aimed to quantify the effects of creatine supplementation in studies that included different exercise modalities or no exercise on upper- and lower-body muscular strength and power in adults. Methods: A comprehensive search of PubMed, Scopus, and Web of Science was conducted through 21 September 2024 to identify randomized controlled trials evaluating the effects of creatine supplementation on strength (bench/chest press, leg press, and handgrip) and power (upper and lower body). Weighted mean differences (WMDs) and 95% confidence intervals (CIs) were calculated using random-effects modeling. Subgroup analyses examined the influence of age, sex, training status, dose, duration, and training frequency. Results: A total of 69 studies with 1937 participants were included for analysis. Creatine plus resistance training produced small but statistically significant improvements in bench and chest press strength [WMD = 1.43 kg, p = 0.002], squat strength [WMD = 5.64 kg, p = 0.001], vertical jump [WMD = 1.48 cm, p = 0.01], and Wingate peak power [WMD = 47.81 Watts, p = 0.004] when compared to the placebo. Additionally, creatine supplementation combined with exercise training revealed no significant differences in handgrip strength [WMD = 4.26 kg, p = 0.10] and leg press strength [WMD = 3.129 kg, p = 0.11], when compared with the placebo. Furthermore, subgroup analysis based on age revealed significant increases in bench and chest press [WMD = 1.81 kg, p = 0.002], leg press [WMD = 8.30 kg, p = 0.004], and squat strength [WMD = 6.46 kg, p = 0.001] for younger adults but not for older adults. Subgroup analyses by sex revealed significant increases in leg press strength [WMD = 9.79 kg, p = 0.001], squat strength [WMD = 6.43 kg, p = 0.001], vertical jump [WMD = 1.52 cm, p = 0.04], and Wingate peak power [WMD = 55.31 Watts, p = 0.001] in males, but this was not observed in females. Conclusions: This meta-analysis indicates that creatine supplementation, especially when combined with resistance training, significantly improves strength in key compound lifts such as the bench or chest press and squat, as well as muscular power, but effects are not uniform across all measures. Benefits were most consistent in younger adults and males, while older adults and females showed smaller or non-significant changes in several outcomes. No overall improvement was observed for handgrip strength or leg press strength, suggesting that the ergogenic effects may be more pronounced in certain multi-joint compound exercises like the squat and bench press. Although the leg press is also a multi-joint exercise, results for this measure were mixed in our analysis, which may reflect differences in study design, participant characteristics, or variability in testing protocols. The sensitivity of strength tests to detect changes appears to vary, with smaller or more isolated measures showing less responsiveness. More well-powered trials in underrepresented groups, particularly women and older adults, are needed to clarify population-specific responses.

Although creatine supplementation is well-known to increase exercise performance in acute high-intensity exercises, its role in aerobic performance based on VO₂max is more controversial. Thus, we performed a systematic review and meta-analysis on the effects of creatine supplementation on VO₂max. PubMed, Cochrane, Embase, and ScienceDirect were searched for randomized controlled trials (RCTs) reporting VO₂max in creatine supplementation and placebo groups before and after supplementation. We computed a random-effects meta-analysis on VO₂max at baseline, within groups following supplementation, on changes on VO₂max between groups, and after supplementation between groups. Sensitivity analyses and meta-regression were conducted. We included 19 RCTs for a total of 424 individuals (mean age 30 years old, 82% men). VO₂max did not differ at baseline between groups (creatine and placebo). Participants in both groups were engaged in exercise interventions in most studies (80%). Using changes in VO₂max, VO₂max increased in both groups but increased less after creatine supplementation than placebo (effect size [ES] = −0.32, 95%CI = −0.51 to −0.12, p = 0.002). Comparisons after creatine supplementation confirmed a lower VO₂max in the creatine group compared to the placebo group (ES= −0.20, 95%CI = −0.39 to −0.001, p = 0.049). Meta-analysis after exclusion from meta-funnel resulted in similar outcomes in a subgroup of young and healthy participants. Meta-regressions on characteristics of supplementation, physical training, or sociodemographic were not statistically significant. Creatine supplementation has a negative effect on VO₂max, regardless of the characteristics of training, supplementation, or population characteristics. Supplemental data for this article is available online at https://doi.org/10.1080/10408398.2021.2008864 .

Musculoskeletal disorders (MSDs) constitute a major occupational health problem in the working population, substantially impacting the quality of life of employees. They also cause considerable economic cost to the healthcare system, with, notably, the reimbursement of treatments and compensation for lost income. MSDs manifest as localized pain or functional difficulty in one or more anatomical areas, such as the cervical spine, shoulder, elbow, hand, and wrist. Although prevalence varies depending on the region considered and the method of assessment, a prevalence of 30% is found in different epidemiological studies. The disease needs to be prevented, not only for medical and economic reasons, but also for legal reasons, owing to the requirement of assessing occupational risks. The strategy envisaged may thus revolve around active, multimodal prevention that has employees fully involved at the heart of their care. Although physical exercise is widely recommended, few studies with a good level of evidence have enabled us to base a complete, well-constructed intervention on exercise that can be offered as secondary prevention in these disorders. A prospective, multicenter, comparative (intervention arm vs. control arm), randomized (immediate vs. later treatment) study using Zelen’s design. This study falls under active prevention of MSDs of the upper extremities (UE-MSDs). Participants are workers aged between 18 and 65 years with latent or symptomatic MSDS, with any type of job or workstation, with or without an history of sick leave. The primary aim is to show the superiority at 3 months of a combination of spa therapy, exercise, and self-management workshops for 6 days over usual care in the management of MSDs in terms of employee functional capacity in personal and professional daily life. Secondary aims are to assess the benefit of the intervention in terms of pain, quality of life, and accumulated duration of sick leave. This randomized controlled trial is the first that will aim to evaluate multidisciplinary management of UE-MSDs using nonpharmacological treatment combining exercise, self-management, and spa therapy. The originality of this intervention lies, in its short, intensive format, which is compatible with remaining in work; and in its multidisciplinary approach. This trial has the potential to demonstrate, with a good level of evidence, the benefits of a short course of spa therapy combined with a personalized self-management program on the functional capacity, pain, and quality of life of employees in their daily life. Clinical trial.gov NCT02702466 retrospectively registered. Protocol: Version 4 of 9/10/2015.