***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background To improve a sustainable healthy working life , we have developed the intervention ' Staying healthy at work ' , which endeavours to enhance work participation of employees aged 45 years and older by increasing their problem-solving capacity and stimulating their awareness of their role and responsibility towards a healthy working life . This research study aims to evaluate the process and the effectiveness of the intervention compared with care as usual . Methods / design The study is a cluster-r and omized controlled trial design ( r and omized at the supervisor level ) , with a 1-year follow-up . Workers aged 45 years and older have been enrolled in the study . Workers in the intervention group are receiving the intervention ' Staying healthy at work ' . The main focus of the intervention is to promote a healthy working life of ageing workers by : ( 1 ) changing workers awareness and behaviour , by emphasizing their own decisive role in attaining goals ; ( 2 ) improving the supervisors ' ability to support workers in taking the necessary action , by means of enhancing knowledge and competence ; and ( 3 ) enhancing the use of the human re source professionals and the occupational health tools available within the organization . The supervisors in the intervention group have been trained how to present themselves as a source of support for the worker . Workers in the control group are receiving care as usual ; supervisors in the control group have not participated in the training . Measurements have been taken at baseline and will be followed up at 3 , 6 and 12 months . The primary outcome measures are vitality , work ability and productivity . The secondary outcomes measures include fatigue , job strain , work attitude , self-efficacy and work engagement . A process evaluation will be conducted at both the supervisor and the worker levels , and satisfaction with the content of the intervention will be assessed . Discussion The intervention ' Staying healthy at work ' has the potential to provide evidence -based knowledge of an innovative method to promote a sustainable healthy working life in the older working population . The results of the study will be relevant for workers , employers , occupational health professionals and human re source professionals . Trial registration The trial is registered with the Dutch Trial Register under number NTR2270 OBJECTIVE Numerous studies has shown that regular physical exercise can reduce musculoskeletal pain , but the optimal setting to achieve high adherence and effectiveness remains unknown . This study investigated the effect of workplace versus home-based physical exercise on musculoskeletal pain among healthcare workers . METHODS The r and omized controlled trial ( RCT ) comprised 200 female healthcare workers from 18 departments at 3 hospitals . Participants were r and omly allocated at the cluster level to ten weeks of : ( i ) workplace physical exercise ( WORK ) performed during working hours for 5 × 10 minutes per week and up to 5 group-based coaching sessions on motivation for regular physical exercise , or ( ii ) home-based physical exercise ( HOME ) performed during leisure time for 5 × 10 minutes per week . Both groups received ergonomic counseling on patient h and ling and use of lifting aides . Average pain intensity ( 0 - 10 scale ) in the low back and neck/shoulder was the primary outcome . RESULTS Per week , 2.2 ( SD 1.1 ) and 1.0 ( SD 1.2 ) training sessions were performed in WORK and HOME groups , respectively . Pain intensity , back muscle strength and use of analgesics improved more following WORK than HOME ( P<0.05 ) . Between-group differences at follow-up ( WORK versus HOME ) was -0.7 points for pain intensity [ 95 % confidence interval ( 95 % CI ) -1.0- -0.3 ] , 5.5 Nm for back muscle strength ( 95 % CI 2.0 - 9.0 ) , and -0.4 days per week for use of analgesics ( 95 % CI -0.7- -0.2 ) . The effect size for between-group differences in pain intensity was small ( Cohen 's d=0.31 ) . CONCLUSIONS Workplace physical exercise is more effective than home-based exercise in reducing musculoskeletal pain , increasing muscle strength and reducing the use of analgesics among healthcare workers Objective : To investigate whether an exercise intervention shown to increase aerobic capacity , would also lead to less musculoskeletal pain ; improved work ability , productivity , and perceived physical exertion ; and less sick leave . Methods : Sixty-seven construction workers were r and omized into an exercise group training 3 × 20 minutes per week and a control group . Question naires and text messages were completed before and after the 12-week intervention . Results : No significant changes were found in musculoskeletal pain , work ability , productivity , perceived physical exertion , and sick leave with the intervention . Question naires and text messages provided similar results of pain and work ability . Conclusions : Although the intervention improved aerobic capacity , it was not successful in improving musculoskeletal pain and other work-related factors . A detectable improvement presumably requires a more multifaceted intervention , larger sample size , or longer follow-up . Text messages may be a convenient data - collection method in future studies Background Only a few workplace initiatives among cleaners have been reported , even though they constitute a job group in great need of health promotion . The purpose of this trial was to evaluate the effect of either physical coordination training or cognitive behavioural training on musculoskeletal pain , work ability and sickness absence among cleaners . Methods A cluster-r and omised controlled trial was conducted among 294 female cleaners allocated to either physical coordination training ( PCT ) , cognitive behavioural training ( CBTr ) or a reference group ( REF ) .  Question naires about musculoskeletal pain and work ability were completed at baseline and after one year 's intervention . Sickness absence data were obtained from the managers ' records . Analyses were performed according to the intention-to-treat-principle ( ITT ) . Results No overall reduction in musculoskeletal pain , work ability or sickness absence from either PCT or CBTr compared with REF was found in conservative ITT analyses . However , explorative analyses revealed a treatment effect for musculoskeletal pain of the PCT . People with chronic neck/shoulder pain at baseline were more frequently non-chronic at follow-up after PCT compared with REF ( p = 0.05 ) . Conclusions The PCT intervention appeared effective for reducing chronic neck/shoulder pain among the female cleaners . It is recommended that future interventions among similar high-risk job groups focus on the implementation aspects of the interventions to maximise outcomes more distal from the intervention such as work ability and sickness absence . Trial registration IS RCT N : IS RCT Background To prolong sustainable healthy working lives of construction workers , a worksite prevention program was developed which aim ed to improve the health and work ability of construction workers . The aim of the current study was to investigate the effectiveness of this program on social support at work , work engagement , physical workload and need for recovery . Methods Fifteen departments from six construction companies participated in this cluster r and omized controlled trial ; 8 departments ( n=171 workers ) were r and omized to an intervention group and 7 departments ( n=122 workers ) to a control group . The intervention consisted of two individual training sessions of a physical therapist to lower the physical workload , a Rest-Break tool to improve the balance between work and recovery , and two empowerment training sessions to increase the influence of the construction workers at the worksite . Data on work engagement , social support at work , physical workload , and need for recovery were collected at baseline , and at three , six and 12 months after the start of the intervention using question naires . Results No differences between the intervention and control group were found for work engagement , social support at work , and need for recovery . At 6 months follow-up , the control group reported a small but statistically significant reduction of physical workload . Conclusion The intervention neither improved social support nor work engagement , nor was it effective in reducing the physical workload and need for recovery  among construction workers . Trial registration to test early  nutritional interventions  and prospect i ve observational cohorts . RCTs are generally accepted as method ologically the best approach for informing health policy . They can equalise unknown as well as known confounding factors and so can demonstrate causation ; they permit estimation of effect size and so can be used to assess likely Objectives This 40-week workplace physical training RCT investigated the effect of soccer and Zumba , respectively , on muscle pain intensity and duration , work ability , and rating of perceived exertion ( RPE ) during work among female hospital employees . Methods 107 hospital employees were cluster-r and omized into two training groups , and a control group . The training was conducted outside working hours as two-three 1-h sessions per week for the first 12 weeks , and continued as one-two 1-h sessions per week for the last 28 weeks . Muscle pain intensity and duration , work ability , and RPE during work were measured at baseline and after 12 and 40 weeks . Results After 12 weeks , both the soccer ( −1.9 , 95 % CI , −3.0 , −0.8 , P = 0.001 ) and the Zumba group ( −1.3 , 95 % CI , −2.3 , −0.3 , P = 0.01 ) reduced the pain intensity ( on a scale from 0 to 10 ) in the neck-shoulder region ( eta squared = 0.109 ) , whereas only the soccer group ( −1.9 , 95 % CI , −3.2 , −0.7 , P = 0.002 , eta squared = 0.092 ) showed a reduction after 40 weeks referencing the control group . After 40 weeks , both the soccer ( -16.4 days , 95 % CI , −29.6 , −3.2 , P<0.02 ) and the Zumba group ( -16.6 days , 95 % CI , −28.9 , −4.2 , P<0.01 ) reduced the pain duration during the past 3 months in the neck-shoulder region ( eta squared = 0.077 ) . No significant effects on intensity or duration of pain in the lower back , RPE during work or work ability were found . Conclusions The present study indicates that workplace initiated soccer and Zumba training improve neck-shoulder pain intensity as well as duration among female hospital employees . Trial Registration International St and ard R and omized Controlled Trial Number Register IS RCT N 61986892 Health risk appraisal s ( HRA ) are a common type of workplace health promotion programme offered by American employers . In the United Kingdom , evidence of their effectiveness for promoting health behaviour change remains inconclusive . This r and omized controlled trial examined the effects of two HRA interventions on lifestyle parameters , mental health and work ability in a UK context . A total of 180 employees were r and omized into one of three groups : Group A ( HRA augmented with health promotion and education activities ) , Group B ( HRA only ) and Group C ( control , no intervention ) . After 12 months , changes in mean scoring in 10 lifestyle , mental health and work ability indices were compared , Groups A and B demonstrated non-significant improvements in 70 % and 80 % , respectively , compared with controls ( 40 % ) . Odds ratios revealed that , compared with the control group , Group A was 29.2 ( 95 % CI : 9.22 - 92.27 ) times more likely to report a perceived change in lifestyle behaviour ; Group B 4.4 times ( 95 % CI : 1.65 - 11.44 ) . In conclusion , participation in the HRA was associated with a higher likelihood of perceived lifestyle behaviour change which was further increased in the augmented HRA group , thereby providing preliminary evidence that HRA and augmented HRA in particular may help UK employees make positive healthy lifestyle changes OBJECTIVES This multicentered r and omized controlled trial evaluated the effect of worksite exercise intervention on perceived work ability and sick leaves . METHODS Women ( N = 260 , mean age 40 years ) engaged in physically dem and ing laundry work were individually r and omized into an intervention ( N = 133 ) or control ( N = 127 ) group . Perceived work ability was assessed with question naires at 3 , 8 , 12 , and 15 months . Sick leave information was obtained from the personnel administration . Follow-up attendance was 100 % at 3 months but declined gradually to 90 % by 15 months . Both the intervention and control subjects received a 30-minute feedback on their physical capacity from a physiotherapist and individual exercise prescription and counseling . The intervention subjects also participated in worksite exercise training guided by a physiotherapist . Sixty-minute sessions ( N = 26 ) were held once a week for 8 months . About 50 % of the intervention group participated in at least two-thirds of the sessions . RESULTS According to a dichotomized work ability index , at 12 months , workers with " good " or " excellent " work ability increased more in the intervention group than in the control group ( 11.0 % , 95 % CI 0.2 - 21.9 ) , as did the health-related prognosis of work ability at 8 months ( 8.1 % , 95 % CI 0.5 - 16.3 ) . There were no statistically significant differences between the two groups as regards job satisfaction , work ability index ( including series of questions on 7 items ) , or sick leaves . CONCLUSIONS Physical activity once a week at worksites improves the perceived work ability of women with physically dem and ing work only slightly . Perceived work ability and sick leaves can not be affected very positively using single-component exercise intervention . Work ability promotion may need a more multiprofessional approach Purpose The objective of the present study is to investigate the effects of a worksite health promotion intervention on musculoskeletal symptoms , physical functioning , work ability , work-related vitality , work performance , and sickness absence . Methods In a r and omized controlled design , 314 construction workers were r and omized into an intervention group ( n = 162 ) receiving personal coaching , tailored information , and material s , and a control group ( n = 152 ) receiving usual care 
    Output:
    
Conclusions The meta- analysis showed a small positive effect , suggesting that workplace interventions might improve work ability .