Effects of Ergonomics Training Plus Structured Exercise Versus Ergonomics Training Alone on Musculoskeletal Pain, Disability, and Burnout in Schoolteachers: A Randomized Controlled Trial

Background/Objectives: Musculoskeletal disorders are common among teachers, but randomized evidence on adding exercise to ergonomics training is scarce. This trial compared ergonomics training plus structured exercise with ergonomics training alone. Methods: Eighty teachers with musculoskeletal pain lasting at least three months were stratified by school level and randomized 1:1. Both groups attended four ergonomics sessions and received weekly telephone calls; the ergonomics-plus-exercise group also performed a 12-week, largely self-directed program of stretching, strengthening, and core stabilization. Registered primary outcomes were the Oswestry Disability Index (ODI), Neck Disability Index (NDI), Maslach Burnout Inventory–Educators Survey, and Nordic Musculoskeletal Questionnaire; pain intensity (VAS) was secondary. A blinded assessor collected outcomes at baseline and week 12. Results: All participants completed the trial. Group × time interactions favored ergonomics plus exercise for ODI (difference in change −6.80; 95% CI −9.22 to −4.38), NDI (−4.90; −7.53 to −2.27), emotional exhaustion (−2.63; −3.89 to −1.36), depersonalization, and personal accomplishment (Holm-adjusted p ≤ 0.013), and for VAS (−1.18; −1.48 to −0.87). At least 30% improvement occurred in 80% versus 10% of participants for ODI and 90% versus 38% for NDI, but in 95% versus 93% for VAS. The number of symptomatic body regions decreased more with exercise (−0.67; −1.15 to −0.20); in unadjusted exploratory region-specific analyses, only the shoulder reached nominal significance, with baseline imbalance. Conclusions: Adding a structured exercise program to ergonomics training gave additional short-term improvements in disability and burnout. Mean differences were modest, outcomes and adherence were self-reported, and participants knew their allocation.