A New Instrument for Assessing Work-Related Body Mechanics and Strain in the General Population

  • Sonia Sharma
    Address reprint requests to Sonia Sharma, BDS, MS, PhD, Department of Neurosurgery, University of Rochester Medical Center, 2180 South Clinton Avenue, Rochester, NY 14618, USA.
    Department of Neurosurgery, University of Rochester Medical Center, Rochester, New York

    Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Malmö, Sweden
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  • Peter M. Nilsson
    Department of Clinical Sciences, Research Group Internal Medicine – Epidemiology, Lund University, Skåne University Hospital, Malmö, Sweden

    Strategic Research Area EpiHealth: Epidemiology for Health, Lund University, Lund, Sweden
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  • Per-Olof Östergren
    Strategic Research Area EpiHealth: Epidemiology for Health, Lund University, Lund, Sweden

    Department of Clinical Sciences in Malmö, Division of Social Medicine and Global Health, Lund University, Lund, Sweden
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  • Birgitta Häggman-Henrikson
    Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Malmö, Sweden

    Department of Odontology, Clinical Oral Physiology, Faculty of Medicine, Umeå University, Umeå, Sweden
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  • Thomas List
    Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Malmö, Sweden

    Skåne University Hospital, Specialized Pain Rehabilitation, Lund, Sweden
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  • Michael A. Kallen
    Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
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Published:October 07, 2022DOI:


      • Work-related body mechanics strain is associated with chronic pain.
      • Short-form presents new opportunity for epidemiological and large-scale clinical studies.
      • Cumulative effects of body strain on chronic pain should be tested in future research.
      • Ergonomic interventions supporting body mechanics changes during daily activities need testing.


      Clinical pain is often linked to poor body mechanics, with individuals sometimes presenting multiple painful disorders. Such disorders may be influenced by behaviors that affect the general resiliency and health of the musculoskeletal system. We aimed to develop a self-reported scale using the Malmö Diet and Cancer Study questions on work-related body mechanical exposures. An expert panel identified 41 variables having content validity for musculoskeletal problems. Exploratory factor analysis was conducted on a random selection of 50% of the cohort (n = 6,789 adults); the remaining was reserved for confirmatory factor analyses (CFA), item response theory (IRT) item calibration, and differential item functioning investigations. Supported by standard measure development methods and fit criteria, the final unidimensional item bank contains 13 items. Overall CFA statistics (root mean square error of approximation = .09; comparative fit index = .96; Tucker-Lewis index = .96; standardized root mean residuals = .05) indicated excellent single-factor model fit and appropriateness of IRT modeling and calibration. Expert review and item information values (score-precision) guided selection of an 8-item short form with acceptable score-level reliabilities (≥.70) for T-scores = 39–80+. This measure provides reliable assessment of body mechanics strain in adults and can be useful when evaluating different contributions to musculoskeletal problems affecting pain-treatment success in future clinical research.


      This article presents the development and psychometric properties of a new measure, “Work-related Body Mechanics and Strain Scale (WR-BMSS).” The scale has 13-items or alternatively an 8-item short form. This measure could potentially help clinicians who seek to assess how musculoskeletal problems may contribute to patient pain and disability.

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