Effects of Adding a Structured Exercise Programme to Ergonomics Training in Women Dairy Farmers: A Randomised...

Background/Objectives: Milking exposes women dairy farmers to sustained trunk flexion and repetitive upper-limb loading, producing a high burden of musculoskeletal disorders. Ergonomics education is the conventional preventive strategy, but added benefit from structured exercise is untested in this population. Methods: In this assessor-blinded randomised controlled trial, 50 women who had milked cows for ≥5 years were allocated to ergonomics training alone (control, n = 25) or ergonomics training plus a 12-week, home-based, equipment-free exercise programme (experimental, n = 25). The primary outcome was pain intensity (NRS), designated as primary only after data collection, so all analyses are exploratory; secondary outcomes were musculoskeletal symptoms (Nordic Questionnaire, seven-day recall at both assessments), upper-limb function (QuickDASH), depression (BDI) and quality of life (WHOQOL-BREF). Continuous outcomes were analysed by mixed-model ANOVA and ANCOVA. Results: All participants completed the trial, with self-reported exercise adherence of 100%. Time × group interactions favoured the combined intervention for pain (F_1,48 = 55.19, p < 0.001; baseline-adjusted mean difference -1.25, 95% CI -1.58 to -0.92), upper-limb function, depressive symptom scores and three WHOQOL-BREF domains (all p < 0.05), but not social relationships (p = 0.896). Mean NRS reduction was -3.76 ± 0.66 versus -2.24 ± 0.78 (d = -2.10), and symptomatic body regions fell by -2.64 ± 0.70 versus -1.20 ± 1.53 (p < 0.001). Conclusions: Both groups improved, and adding a 12-week equipment-free exercise programme was associated with greater short-term, self-reported gains. These exploratory findings from a small single-region sample need confirmation in larger trials with objective adherence measures and longer follow-up.