Ergonomics and Exercise Training as a Basic Intervention for Work-Related Musculoskeletal Disorders in Construction Workers: A Randomized Controlled Trial

Background: Work-related musculoskeletal disorders (WRMSDs) are highly prevalent among construction workers. Ergonomics training and exercise are both used for their management, but the incremental benefit of adding exercise to ergonomics training in this population is unclear. Our aim was to evaluate whether adding a supervised exercise programme to ergonomics training provides additional benefit over ergonomics training alone in construction workers with WRMSDs. Methods: In this single-centre, two-arm randomized controlled trial, 52 male construction workers with musculoskeletal complaints were allocated to an ergonomics training plus exercise group (n = 26) or an ergonomics training alone group (active comparator, n = 26) for 12 weeks. The primary outcome was pain intensity (Visual Analogue Scale—VAS); secondary outcomes were musculoskeletal symptom burden (Extended Nordic Musculoskeletal Questionnaire, NMQ-E), fatigue (Fatigue Severity Scale—FSS), sleep quality (Pittsburgh Sleep Quality Index—PSQI), and occupational burnout (Maslach Burnout Inventory—MBI). The pre-specified primary contrast was the baseline-adjusted between-group difference at 12 weeks (ANCOVA), with a responder analysis as a sensitivity check. Results: Both groups improved significantly from baseline in terms of pain, fatigue, sleep quality, and musculoskeletal symptom burden (all p < 0.001) and in personal accomplishment (p < 0.001); emotional exhaustion and depersonalization were unchanged in both arms. Baseline-adjusted between-group comparisons showed no statistically significant incremental effect of added exercise on pain (adjusted difference −0.34, 95% CI −0.99 to 0.32), fatigue, sleep, symptom burden, or any burnout dimension. The exercise arm showed numerically greater improvements in pain, fatigue, and symptom burden and a higher proportion achieving ≥30% pain relief (96% vs. 77%; odds ratio 7.5), but these differences did not reach statistical significance (p = 0.099). Conclusions: Over a period of 12 weeks, ergonomics training with or without added exercise was associated with significant improvements in musculoskeletal and related outcomes; however, adding exercise to ergonomics training produced no statistically significant incremental benefit. A non-significant trend toward greater pain response with added exercise warrants confirmation in larger, longer trials.