Values are means (SD). Post-hoc Bonferroni comparisons were significant at p < 0.05 between all tertile pairs for pain intensity, multi-site burden, and PSS-14. FHP: forward head posture; HRV: heart rate variability; PSS-14: Perceived Stress Scale-14.
AL: Conceptualization, Methodology, Investigation, Formal analysis, Data curation, Visualization, Writing—original draft, Writing—review & editing, Supervision, Project administration. BL: Investigation, Data curation, Formal analysis, Writing—review & editing. Both authors read and approved the submitted version.
Conflicts of interest
The authors declare that they have no conflicts of interest related to this research. Adrian Low is a HeartMath-certified practitioner; this certification did not influence the design, conduct, analysis, or interpretation of the study. The HeartMath Institute had no involvement in this research.
Ethical approval
The Heart Rate Variability and Work-Related Musculoskeletal Disorder Risk study was approved by the Ethics Committee of the Hong Kong Association of Psychology (Approval No. HKAP-20251015-001, approved October 15, 2025). The study was conducted in accordance with the Declaration of Helsinki.
Consent to participate
Informed consent to participate in the study was obtained from all participants.
Consent to publication
Informed consent to publication was obtained from relevant participants. All participants provided written informed consent for the publication of de-identified aggregated data derived from their participation in the study. No individually identifiable information is included in this manuscript.
Availability of data and materials
The datasets generated and analyzed during the current study are not publicly available due to participant confidentiality terms stipulated in the ethics approval but are available from the corresponding author on reasonable request, subject to the participant consent terms.
Funding
This research received no external or internal funding or financial support.
Open Exploration maintains a neutral stance on jurisdictional claims in published institutional affiliations and maps. All opinions expressed in this article are the personal views of the author(s) and do not represent the stance of the editorial team or the publisher.
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