Article type
Abstract
"Background: Work-related complaints of the arm, neck or shoulder (CANS) are disorders that develop as a result of repetitive movements, awkward postures and impact of external forces such as when operating vibrating tools. These disorders affect working populations across the world.
Objectives: To assess the effectiveness of ergonomic interventions for work-related CANS in adults on pain, functional status and work-related outcomes.
Methods: This is an update of an existing Cochrane review. We searched eight databases until September 2023. We included randomised (and quasi) controlled trials evaluating ergonomic interventions for work-related CANS in adults. We excluded trials that investigated conservative management (i.e., exercise therapy), injections/surgery. Two review authors independently selected trials for inclusion, extracted data and assessed risk of bias using a modified version of the assessment tool developed by Cochrane. We assessed the overall certainty of the evidence using the GRADE approach.
Results: We included 20 studies including a total of 2478 participants. We judged 18 studies to have a high-risk of bias.
There is very uncertain evidence that ergonomic interventions reduce pain when compared with no intervention in the short-term [<3 months] (SMD= -0.35, 95%CI -0.97 to 0.26; 3 studies, 235 participants) and long-term [>3 months] (acute-pain [3-12 months duration]: SMD= -1.00, 95%CI -1.94 to -0.07; 3 studies, 194 participants, and chronic-pain [>12 months duration]: SMD= -0.26, 95%CI -0.54 to -0.00; 5 studies, 534 participants). There was low certainty evidence that ergonomic interventions have no effect on disability when compared to no treatment (SMD= -0.33, 95%CI -0.71 to 0.06; 2 studies, 107 participants). There was low certainty evidence that ergonomic intervention does not change sickness absence compared to no treatment (RR= 0.78, 95%CI 0.45 to 1.35; 2 RCTs, 326 participants).
Conclusions: We found low- to very-low certainty evidence that in patients with non-specific CANS ergonomic interventions when compared to no treatment have a small reduction short- and long-term pain, very-low certainty evidence of no difference in functional status and no difference in sick leave.
"
Objectives: To assess the effectiveness of ergonomic interventions for work-related CANS in adults on pain, functional status and work-related outcomes.
Methods: This is an update of an existing Cochrane review. We searched eight databases until September 2023. We included randomised (and quasi) controlled trials evaluating ergonomic interventions for work-related CANS in adults. We excluded trials that investigated conservative management (i.e., exercise therapy), injections/surgery. Two review authors independently selected trials for inclusion, extracted data and assessed risk of bias using a modified version of the assessment tool developed by Cochrane. We assessed the overall certainty of the evidence using the GRADE approach.
Results: We included 20 studies including a total of 2478 participants. We judged 18 studies to have a high-risk of bias.
There is very uncertain evidence that ergonomic interventions reduce pain when compared with no intervention in the short-term [<3 months] (SMD= -0.35, 95%CI -0.97 to 0.26; 3 studies, 235 participants) and long-term [>3 months] (acute-pain [3-12 months duration]: SMD= -1.00, 95%CI -1.94 to -0.07; 3 studies, 194 participants, and chronic-pain [>12 months duration]: SMD= -0.26, 95%CI -0.54 to -0.00; 5 studies, 534 participants). There was low certainty evidence that ergonomic interventions have no effect on disability when compared to no treatment (SMD= -0.33, 95%CI -0.71 to 0.06; 2 studies, 107 participants). There was low certainty evidence that ergonomic intervention does not change sickness absence compared to no treatment (RR= 0.78, 95%CI 0.45 to 1.35; 2 RCTs, 326 participants).
Conclusions: We found low- to very-low certainty evidence that in patients with non-specific CANS ergonomic interventions when compared to no treatment have a small reduction short- and long-term pain, very-low certainty evidence of no difference in functional status and no difference in sick leave.
"