Effectiveness of workplace interventions in the prevention of upper extremity musculoskeletal disorders and symptoms: an update of the evidence

by:Frank Tech     2020-06-14
The burden of work-induced disabling muscle and bone pain and injury (muscle and bone disease, MSDs-
The related reasons for many workplaces are still large.
There is little consensus on the most appropriate interventions for MSDs.
Our goal is to update the system review of the workplace
Prevention and management of basic interventions for upper limb MSD (UEMSD.
We followed the system review process and adaptive best evidence synthesis developed by the Institute of Work and Health.
Six electronic databases (including January 2008-April 2013) were searched, resulting in 9909 non-
Duplicate references. 26 high-
Medium quality-
The quality studies related to our research questions, combined with 35 of the original reviews, combined evidence from 30 different intervention categories.
There is strong evidence that there is an intervention category, resistance training, which leads to the recommendation: the implementation of the workplace
An exercise program based on resistance training can help prevent and manage UEMSD and symptoms.
Synthesis also reveals moderate evidence of stretching items, mouse use feedback, and forearm support in preventing UEMSD or symptoms.
There is also moderate evidence that there is no benefit to EMG biofeedback, work stress management training, and office workstation adjustments for UEMSD and symptoms.
Messages were suggested for both these and other intervention categories.
Job introduction-
The associated skeletal diseases (MSDs) are a range of diseases of muscle, tendon, joint and nerve pain that may affect all parts of the body, although the neck, the most common part is the upper limb and the back.
Overall Work 1, 2-
The associated MSDs account for 29% of all work-related injuries in the United States.
2 MSDs account for 40% to 60% of losses in Canada
Time claim since 2000.
In Canada and the United States, upper limb MSDs (UEMSDs) and lower back pain are the main causes of work disability --
Related damage
In Europe, UEMSDs and lower back pain are considered to be an increasingly serious health problem, accounting for about 39% of occupational diseases.
Recent concerns and research have shown that MSDs is also considered an increasingly serious problem in the developing world.
7-12 work is estimated
The cost of related UEMSDs and lower back pain is between 0.
Accounting for 5% and 2% of eu gdp.
1 UEMSDs is an important reason for disability claims costs and productivity losses in many economic sectors around the world.
To sum up, UEMSDs is a popular and costly focus prevention campaign. The peer-
Reviewing the literature on workplace prevention, various interventions that have been implemented and evaluated are described.
However, few studies have shown a continuing positive impact on symptoms, claims and disability outcomes.
Overall, research and comments to date suggest that there is no \"magic bullet\" to cope with the huge burden of UEMSD.
18-23 thus, the systematic review has so far failed to provide strong guidance for practice.
Despite the lack of guidance from the literature, occupational health and safety practitioners have created workplaces --
Interventions based on training, knowledge and experience to reduce the burden on UEMSD.
Challenges to doing a good job
In design, rigorous evaluation is an obstacle to building a strong scientific evidence base needed to guide practice.
Poor implementation of interventions is not expected to lead to sustainable changes in the results of the study, another obstacle.
Kristensen26 calls this program failure and theoretical failure.
Implementation aspects of the workplace
The basic intervention explored30-33 reveals the importance of intervention intensity, implementation, and scientific rigor.
Kennedy et al found moderate evidence of ARM support in a previous review, as well as limited evidence of ergonomic training and workstation adjustments, new chairs and rest times.
The level of evidence of the intervention associated with \"no effect\" is: There is also strong evidence that the workstation adjustment itself has no effect;
Moderate evidence of ineffective feedback training and work stress management training;
There is limited evidence of no impact on cognitive behavior training.
The overall conclusion of the review was that it was not possible to advise practitioners on how to prevent or manage the UEMSDs.
Therefore, the research objective is to systematically review the literature and synthesize evidence on the effectiveness of the workplace
Intervention based on UEMSDs.
This is the first update from previous reviews.
23 stakeholders from Ontario, Canada have been involved repeatedly throughout the process, especially in improving the category of evidence synthesis and developing practical information based on synthesis to support evidence --based practice.
Methods systematic review followed six retrospective steps developed by the Institute of Work and Health for the prevention review of OHS: 34 (1) problem Development, (2) literature search, (3) relevance/inclusion screening, (4) quality assessment, (5) data extraction and (6) synthesis.
The review team was involved in all the review steps.
The team consists of 11 researchers from Canada, Europe and the United States who have expertise/experience in conducting MSD research or systematic reviews.
The IWH system review programme follows a comprehensive stakeholder engagement model during the review.
35 This leads to feedback from stakeholders throughout the review process.
In this review, the stakeholders are all from Ontario, including ergonomists, decision makers, labor, employers, business and disability management consultants.
The review team and stakeholders attended a meeting to discuss the review of updated research issues and proposed search terms.
The review team and stakeholders retain the original review questions and search terms for this update.
Six electronic databases were retrieved by literature retrieval: MEDLINE, EMBASE, cumulative index of nursing and related health literature (CINAHL), ohs ccinfo web Center, Canada, Cochrane Library, ergonomic summary from 2008 to April 2013.
These databases are selected based on the database that generated the reference in the original review and are still available.
Based on feedback from stakeholders, other databases have been added to the search.
The search strategy, guided by the initial review search, was designed to be inclusive and used terms in three broad areas: work setting terms, intervention terms, and health/claim results terms.
Combine the terms in the work settings and intervention categories using the Boolean OR operator, and then combine the three main categories using the Boolean and operator.
There is a big difference between search terms and database languages;
Search terms are therefore customized.
In most cases, search for the title, summary, or topic title of the keyword.
In addition to database search, a reference list of all papers selected for review was manually searched.
The team also contacted experts in the field and looked for pre-published references to ensure a full search.
References are loaded into commercially available review software (DistillerSR) and 36 are also used for all remaining review steps.
DistillerSR is an online application designed specifically for the screening, quality identification and data extraction phases of system review.
The relevance screening review team designed five screening criteria to exclude articles that were not related to our review questions: (1) Non-
Comments/edits in English;
(2) not studying in the working environment;
(3) no OHS intervention was evaluated;
(4) contrast groups are not used;
(5) the results of the study do not include Symptoms, signs, diseases, injuries, claims or loss of time of the upper extremity muscles and bones.
The review panel decided not
Based on English references with lower yields in previous reviews and other preventive reviews.
We noticed that
English articles are excluded due to other criteria in this review.
First, a reviewer screens the titles and summaries of the references.
In order to limit the possibility of deviation, the quality control (QC) steps were implemented.
The QC reviewers independently evaluated a set of 446 randomly selected titles and summaries (about 5% of the references came from the search ).
The response of the QC auditor was directly compared with the response of the audit team and 92 conflicts were found (20% ).
However, only 6 (1.
3%) the review team excluded references, and the quality control reviewers included conflicts of references.
The review team therefore believes that the screening of titles and summaries reflects the requirements for inclusion and exclusion. The small (1.
3%) the number of discrepancies indicates that reviewers have a similar understanding and application of screening criteria.
Second, the remaining full
Filter text articles using the same criteria, reviewed and agreed upon independently by two reviewers.
When consensus could not be reached, a third reviewer was consulted.
Third, relevant criteria were re-examined in each subsequent review step, and articles were excluded if consensus was reached between the two reviewers.
The quality evaluation has carried on the method quality evaluation to the related article.
Since this is a review update, 23 identical criteria and scoring algorithms are used.
The quality is assessed using 16 methodological criteria in the following broad headings: Design and objectives, recruitment levels, intervention features, intervention intensity, results, and analysis.
The method quality score for each article is based on the weighted sum score of 16 quality criteria (the highest score is 41 points ).
The weighted values assigned to 16 criteria range from \"a little important\" (1) to \"very important\" (3.
Each article gets a quality ranking score by dividing the weighted score by 41 and then multiplying it by 100.
Quality rankings are used to classify articles into three categories: high (> 85%), medium (50-85%), and low (
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