Ergonomic design and training for preventing work-related musculoskeletal disorders of the upper limb and neck in adults

Abstract

Background Work-related upper limb and neck musculoskeletal disorders (MSDs) are one of the most common occupational disorders around the world. Although ergonomic design and training are likely to reduce the risk of workers developing work-related upper limb and neck MSDs, the evidence is unclear. Objectives To assess the effects of workplace ergonomic design or training interventions, or both, for the prevention of work-related upper limb and neck MSDs in adults. Search methods We searched MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), CINAHL, AMED, Web of Science (Science Citation Index), SPORTDiscus, Cochrane Occupational Safety and Health Review Group Database and Cochrane Bone, Joint and Muscle Trauma Group Specialised Register to July 2010, and Physiotherapy Evidence Database, US Centers for Disease Control and Prevention, the National Institute for Occupational Safety and Health database, and International Occupational Safety and Health Information Centre database to November 2010. Selection criteria We included randomised controlled trials (RCTs) of ergonomic workplace interventions for preventing work-related upper limb and neck MSDs. We included only studies with a baseline prevalence of MSDs of the upper limb or neck, or both, of less than 25%. Data collection and analysis Two review authors independently extracted data and assessed risk of bias. We included studies with relevant data that we judged to be sufficiently homogeneous regarding the intervention and outcome in the meta-analysis. We assessed the overall quality of the evidence for each comparison using the GRADE approach. Main results We included 13 RCTS (2397 workers). Eleven studies were conducted in an office environemtn and two in a healthcare setting. judged one study to have a low risk of bias. The 13 studies evaluated effectiveness of ergonomic equipment, supplementary breaks reduced work hours, erogonomic training a combination of ergonomic training and equipment, and patient lifting interventions preventing work-related MSDs of the upper limb and neck in adults. Overall, there was moderate-quality evidence that arm support with alternative mouse reduced the incidence of neck/shoulder disorder (risk ration (RR) 0.52; 95% confidence interval (CI) 0.27 to 0.99) but not the incidence of right upper limb MSDs (RR 0.73 95% CI 0.33 to 1.66); and low-quality evidence that this intervention reduced neck/shoulder discomfort (standardised mean difference (SMD -0.41; 95% CI -0.69 to -0.12) and right upper limb discomfort (SMD -0.34; 95% CI -0.63 to -0.06). There was also moderate-quality evidence that the incidence of neck\shoulder and right upper limb disorders were not reduced when comparing alternative mouse and conventional mouse (neck/shoulder RR 0.62; 95% CI 0.19 to 200 right upper limb RR 0.91; 95% CI 0.48 to 1.72) arm support and no arm suport with conventional mouse (necl/shoulder Rr 0.67; 95% CI 0.36 to 1.24). Authors' conclusion We found moderate-quality evidence to suggest that the use of arm support with alternative mouse may reduce the incidence of neck/shoulder MSDs, but not right upper limb MSDs. Morever, we found moderate-qualithy evidence to suggest that the incidence . This review highlights the need for high-quality RCTs examining the prevention MSDs of the upper limb and neck.