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Meta-Analysis
. 2011 Apr 13;2011(4):CD008160.
doi: 10.1002/14651858.CD008160.pub2.

Workplace interventions for neck pain in workers

Randi Wågø Aas  1 , Hanne Tuntland, Kari Anne Holte, Cecilie Røe, Thomas Lund, Staffan Marklund, Anders Moller
Affiliations
Meta-Analysis

Workplace interventions for neck pain in workers

Randi Wågø Aas et al. Cochrane Database Syst Rev. .

Abstract

Background: Musculoskeletal disorders are the most common cause of disability in many industrial countries. Recurrent and chronic pain accounts for a substantial portion of workers' absenteeism. Neck pain seems to be more prominent in the general population than previously known.

Objectives: To determine the effectiveness of workplace interventions (WIs) in adult workers with neck pain.

Search strategy: We searched: CENTRAL (The Cochrane Library 2009, issue 3), and MEDLINE, EMBASE, CINAHL, PsycINFO, ISI Web of Science, OTseeker, PEDro to July 2009, with no language limitations;screened reference lists; and contacted experts in the field.

Selection criteria: We included randomised controlled trials (RCT), in which at least 50% of the participants had neck pain at baseline and received interventions conducted at the workplace.

Data collection and analysis: Two review authors independently extracted data and assessed risk of bias. Authors were contacted for missing information. Since the interventions varied to a large extend, International Classification of Functioning, Disability and Health (ICF) terminology was used to classify the intervention components. This heterogeneity restricted pooling of data to only one meta-analysis of two studies.

Main results: We identified 1995 references and included10 RCTs (2745 workers). Two studies were assessed with low risk of bias. Most trials (N = 8) examined office workers. Few workers were sick-listed. Thus, WIs were seldom designed to improve return-to-work. Overall, there was low quality evidence that showed no significant differences between WIs and no intervention for pain prevalence or severity. If present, significant results in favour of WIs were not sustained across follow-up times. There was moderate quality evidence (1 study, 415 workers) that a four-component WI was significantly more effective in reducing sick leave in the intermediate-term (OR 0.56, 95% CI 0.33 to 0.95), but not in the short- (OR 0.83, 95% CI 0.52 to 1.34) or long-term (OR 1.28, 95% CI 0.73 to 2.26). These findings might be because only a small proportion of the workers were sick-listed.

Authors' conclusions: Overall, this review found low quality evidence that neither supported nor refuted the benefits of any specific WI for pain relief and moderate quality evidence that a multiple-component intervention reduced sickness absence in the intermediate-term, which was not sustained over time. Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. There is an urgent need for high quality RCTs with well designed WIs.

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Conflict of interest statement

None known.

Figures

Figure 1
Figure 1
International Classification of functioning, disability and Health, ICF (WHO 2001). The model and definitions of the health and health‐related components in ICF
Figure 2
Figure 2
Methodological quality summary: review authors' judgements about each methodological quality item for each included study.
Figure 3
Figure 3
Forest plot of comparison: Four component workplace intervention versus no intervention. Intermediate‐term effect: Prevalence of musculoskeletal sick leave past 3 months
Figure 4
Figure 4
Forest plot of comparison: Two component workplace intervention versus no intervention. Short‐term effect. Outcome:Musculoskeletal discomfort in the neck (Arm: Intensive ergonomic).
Figure 5
Figure 5
Forest plot of comparison: Two component workplace intervention versus no intervention. Short‐term effect: Outcome: Musculoskeletal discomfort in the neck (Arm: Ergonomic education)
Figure 6
Figure 6
Forest plot of comparison: Physical environment modification versus another physical environment modification. Long‐term effect: Prevalence of discomfort in neck/shoulder (Computer screen angle, high vs. low line‐of‐sight)
Analysis 1.1
Analysis 1.1
Comparison 1 Four‐component workplace intervention versus no intervention, Outcome 1 Short‐term effect: Prevalence of neck pain.
Analysis 1.2
Analysis 1.2
Comparison 1 Four‐component workplace intervention versus no intervention, Outcome 2 Intermediate‐term effect: Prevalence of neck pain.
Analysis 1.3
Analysis 1.3
Comparison 1 Four‐component workplace intervention versus no intervention, Outcome 3 Long‐term effect: Prevalence of neck pain.
Analysis 1.4
Analysis 1.4
Comparison 1 Four‐component workplace intervention versus no intervention, Outcome 4 Short‐term effect: Prevalence of musculoskeletal sick leave past 3 months.
Analysis 1.5
Analysis 1.5
Comparison 1 Four‐component workplace intervention versus no intervention, Outcome 5 Intermediate‐term effect: Prevalence of musculoskeletal sick leave past 3 months.
Analysis 1.6
Analysis 1.6
Comparison 1 Four‐component workplace intervention versus no intervention, Outcome 6 Long‐term effect: Prevalence of musculoskeletal sick leave past 3 months.
Analysis 2.1
Analysis 2.1
Comparison 2 Three‐component workplace intervention versus no intervention, Outcome 1 Long‐term effect: Musculoskeletal discomfort (Arm: Operators with supervisors).
Analysis 2.2
Analysis 2.2
Comparison 2 Three‐component workplace intervention versus no intervention, Outcome 2 Long‐term effect: Musculoskeletal discomfort (Arm: Operators without supervisors).
Analysis 2.3
Analysis 2.3
Comparison 2 Three‐component workplace intervention versus no intervention, Outcome 3 Long‐term effect: Musculoskeletal discomfort (Arm: Managers only).
Analysis 3.1
Analysis 3.1
Comparison 3 Two‐component (mental education + physical health education, relaxation & breaks) workplace intervention versus no intervention, Outcome 1 Intermediate‐term: Current pain (Arm: Workstyle group).
Analysis 3.2
Analysis 3.2
Comparison 3 Two‐component (mental education + physical health education, relaxation & breaks) workplace intervention versus no intervention, Outcome 2 Intermediate‐term effect: Current pain (Arm: Workstyle+physical activity group).
Analysis 3.3
Analysis 3.3
Comparison 3 Two‐component (mental education + physical health education, relaxation & breaks) workplace intervention versus no intervention, Outcome 3 Intermediate‐term effect: Prevalence 0 month without symptoms (Arm: Workstyle group).
Analysis 3.4
Analysis 3.4
Comparison 3 Two‐component (mental education + physical health education, relaxation & breaks) workplace intervention versus no intervention, Outcome 4 Intermediate‐term effect: Prevalence 0 month without symptoms (Arm: Workstyle+physical activity group).
Analysis 3.5
Analysis 3.5
Comparison 3 Two‐component (mental education + physical health education, relaxation & breaks) workplace intervention versus no intervention, Outcome 5 Intermediate‐term effect: Prevalence 1‐2 months without symptoms (Arm: Workstyle group).
Analysis 3.6
Analysis 3.6
Comparison 3 Two‐component (mental education + physical health education, relaxation & breaks) workplace intervention versus no intervention, Outcome 6 Intermediate‐term effect: Prevalence 1‐2 months without symptoms (Arm: Workstyle+physical activity group).
Analysis 3.7
Analysis 3.7
Comparison 3 Two‐component (mental education + physical health education, relaxation & breaks) workplace intervention versus no intervention, Outcome 7 Intermediate‐term effect: Prevalence 3‐6 months without symptoms (Arm: Workstyle group).
Analysis 3.8
Analysis 3.8
Comparison 3 Two‐component (mental education + physical health education, relaxation & breaks) workplace intervention versus no intervention, Outcome 8 Intermediate‐term effect: Prevalence 3‐6 months without symptoms (Arm: Workstyle+physical activity group).
Analysis 3.9
Analysis 3.9
Comparison 3 Two‐component (mental education + physical health education, relaxation & breaks) workplace intervention versus no intervention, Outcome 9 Long‐term effect: Current pain (Arm: Workstyle group).
Analysis 3.10
Analysis 3.10
Comparison 3 Two‐component (mental education + physical health education, relaxation & breaks) workplace intervention versus no intervention, Outcome 10 Long‐term effect: Current pain (Arm: Workstyle+physical activity group).
Analysis 3.11
Analysis 3.11
Comparison 3 Two‐component (mental education + physical health education, relaxation & breaks) workplace intervention versus no intervention, Outcome 11 Long‐term effect: Prevalence 0 month without symptoms (Arm: Workstyle group).
Analysis 3.12
Analysis 3.12
Comparison 3 Two‐component (mental education + physical health education, relaxation & breaks) workplace intervention versus no intervention, Outcome 12 Long‐term effect: Prevalence 0 month without symptoms (Arm: Workstyle+physical activity group).
Analysis 3.13
Analysis 3.13
Comparison 3 Two‐component (mental education + physical health education, relaxation & breaks) workplace intervention versus no intervention, Outcome 13 Long‐term effect: Prevalence 1‐2 months without symptoms (Arm: Workstyle group).
Analysis 3.14
Analysis 3.14
Comparison 3 Two‐component (mental education + physical health education, relaxation & breaks) workplace intervention versus no intervention, Outcome 14 Long‐term effect: Prevalence 1‐2 months without symptoms (Arm: Workstyle+physical activity group).
Analysis 3.15
Analysis 3.15
Comparison 3 Two‐component (mental education + physical health education, relaxation & breaks) workplace intervention versus no intervention, Outcome 15 Long‐term effect: Prevalence 3‐6 months without symptoms (Arm: Workstyle group).
Analysis 3.16
Analysis 3.16
Comparison 3 Two‐component (mental education + physical health education, relaxation & breaks) workplace intervention versus no intervention, Outcome 16 Long‐term effect: Prevalence 3‐6 months without symptoms (Arm: Workstyle+physical activity group).
Analysis 4.1
Analysis 4.1
Comparison 4 Two‐component workplace intervention (physical health education, relaxation & breaks + physical environment modifications) versus no intervention, Outcome 1 Short‐term effect: Musculoskeletal discomfort in the neck (Arm: Intensive ergonomic).
Analysis 4.2
Analysis 4.2
Comparison 4 Two‐component workplace intervention (physical health education, relaxation & breaks + physical environment modifications) versus no intervention, Outcome 2 Short‐term effect: Musculoskeletal discomfort in the neck (Arm: Ergonomic education).
Analysis 4.3
Analysis 4.3
Comparison 4 Two‐component workplace intervention (physical health education, relaxation & breaks + physical environment modifications) versus no intervention, Outcome 3 Intermediate‐term effect: Musculoskeletal discomfort (Arm: Intensive ergonomics).
Analysis 4.4
Analysis 4.4
Comparison 4 Two‐component workplace intervention (physical health education, relaxation & breaks + physical environment modifications) versus no intervention, Outcome 4 Intermediate‐term effect: Musculoskeletal discomfort (Arm: Ergonomic education).
Analysis 5.1
Analysis 5.1
Comparison 5 Mental health education vs. no intervention, Outcome 1 Long‐term effect: Change in pain drawing neck/shoulder.
Analysis 5.2
Analysis 5.2
Comparison 5 Mental health education vs. no intervention, Outcome 2 Long‐term effect: Change in interference due to neck‐shoulder pain last month.
Analysis 6.1
Analysis 6.1
Comparison 6 Physical environment modification versus another physical environment modification, Outcome 1 Short‐term effect: Prevalence of neck pain (Downward‐tilted vs. flat keyboard in computer work).
Analysis 6.2
Analysis 6.2
Comparison 6 Physical environment modification versus another physical environment modification, Outcome 2 Long‐term effect: Prevalence of discomfort in neck/shoulder (Computer screen angle, high vs. low line‐of‐sight).
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References

References to studies included in this review

    1. Bernaards CM, Ariens GAM, Knol DL, Hildebrandt VH. The effectiveness of a work style intervention and a lifestyle physical activity intervention on the recovery from neck and upper limb symptoms in computer workers. Pain 2007;132:142‐53. - PubMed
    1. Fostervold KI, Aarås A, Lie I. Work with visual display units: Long‐term health effects of high and downward line‐of‐sight in ordinary office environments. International Journal of Industrial Ergonomics 2006;36:331‐43.
    1. Haukka E, Leino‐Arjas P, Viikari‐Juntura E, Takala EP, Malmivaara A, Hopsu L, et al. A randomised controlled trial on whether a participatory ergonomics intervention could prevent musculoskeletal disorders. Occupational and Environmental Medicine 2008;65:849‐56. - PubMed
    1. Hedge A, Morimoto S, McCrobie D. Effects of keyboard tray geometry on upper body posture and comfort. Ergonomics 1999;42(10):1333‐49. - PubMed
    1. Horneij E, Hernborg B, Jensen I, Ekdahl C. No significant differences between intervention programmes on neck, shoulder and low back pain: A prospective randomized study among home‐care personnel. J Rehabil Med 2001;33:170‐6. - PubMed

References to studies excluded from this review

    1. Aarås A, Ro O, Thorsen M. Can a More Neutral Position of the Forearm When Operating a Computer Mouse Reduce the Pain Level for Visial Display Unit Operators? A Prospective Epidemiological Intervention Study. International Journal of Human‐Computer Interaction 1999;11(2):79‐94.
    1. Arnetz BB, Sjögren B, Rydēhn B, Meisel R. Early workplace intervention for employees with musculoskeletal ‐related absenteeism: A prospective controlled intervention study. Journal of occupational and environmental medicine 2003;45(5):499‐506. - PubMed
    1. Borchgrevink GE, Kaasa AA, McDonagh D, Stiles TC, Haraldseth O, Lereim I. Acute treatment of whiplash neck sprain injuries. Spine 1998;23(1):25‐31. - PubMed
    1. Brisson C, Montreuil S, Punnett L. Effects of an ergonomic training program on workers with video display units. Scandinavian Journal of Work Environment and Health 1999;25(3):255‐63. - PubMed
    1. Bultmann U, Sherson D, Olsen J, Hansen CL, Lund T, Kilsgaard J. Coordinated and tailored work rehabilitation: a randomized controlled trial with economic evaluation undertaken with workers on sick leave due to musculoskeletal disorders. Journal of Occupational Rehabilitation 2009;19(1):81‐93. - PubMed

Additional references

    1. Aas RW, Elliningsen KL, Lindøe P, Moller A. Leadership qualities in the return to work process: A content analysis. Journal of Occupational Rehabilitation 2008;18(4):335‐46. - PubMed
    1. Aas RW. Fast return. Evidence‐based rehabilitation of sick listed [Raskt tilbake. Kunnskapsbasert rehabilitering av sykmeldte]. [Raskt tilbake. Kunnskapsbasert rehabilitering av sykmeldte] Norwegian. Oslo: Gyldendal Akademisk, 2009.
    1. Aas RW, Thingbø C, Holte KA, Lie K, Lode IA. On long term sick leave due to musculoskeletal diseases and disorders. Experiences of work demands. Work. A journal of Prevention, Assessment and Rehabilitation 2011;(In press). - PubMed
    1. Anema JR, Steenstra IA, Bongers PM, Vet HC, Knol DL, Loisel P, Mechelen W. Multidisiplinary rehabilitation for subacute low back pain: graded activity or workplace intervention or both? A randomized controlled trial. Spine 2007;32(3):291‐98. - PubMed
    1. Ariens GA, Mechelen W, Bongers PM, Bouter LM, Wal G. Physical risk factors for neck pain. Scand J Work Environ Health 2000;26(1):7‐19. - PubMed