Risk factors for neck and upper extremity disorders among computers users and the effect of interventions: an overview of systematic reviews

Abstract

Background: To summarize systematic reviews that 1) assessed the evidence for causal relationships between computer work and the occurrence of carpal tunnel syndrome (CTS) or upper extremity musculoskeletal disorders (UEMSDs), or 2) reported on intervention studies among computer users/or office workers.

Methodology/principal findings: PubMed, Embase, CINAHL and Web of Science were searched for reviews published between 1999 and 2010. Additional publications were provided by content area experts. The primary author extracted all data using a purpose-built form, while two of the authors evaluated the quality of the reviews using recommended standard criteria from AMSTAR; disagreements were resolved by discussion. The quality of evidence syntheses in the included reviews was assessed qualitatively for each outcome and for the interventions. Altogether, 1,349 review titles were identified, 47 reviews were retrieved for full text relevance assessment, and 17 reviews were finally included as being relevant and of sufficient quality. The degrees of focus and rigorousness of these 17 reviews were highly variable. Three reviews on risk factors for carpal tunnel syndrome were rated moderate to high quality, 8 reviews on risk factors for UEMSDs ranged from low to moderate/high quality, and 6 reviews on intervention studies were of moderate to high quality. The quality of the evidence for computer use as a risk factor for CTS was insufficient, while the evidence for computer use and UEMSDs was moderate regarding pain complaints and limited for specific musculoskeletal disorders. From the reviews on intervention studies no strong evidence based recommendations could be given.

Conclusions/significance: Computer use is associated with pain complaints, but it is still not very clear if this association is causal. The evidence for specific disorders or diseases is limited. No effective interventions have yet been documented.

Figure 1. Flow of Included Studies.

Figure 2. Overlap of original papers included in reviews from 2004 to 2006 of risk factors for Upper Extremity Musculoskeletal Disorders (UEMSDs).

Numbers and percentages inside the ellipses show the overlap of the original studies included in the four reviews. Percentages outside the ellipses illustrate the percentage of all 61 original studies included in each of the four reviews , , , .

Figure 3. Overlap of original papers included in reviews from 2006 to 2010 of risk factors for Upper Extremity Musculoskeletal Disorders (UEMSDs).

Numbers and percentages inside the ellipses show the overlap of the original studies included in the four reviews. Percentages outside the ellipses illustrate the percentage of all 68 original studies included in each of the four reviews , , , .

Figure 4. Overlap of original papers on intervention studies among office workers included in reviews from 2006 to 2007.

Numbers and percentages inside the circles show the overlap of the original studies included in the four reviews. Percentages outside the circles illustrate the percentage of all 33 original studies included in each of the four reviews , , .

Figure 5. Overlap of original papers on intervention studies among office workers included in reviews from 2009 to 2010.

Numbers and percentages inside the circles show the overlap of the original studies included in the four reviews. Percentages outside the circles illustrate the percentage of all 47 original studies included in each of the four reviews , , .