Elders L A, van der Beek A J, Burdorf A
Department of Public Health, Erasmus University Rotterdam, The Netherlands.
Int Arch Occup Environ Health. 2000 Jul;73(5):339-48. doi: 10.1007/s004200000127.
The aim was to review the literature with regard to the effectiveness of intervention programmes for the prevention of aggravation of back disorders or prolonged duration of sickness absence.
A systematic search of the literature was performed using three groups of key words and inclusion/exclusion criteria. Effectiveness was evaluated using two measures: the difference between intervention and referent groups in return to work, and the fraction of sickness absence among referent groups that could be prevented if these referents had undergone the same intervention (preventable fraction).
Twelve articles with quantitative information on the effect of ergonomic interventions on return to work were included. In eight studies, introduction of a back-school programme was the preferred intervention, combining exercise and functional conditioning, and training in working methods and lifting techniques. In seven out of eight back-school studies, return to work was significantly better in the intervention group. Intervention after 60 days, in the subacute phase of back pain, showed the most promising results. In these studies the preventable fraction varied between -11% and 80%, largely depending on the stage and phase of back disorders and the time of follow-up. The success of intervention also depended on the profile of the referents when left untampered. In all studies compliance during the intervention was fairly good, but there was a lack of information on sustainability of the intervention during the follow-up and on recurrence of back complaints and consequent sickness absence.
Few studies were performed to assess the outcome return to work after ergonomic intervention. However, there is evidence that intervention in the subacute phase of back pain is preferable. Future intervention studies should address intervention sustainability and recurrence of sickness absence due to back pain over at least a 1-year follow-up period.
旨在回顾关于预防背部疾病加重或病假持续时间延长的干预计划有效性的文献。
使用三组关键词和纳入/排除标准对文献进行系统检索。有效性通过两种指标进行评估：干预组与对照组在重返工作方面的差异，以及如果对照组接受相同干预可预防的病假比例（可预防比例）。
纳入了12篇关于人体工程学干预对重返工作影响的定量信息文章。在8项研究中，引入背部学校计划是首选干预措施，该计划结合了运动和功能训练，以及工作方法和搬运技术培训。在8项背部学校研究中的7项中，干预组的重返工作情况明显更好。在背痛亚急性期60天后进行干预显示出最有希望的结果。在这些研究中，可预防比例在-11%至80%之间变化，很大程度上取决于背部疾病的阶段和时期以及随访时间。干预的成功还取决于对照组未受干预时的情况。在所有研究中，干预期间的依从性相当好，但缺乏关于随访期间干预可持续性以及背部疼痛复发和随之而来的病假情况的信息。
很少有研究评估人体工程学干预后重返工作的结果。然而，有证据表明在背痛亚急性期进行干预更可取。未来的干预研究应至少在1年的随访期内关注干预的可持续性以及因背痛导致的病假复发情况。
