Mansfield Michael, Thacker Michael, Smith Toby
School of Health and Social Care, Division of Allied Health Sciences, London South Bank University, London, UK.
Centre for Human and Aerospace Physiological Sciences, King's College London, London, UK.
Musculoskeletal Care. 2018 Mar;16(1):178-187. doi: 10.1002/msc.1204. Epub 2017 Jun 29.
Workers in various occupations often report work-related upper quadrant disorders (WRUQDs). Research has shown that associative factors for WRUQDs include psychosocial and environmental elements, gender and physical activity levels. To date, no review has investigated whether physical activity participation is associated with and/or predicts the development of WRUQDs, so the present study set out to determine this.
A systematic review was conducted including searches of PubMed (MEDLINE), EMBASE and CINAHL from inception to 31 March 2017. Quantitative studies, including any outcome measure of physical activity participation and its association with and/or prediction of WRUQDs, were included. One reviewer conducted the search and two reviewers independently assessed eligibility and completed methodological quality assessment using a modified Downs and Black checklist. Data were analysed narratively.
Eight studies were eligible for inclusion in the final review. The quality of these ranged from moderate to high quality. Three studies reported no statistical difference between physical activity participation and the risk of developing WRUQD. Three studies reported a negative and one study a positive association between physical activity participation and WRUQDs. One study reported that little or no physical exercise participation was a risk factor for WRUQD.
There is limited evidence for a negative association between physical activity participation and the development of WRUQDs. However, this was not a consistent finding across all studies included. Further research is indicated in standardizing diagnostic criteria and the measurement of physical activity participation in this patient population.
从事各种职业的工人经常报告与工作相关的上象限疾病（WRUQD）。研究表明，WRUQD的相关因素包括心理社会和环境因素、性别以及身体活动水平。迄今为止，尚无综述研究身体活动参与是否与WRUQD的发生相关及/或能否预测其发展，因此本研究旨在确定这一点。
进行了一项系统综述，包括检索自起始至2017年3月31日的PubMed（MEDLINE）、EMBASE和CINAHL数据库。纳入定量研究，包括身体活动参与的任何结果测量及其与WRUQD的关联及/或预测。由一名评审员进行检索，两名评审员独立评估纳入资格，并使用改良的唐斯和布莱克检查表完成方法学质量评估。对数据进行叙述性分析。
八项研究符合纳入最终综述的条件。这些研究的质量从中等到高质量不等。三项研究报告身体活动参与与发生WRUQD的风险之间无统计学差异。三项研究报告身体活动参与与WRUQD之间呈负相关，一项研究报告呈正相关。一项研究报告几乎不参与体育锻炼是WRUQD的一个风险因素。
身体活动参与与WRUQD发生之间存在负相关的证据有限。然而，这并非所有纳入研究的一致发现。需要进一步研究来规范该患者群体中身体活动参与的诊断标准和测量方法。
