Hou Wen-Hsuan, Chi Ching-Chi, Lo Heng-Lien, Chou Yun-Yun, Kuo Ken N, Chuang Hung-Yi
School of Gerontology Health Management and Master Program in Long-Term Care, College of Nursing, Taipei Medical University, No. 250 Wuxing Street, Taipei, Taiwan, 11031.
Cochrane Database Syst Rev. 2017 Dec 6;12(12):CD010002. doi: 10.1002/14651858.CD010002.pub3.
Traumatic upper limb injury is a leading cause of work-related disability. After return-to-work (RTW), many survivors of injuries are able to regain a quality of life (QoL) comparable with the normal population. Since RTW plays an important role in economic productivity and regaining health-related QoL, enhancing RTW in workers with traumatic limb injuries is the primary goal of rehabilitation. Vocational rehabilitation has been commonly employed in the field of occupational safety and health to increase the number of injured people returning to the labour market, prevent illness, increase well-being, and reduce disability.
To assess the effects of vocational rehabilitation programmes for enhancing RTW in workers with traumatic upper limb injuries.
This is an update of a Cochrane review previously published in 2013. We updated our searches of the following databases: the Cochrane Central Register of Controlled Trials (CENTRAL; 2017, Issue 9), MEDLINE (to 30 August 2017), EMBASE (to 3 September 2017), CINAHL (to 6 September 2017), and PsycINFO (to 6 September 2017), and we handsearched the references lists of relevant review articles.
We aimed to include all randomised controlled trials (RCTs) comparing vocational rehabilitation with an alternative (control) intervention such as standard rehabilitation, a limited form of the vocational rehabilitation intervention (such as advice on RTW, referral information, or liaison with employer), or waiting-list controls.
Two authors independently inspected abstracts, and we obtained full papers when necessary. When the two authors disagreed about the inclusion of a study, we resolved disagreements by discussion. A third author arbitrated when necessary.
Our updated search identified 466 citations. Based on assessments of their titles and abstracts, we decided to evaluate the full texts of five records; however, none met our inclusion criteria.
AUTHORS' CONCLUSIONS: There is currently no high-quality evidence to support or refute the efficacy of vocational rehabilitation for enhancing RTW in workers with traumatic upper limb injuries. Since injured people in occupational settings frequently receive vocational rehabilitation with the aim of decreasing work disability, enhancing RTW, increasing productivity, and containing the welfare cost, further high-quality RCTs assessing the efficacy of vocational rehabilitation for workers with traumatic upper limb injury are needed to fill this gap in knowledge.
创伤性上肢损伤是导致与工作相关残疾的主要原因。重返工作岗位（RTW）后，许多受伤幸存者能够恢复与正常人群相当的生活质量（QoL）。由于重返工作岗位在经济生产力和恢复与健康相关的生活质量方面发挥着重要作用，因此提高创伤性肢体损伤工人的重返工作岗位率是康复的主要目标。职业康复已在职业安全与健康领域普遍应用，以增加受伤人员重返劳动力市场的数量、预防疾病、提高幸福感并减少残疾。
评估职业康复计划对提高创伤性上肢损伤工人重返工作岗位率的效果。
这是对2013年发表的Cochrane系统评价的更新。我们更新了对以下数据库的检索：Cochrane对照试验中心注册库（CENTRAL；2017年第9期）、MEDLINE（截至2017年8月30日）、EMBASE（截至2017年9月3日）、CINAHL（截至2017年9月6日）和PsycINFO（截至2017年9月6日），并手工检索了相关综述文章的参考文献列表。
我们旨在纳入所有比较职业康复与替代（对照）干预措施的随机对照试验（RCT），如标准康复、有限形式的职业康复干预（如关于重返工作岗位的建议、转诊信息或与雇主的联络）或等待名单对照。
两位作者独立检查摘要，必要时获取全文。当两位作者对一项研究的纳入存在分歧时，我们通过讨论解决分歧。必要时由第三位作者进行仲裁。
我们更新后的检索共识别出466条引文。根据对其标题和摘要的评估，我们决定评估5条记录的全文；然而，没有一条符合我们的纳入标准。
目前没有高质量证据支持或反驳职业康复对提高创伤性上肢损伤工人重返工作岗位率的疗效。由于职业环境中的受伤人员经常接受职业康复，目的是减少工作残疾、提高重返工作岗位率、提高生产力并控制福利成本，因此需要进一步开展高质量的随机对照试验来评估职业康复对创伤性上肢损伤工人的疗效，以填补这一知识空白。
