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工作场所干预措施在康复肌肉骨骼疾病和预防体力和久坐职业工人中其后果的有效性:系统评价方案。

Effectiveness of workplace interventions in rehabilitating musculoskeletal disorders and preventing its consequences among workers with physical and sedentary employment: systematic review protocol.

机构信息

National Research Centre for the Working Environment (NRCWE), Lersø parkallé 105, DK-2100, Copenhagen Ø, Denmark.

Sport Sciences, Department of Health Science and Technology, Aalborg University, DK-9220, Aalborg, Denmark.

出版信息

Syst Rev. 2019 Aug 27;8(1):219. doi: 10.1186/s13643-019-1127-0.

Abstract

BACKGROUND

Musculoskeletal disorders (MSDs) are the leading cause of work disability and sickness absence worldwide. The prevalence of MSDs increases with age, consequently challenging sustainable employability among the growing ageing workforce. Knowledge of feasible and efficient workplace-based interventions to rehabilitate MSD or prevent its consequences is therefore warranted. This systematic review will evaluate the effectiveness of workplace-based interventions on MSDs and its consequences among adult workers with physical and sedentary work tasks, respectively.

METHODS

We will search the following bibliographic databases: PubMed (including the database 'MEDLINE') and Web of Science Core Collection (including the databases 'Science Citation Index Expanded', 'Social Sciences Citation Index' and 'Arts & Humanities Citation Index'). Manual searches will also be performed. We will include randomised controlled trials (RCTs) and non-RCTs reported in English in which (1) participants are adult workers with MSD, (2) interventions are aiming at rehabilitating pain symptoms of MSD or preventing the consequences of MSD and (3) interventions are initiated and/or carried out at the workplace. The review will adhere to the 'Preferred Reporting Items for Systematic reviews and Meta-Analyses' (PRISMA) guidelines for reporting systematic reviews and the Institute for Work and Health (IWH) guidelines for workplace-based interventions. For the primary evaluation of the review, the quality assessment and evidence synthesis will conform to the IWH guidelines. Secondary evaluation will include a meta-analysis (unless the included studies do not allow this due to heterogeneity) and employ the risk of bias domains recommended by Cochrane along with the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach on the studies with pain intensity as an outcome.

DISCUSSION

This systematic review will provide knowledge on effective workplace-based interventions among physical and sedentary workers with MSD. RCTs are considered the most powerful experimental design in clinical trials, but solely including these may be too restrictive to understand effective workplace-based interventions where randomised and carefully controlled trials (RCTs) are not always possible. In order to maximize practical relevance, the selection process will, therefore, include both RCTs and non-RCTs and the quality assessment and evidence synthesis will conform to IWH guidelines focusing on developing practical guidelines for stakeholders. The result of this work will form the basis for industry-specific evidence-based recommendations on effective workplace-based interventions for rehabilitation of MSDs and its consequences that will later be operationalised into concrete and user-friendly practical tools for workplaces.

SYSTEMATIC REVIEW REGISTRATION

International Prospective Register of Systematic Reviews (PROSPERO) number CRD42018116752 .

摘要

背景

肌肉骨骼疾病(MSD)是全球导致工作残疾和病假的主要原因。随着年龄的增长,MSD 的患病率会增加,这对不断增长的老年劳动力的可持续就业能力构成了挑战。因此,有必要了解可行且有效的基于工作场所的干预措施,以康复 MSD 或预防其后果。本系统评价将分别评估针对有体力劳动和久坐工作任务的成年工人的基于工作场所的干预措施对 MSD 及其后果的有效性。

方法

我们将检索以下文献数据库:PubMed(包括数据库“MEDLINE”)和 Web of Science 核心合集(包括数据库“科学引文索引扩展”、“社会科学引文索引”和“艺术与人文引文索引”)。还将进行手动搜索。我们将纳入以英语报告的随机对照试验(RCT)和非 RCT,其中:(1)参与者为有 MSD 的成年工人;(2)干预措施旨在康复 MSD 的疼痛症状或预防 MSD 的后果;(3)干预措施在工作场所启动和/或实施。本综述将遵循“系统评价和荟萃分析的首选报告项目”(PRISMA)指南进行报告,并遵循工作场所健康研究所(IWH)指南进行基于工作场所的干预措施。对于综述的初步评估,质量评估和证据综合将符合 IWH 指南。次要评估将包括荟萃分析(除非由于异质性,纳入的研究不允许进行荟萃分析),并采用 Cochrane 推荐的偏倚风险领域以及对作为结局的疼痛强度的研究进行的推荐分级、评估、制定与评价(GRADE)方法。

讨论

本系统评价将提供针对有 MSD 的体力劳动和久坐工人的有效基于工作场所的干预措施方面的知识。RCT 被认为是临床试验中最有力的实验设计,但仅纳入这些研究可能过于局限,无法了解在无法进行随机和精心控制的试验(RCT)的情况下有效的基于工作场所的干预措施。为了最大限度地提高实际相关性,选择过程将同时包括 RCT 和非 RCT,质量评估和证据综合将符合 IWH 指南,重点是为利益相关者制定实用指南。这项工作的结果将为针对 MSD 康复及其后果的特定行业基于工作场所的干预措施提供循证建议奠定基础,这些建议随后将转化为针对工作场所的具体且易于使用的实用工具。

系统评价注册

国际前瞻性系统评价注册库(PROSPERO)编号 CRD42018116752。

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