Associated Graduate Program in Physical Education UPE/UFPB, Recife, Brazil.
Department of Physical Therapy, University of Pernambuco, Petrolina, Brazil.
J Occup Rehabil. 2021 Jun;31(2):243-262. doi: 10.1007/s10926-020-09927-6. Epub 2020 Oct 2.
The main objective of this study is to update the evidence related to the effectiveness of exercise and ergonomic interventions in the perception of shoulder pain intensity in workers considering the shoulder pain intensity and the minimum clinically important change in the analysis. The bibliographic search was conducted in seven databases (Cochrane, EMBASE, SciELO, PubMed, PEDro, Web of Science and Scopus) from March to April 2019. The study selection included randomized controlled trials (RCTs) involving workers with shoulder pain who underwent physical exercises, ergonomics, and combined interventions. To analyze the RCTs, the intensity of pain was divided into two subgroups < 3 and ≥ 3 (0-10 points scale). A total of 27 RCTs were included in the qualitative synthesis considering the perception scales of shoulder pain intensity and the PEDro scale score of assessment of RCTs quality and risk of bias. Within these, seven RCTs were included in the quantitative synthesis. The overall effectiveness of interventions was calculated using a meta-analysis method, and the associated measurement used as a mean difference. The meta-analysis revealed that exercise interventions in workers with shoulder pain > 3 presented a minimally clincially important difference (MCID), but with no difference in workers with pain < 3. The interventions with exercise in workers with pain ≥ 3 at baseline reported a beneficial effect in reducing shoulder pain intensity, and a MCID. However, there was no significant difference for workers with pain < 3 and the effects of ergonomic interventions are still uncertain to reduce shoulder pain in workers.
本研究的主要目的是更新与运动和工效学干预在考虑肩部疼痛强度和分析中的最小临床重要变化的情况下对工人肩部疼痛强度的感知效果相关的证据。文献检索于 2019 年 3 月至 4 月在七个数据库（Cochrane、EMBASE、SciELO、PubMed、PEDro、Web of Science 和 Scopus）进行。研究选择包括接受物理运动、工效学和联合干预的患有肩部疼痛的工人的随机对照试验（RCT）。为了分析 RCT，疼痛强度分为两个亚组<3 和≥3（0-10 分量表）。共有 27 项 RCT 纳入定性综合分析，考虑了肩部疼痛强度的感知量表和 RCT 质量评估的 PEDro 量表评分以及偏倚风险。其中，有 7 项 RCT 纳入定量综合分析。使用荟萃分析方法计算干预措施的总体效果，使用平均值差异作为相关测量值。荟萃分析表明，患有肩部疼痛>3 的工人的运动干预具有最小临床重要差异（MCID），但患有疼痛<3 的工人则没有差异。在基线时患有疼痛≥3 的工人中，运动干预报告说可以减轻肩部疼痛强度和 MCID。但是，对于疼痛<3 的工人，干预效果没有显著差异，并且工效学干预对减轻工人肩部疼痛的效果仍不确定。
