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监督运动疗法比非监督自我保健更能减轻肌肉骨骼疼痛患者的出勤主义:系统评价和荟萃分析。

Supervised Exercise Therapy Reduces Presenteeism to Greater Extent Than Unsupervised Self-Care in Workers with Musculoskeletal Pain: a Systematic Review and Meta-Analysis.

机构信息

Department of Physical Therapy, Saitama Prefectural University, Koshigaya, Saitama, 343-8540, Japan.

Department of Rehabilitation, Maruyama Orthopedic Hospital, Sapporo, Japan.

出版信息

J Occup Rehabil. 2024 Jun;34(2):387-397. doi: 10.1007/s10926-023-10137-z. Epub 2023 Oct 6.

Abstract

PURPOSE

Presenteeism is defined as the loss of work productivity due to health issues in workers, which can be measured subjectively. This study aimed to compare the effectiveness of supervised exercise therapy and unsupervised self-care in reducing presenteeism in workers with musculoskeletal disorders.

METHODS

PubMed, Embase, and Cochrane Library were searched for various keywords from their inception to January 2023. Two examiners independently assessed the eligibility of studies: (1) studies involving workers suffering from musculoskeletal pain, (2) those involving supervised exercise therapy intervention with interactive communication, and (3) those in which the comparison group was subjected to interventions other than supervised exercise therapy, and (4) those including patient-reported outcome measures of presenteeism or work productivity or ability. Standardized mean differences (SMD) were calculated using a random effects model, with higher scores indicating reduced presenteeism in the intervention group compared with that in the comparison group. The GRADE assesses the overall certainty of the evidence.

RESULTS

Only the short-term effects of interventions on presenteeism could be obtained using four studies. The intervention group showed statistically significant short-term effects on presenteeism compared with the comparison group (p < 0.001; SMD, 0.52; 95% confidence interval, 0.27-0.77). The GRADE score was downgraded by two levels from high to low due to concerns for indirectness.

CONCLUSIONS

Although the certainty of the evidence was low, it was assumed that supervised exercise therapy was more effective than unsupervised self-care in reducing presenteeism in workers with musculoskeletal disorders.

摘要

目的

Presenteeism 是指由于工人的健康问题导致工作生产力下降,这可以主观衡量。本研究旨在比较监督运动疗法和非监督自我保健在减少肌肉骨骼疾病工人的 Presenteeism 方面的效果。

方法

从成立到 2023 年 1 月,在 PubMed、Embase 和 Cochrane 图书馆中使用各种关键字进行搜索。两名审查员独立评估研究的资格:(1)涉及患有肌肉骨骼疼痛的工人的研究,(2)涉及有互动交流的监督运动疗法干预的研究,以及(3)比较组接受除监督运动疗法以外的干预的研究,以及(4)包括患者报告的 Presenteeism 或工作生产力或能力的结果测量的研究。使用随机效应模型计算标准化均数差异(SMD),得分越高表示干预组的 Presenteeism 比对照组减少。GRADE 评估证据的总体确定性。

结果

仅使用四项研究获得了干预对 Presenteeism 的短期影响。与对照组相比,干预组在短期对 Presenteeism 显示出统计学上显著的效果(p<0.001;SMD,0.52;95%置信区间,0.27-0.77)。由于对间接性的担忧,GRADE 评分从高降低到低两个等级。

结论

尽管证据的确定性较低,但可以假设监督运动疗法在减少肌肉骨骼疾病工人的 Presenteeism 方面比非监督自我保健更有效。

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