Newington Lisa, Ceh Daniel, Sandford Fiona, Parsons Vaughan, Madan Ira
Barts Bone and Joint Health, Blizard Institute, Queen Mary University of London, First Floor Abernethy Building, 2 Newark Street, London, E1 2AT, UK.
Hand Therapy, Barts Health NHS Trust, London, UK.
J Occup Rehabil. 2024 Dec 5. doi: 10.1007/s10926-024-10251-6.
To systematically identify and evaluate interventions to improve work participation for adults with upper limb musculoskeletal conditions, and explore contextual factors and mechanisms that suggest how the intervention is effective, for whom, and in what setting.
The review protocol was pre-registered with PROSPERO (CRD42023433216). Eligible studies met the following criteria. Population adults (aged ≥ 18 years), with musculoskeletal upper limb conditions including traumatic and non-traumatic presentations. Intervention strategies aimed at enhancing work participation. Outcomes measures including return to work, increased work duties or hours, and work functioning. Study design randomised and non-randomised experimental studies, mixed methods, qualitative studies, and case series. Two reviewers independently screened, extracted data, and completed quality appraisal. Interventions were described using TIDieR and the data presented as a narrative synthesis.
Twenty-two studies were included. Interventions were categorised into three groups: multimodal or multidisciplinary (n = 13), ergonomic (n = 4), and exercise (n = 5). Eight interventions were primarily delivered in the workplace and 14 in healthcare settings. Four outcome domains were reported: return to work (n = 18), self-reported work function (n = 4), work productivity (n = 5), and work-related costs (n = 2). Only exercise interventions showed consistent statistically significant benefits. Heterogeneity in outcomes prevented formal meta-analysis. Only five studies were rated as high quality.
There is insufficient evidence to recommend specific work participation interventions for adults with upper limb musculoskeletal systems. No studies explored the impact of Fit Notes or other formal work guidance documentation.
系统识别和评估旨在改善上肢肌肉骨骼疾病成人工作参与度的干预措施，并探讨相关背景因素和机制，以揭示干预措施对何人、在何种环境下有效以及如何发挥作用。
该综述方案已在PROSPERO（CRD42023433216）上预先注册。符合条件的研究需满足以下标准。研究对象为患有包括创伤性和非创伤性表现的上肢肌肉骨骼疾病的成年人（年龄≥18岁）。干预策略旨在提高工作参与度。结局指标包括重返工作岗位、工作职责或工作时长增加以及工作功能。研究设计包括随机和非随机实验研究、混合方法研究、定性研究以及病例系列研究。两名评审员独立进行筛选、提取数据并完成质量评估。干预措施使用TIDieR进行描述，数据以叙述性综合的形式呈现。
纳入了22项研究。干预措施分为三组：多模式或多学科组（n = 13）、人体工程学组（n = 4）和运动组（n = 5）。八项干预措施主要在工作场所实施，14项在医疗环境中实施。报告了四个结局领域：重返工作岗位（n = 18）、自我报告的工作功能（n = 4）、工作效率（n = 5）和与工作相关的成本（n = 2）。只有运动干预措施显示出一致的统计学显著益处。结局的异质性妨碍了正式的荟萃分析。只有五项研究被评为高质量。
没有足够的证据推荐针对上肢肌肉骨骼系统成人的特定工作参与干预措施。没有研究探讨健康证明或其他正式工作指导文件的影响。
