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Physical ergonomic interventions may not prevent musculoskeletal disorders at workplace

04 Nov 2018

There appears to be inconsistent evidence regarding the use of an arm support or an alternative mouse at the workplace and its effect of the incidence of neck or shoulder musculoskeletal disorders (MSDs) among office workers, according to the results of a review and meta-analysis.

The meta-analysis included 15 randomized controlled trials (RCTs), representing 2,165 workers, evaluating the effects of physical and organisational ergonomic interventions, or combinations of those interventions for preventing work‐related upper limb and neck MSDs among office workers.

Physical ergonomic interventions included improving the equipment and environment of the workplace, whereas organisational ergonomic interventions consisted of allowing optimum workplace and rest time for the musculoskeletal system to recover from fatigue.

Pooled data revealed inconsistent evidence for arm supports and alternative computer mouse designs. Two studies with moderate‐quality evidence showed that an arm support with an alternative computer mouse cut the incidence of neck or shoulder MSDs (risk ratio [RR] 0.52; 95 percent CI, 0.27–0.99) but not the incidence of right upper limb MSDs (RR, 0.73; 0.32–1.66).

Additionally, such physical ergonomic interventions reduced discomfort in the neck or shoulder (standardised mean difference (SMD), −0.41; −0.69 to −0.12) and right upper limb (SMD, −0.34; −0.63 to −0.06), although the quality of evidence was low.

In two studies with moderate‐quality evidence, comparing an alternative computer mouse with a conventional mouse showed no considerable reduction in the incidence of neck or shoulder (RR, 0.62; 0.19–2.00) and right upper limb MSDs (RR, 0.91; 0.48–1.72). Similar results were obtained when evaluating an arm support plus a conventional mouse against a conventional mouse alone (neck or shoulder MSDs: RR, 0.91; 0.12–6.98; right upper limb: RR, 1.07; 0.58–1.96).

Workstation adjustment and sit‐stand desks did not produce significant benefits in terms of upper limb pain or discomfort compared with no intervention.

With respect to physical ergonomic interventions, supplementary breaks appeared to reduce discomfort of the neck (MD, −0.25; −0.40 to −0.11), right shoulder or upper arm (MD, −0.33; −0.46 to −0.19), and right forearm or wrist or hand (MD, –0.18; –0.29 to –0.08) among data entry workers in two studies with very low-quality evidence.

There was low to very low‐quality evidence that participatory and active training interventions in terms of preventing work‐related MSDs of the upper limb or neck or both. Multifaceted interventions showed no effect on any of the six upper limb pain outcomes investigated in one study with very low‐quality evidence.

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