Postupci na radnom mjestu za bol u vratu radnika
Abstract
Background
Musculoskeletal disorders are the most common cause of disability in many industrial countries. Recurrent and chronic pain accounts for a substantial portion of workers' absenteeism. Neck pain seems to be more prominent in the general population than previously known.
Objectives
To determine the effectiveness of workplace interventions (WIs) in adult workers with neck pain.
Search methods
We searched: CENTRAL (The Cochrane Library 2009, issue 3), and MEDLINE, EMBASE, CINAHL, PsycINFO, ISI Web of Science, OTseeker, PEDro to July 2009, with no language limitations;screened reference lists; and contacted experts in the field.
Selection criteria
We included randomised controlled trials (RCT), in which at least 50% of the participants had neck pain at baseline and received interventions conducted at the workplace.
Data collection and analysis
Two review authors independently extracted data and assessed risk of bias. Authors were contacted for missing information. Since the interventions varied to a large extend, International Classification of Functioning, Disability and Health (ICF) terminology was used to classify the intervention components. This heterogeneity restricted pooling of data to only one meta‐analysis of two studies.
Main results
We identified 1995 references and included10 RCTs (2745 workers). Two studies were assessed with low risk of bias. Most trials (N = 8) examined office workers. Few workers were sick‐listed. Thus, WIs were seldom designed to improve return‐to‐work. Overall, there was low quality evidence that showed no significant differences between WIs and no intervention for pain prevalence or severity. If present, significant results in favour of WIs were not sustained across follow‐up times. There was moderate quality evidence (1 study, 415 workers) that a four‐component WI was significantly more effective in reducing sick leave in the intermediate‐term (OR 0.56, 95% CI 0.33 to 0.95), but not in the short‐ (OR 0.83, 95% CI 0.52 to 1.34) or long‐term (OR 1.28, 95% CI 0.73 to 2.26). These findings might be because only a small proportion of the workers were sick‐listed.
Authors' conclusions
Overall, this review found low quality evidence that neither supported nor refuted the benefits of any specific WI for pain relief and moderate quality evidence that a multiple‐component intervention reduced sickness absence in the intermediate‐term, which was not sustained over time. Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. There is an urgent need for high quality RCTs with well designed WIs.
Laički sažetak
Postupci na radnom mjestu za bol u vratu radnika
Istraživanja su pokazala da su mišićno‐koštani poremećaji najčešći uzrok bolovanja i invalidnosti u mnogim industrijskim zemljama. Bol u vratu je češća u općoj populaciji nego što se ranije znalo. Ovaj Cochrane pregled predstavlja podatke iz istraživanja o utjecaju intervencija na radnom mjestu za radnike s bolovima u vratu kojima većinom nije još bila postavljena nikakva dijagnoza bolesti.
U ovaj Cochrane sustavni pregled literature uključeno je deset ispitivanja s 2745 sudionika. Dvije studije su ocijenjene s niskim rizikom od pristranosti. Intervencije na radnom mjestu su se sastojale od edukacije o kontroli stresa, načelima ergonomije, anatomiji, mišićno‐koštanim poremećajima, kao i važnosti tjelesne aktivnosti. Sudionici su educirani za provođenje vježbi tijekom pauza na poslu, zauzimanje opuštenog položaja tijela, ispravan položaj tijela, važnost pauza i odmaranja te načina za opuštanje. Neke studije su također uključile intervencije poput informiranja o tome kako promijeniti radne zadatke kako bi se izbjegla bol u vratu, radno opterećenje, tehniku rada, radna mjesta i radno vrijeme. Nekoliko studija je sugeriralo kako napraviti prilagodbe i dali su preporuke za druge vrste namještaja i opreme na radnom mjestu.
Ovaj pregled je pronašao dokaze niske kvalitete koji pokazuju da ispitanici koji su primili intervencije na radnom mjestu nisu osjećali manju bol od onih koji nisu primili nikakve intervencije. Pronađeni su dokazi umjerene kvalitete (1 ispitivanje, 415 radnika) da su intervencije na radnom mjestu smanjile broj bolovanja među radnicima nakon 6 mjeseci praćenja, ali ne i nakon 3 i 12 mjeseci praćenja. To bi moglo biti zbog toga što je mali broj sudionika u studiji imao dijagnozu bolesti. Daljnja istraživanja će vrlo vjerojatno imati značajan utjecaj na naše povjerenje u procjenu učinka te će vjerojatno promijeniti procjenu i za bol i bolovanja.
