Intervensi di tempat kerja untuk sakit leher dalam kalangan pekerja
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.
Ringkasan bahasa mudah
Intervensi di tempat kerja untuk sakit leher dalam kalangan pekerja
Kajian telah menunjukkan bahawa gangguan otot‐rangka adalah punca cuti sakit dan ketidakupayaan yang paling kerap di negara‐negara perindustrian. Sakit leher adalah lebih kerap dalam masyarakat umum berbanding apa yang diketahui sebelum ini. Kajian Cochrane ini membentangkan maklumat yang diketahui dari kajian intervensi di tempat kerja bagi pekerja yang mengalami sakit leher yang sebahagian besarnya, tidak disenaraikan sebagai sakit.
Sepuluh kajian melibatkan 2745 peserta telah dimasukkan ke dalam ulasan ini. Dua kajian dinilai sebagai berisiko bias rendah. Intervensi di tempat kerja terdiri daripada pendidikan mengenai pengurusan tekanan, prinsip‐prinsip ergonomik, anatomi, gangguan otot‐rangka dan kepentingan aktiviti fizikal. Mereka diajar tentang "pause gymnastics", bagaimana untuk menggunakan postur bekerja yang betul, posisi yang sesuai, kepentingan rehat seketika dan strategi‐strategi untuk memperbaiki relaksasi. Beberapa kajian juga memasukkan cara untuk mengubahsuai tugas, beban kerja, teknik‐teknik bekerja, posisi kerja dan waktu bekerja. Beberapa kajian mencadangkan bagaimana membuat penyelarasan dan syor alternatif kepada susunatur perabot dan peralatan sedia ada di tempat kerja.
Ulasan ini mendapati bukti berkualiti rendah bahawa orang‐orang yang menerima intervensi di tempat kerja tidak mendapat kelegaan sakit lebih banyak daripada orang‐orang yang tidak menerima intervensi. Kami mendapati bukti berkualiti sederhana (1 kajian, 415 pekerja) bahawa intervensi di tempat kerja mengurangkan cuti sakit dalam kalangan pekerja dalam tempoh enam bulan, tetapi tidak pada temujanji susulan pada bulan ketiga dan 12. Ini mungkin disebabkan oleh beberapa peserta dalam kajian ini telah pun dimasukkan dalam senarai sakit. Penyelidikan lanjutan mungkin ada impak dalam keyakinan kami menbuat anggaran kesan intervensi dan mungkin mengubah anggaran untuk kedua‐dua sakit dan cuti sakit.
