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Volume:2 Issue:7 Number:363 ISSN#:2563-5476
Author Verified
RCT
ACE Report #195

A new intervention testing the prevention of repetitive strain injuries


How to Cite

OrthoEvidence. A new intervention testing the prevention of repetitive strain injuries. ACE Report. 2013;2(7):363. Available from: https://myorthoevidene.com/AceReport/Report/195

Study Type:Therapy
OE Level Evidence:2
Journal Level of Evidence:N/A

Effectiveness of a questionnaire based intervention programme on the prevalence of arm, shoulder and neck symptoms, risk factors and sick leave in computer workers: a cluster randomized controlled trial in an occupational setting

BMC Musculoskelet Disord. 2010 May 27;11:99

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Synopsis

1184 Computer workers from 7 Dutch organizations partook a health questionnaire were randomized to two groups, one receiving the feedback on their scores and a preventive advice and the other group continuing with the usual care. The effectiveness of the RSI QuickScan intervention program was found to be small and limited to a decrease in some risk factors exposures only, with no difference in the prevalence of symptoms or sick leave between the groups.

Publication Funding Details +
Funding:
Non-Industry funded
Sponsor:
Netherlands Organization for Health Research and Development (ZonMw) and the Foundation Arbo Unie Netherlands
Conflicts:
Company Employee

Risk of Bias

5.5/10

Reporting Criteria

18/21

Fragility Index

N/A

Was the allocation sequence adequately generated?

Was allocation adequately concealed?

Blinding Treatment Providers: Was knowledge of the allocated interventions adequately prevented?

Blinding Outcome Assessors: Was knowledge of the allocated interventions adequately prevented?

Blinding Patients: Was knowledge of the allocated interventions adequately prevented?

Was loss to follow-up (missing outcome data) infrequent?

Are reports of the study free of suggestion of selective outcome reporting?

Were outcomes objective, patient-important and assessed in a manner to limit bias (ie. duplicate assessors, Independent assessors)?

Was the sample size sufficiently large to assure a balance of prognosis and sufficiently large number of outcome events?

Was investigator expertise/experience with both treatment and control techniques likely the same (ie.were criteria for surgeon participation/expertise provided)?

Yes = 1

Uncertain = 0.5

Not Relevant = 0

No = 0

The Reporting Criteria Assessment evaluates the transparency with which authors report the methodological and trial characteristics of the trial within the publication. The assessment is divided into five categories which are presented below.

3/4

Randomization

2/4

Outcome Measurements

4/4

Inclusion / Exclusion

4/4

Therapy Description

5/5

Statistics

Detsky AS, Naylor CD, O'Rourke K, McGeer AJ, L'Abbé KA. J Clin Epidemiol. 1992;45:255-65

The Fragility Index is a tool that aids in the interpretation of significant findings, providing a measure of strength for a result. The Fragility Index represents the number of consecutive events that need to be added to a dichotomous outcome to make the finding no longer significant. A small number represents a weaker finding and a large number represents a stronger finding.

Why was this study needed now?

In 15 European countries, 25% of the working population was found to have neck/shoulder and arm pain and were shown to have a 31% reduction in the quality of life score. Several preventive measures and exercise programs have been suggested along with frequent breaks. However, there is a lack of evidence regarding the effectiveness of a prevention program. This study specifically look into the efficacy of a preventive program and specific advice on reduction of repetitive strain injuries.

What was the principal research question?

For computer workers, is a questionnaire-based prevention program followed by preventive advice effective in reducing the prevalence of arm, shoulder and neck symptoms or Repetitive Strain Injury (RSI)?

Study Characteristics -
Population:
1184 Computer workers (mean age 44.1 yr; 712M 472F) from 7 Dutch organizations
Intervention:
Intervention Group: Full feedback on their individual RSI QuickScan questionnaire results and a detailed advice on specific preventive actions to take (n=605; 334M 271F)
Comparison:
Usual Care Group: General and limited advice on actions to take after completing the RSI QuickScan (n=578; 378M 200F)
Outcomes:
Primary Outcome Measure: Prevalence of arm, shoulder, and neck symptoms; Secondary Outcome Measures: Scores on risk factors for arm, shoulder and neck symptoms and number of days of sick leave
Methods:
Prospective Clustered RCT
Time:
Baseline, 6 and 12 month follow up by RSI QuickScan questionnaire

What were the important findings?

  • At 12 months follow-up, the intervention and usual care group were not significantly different in the reduction of the prevalence of arm, shoulder, and neck symptoms.
  • The intervention group had a statistically significant improvement in terms of the scores, information, work posture and movement.
  • The intervention and usual care group were not significantly different in changes in the number of sick leave days.
  • Participants receiving the intervention were found to have increased awareness regarding prevention and hence were able to reduce exposure to adverse postures and movements (OR=0.478).

What should I remember most?

The RSI QuickScan intervention program was not effective in reducing the prevalence of arm, shoulder, and neck symptoms. However, participants who received the intervention were certainly found to have increased awareness due to education regarding prevention and hence were able to reduce exposure to adverse postures and movements.

How will this affect the care of my patients?

A newly-developed intervention program in Netherlands has not proved to be significantly effective in reducing the prevalence of repetitive strain injury in computer workers.

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