title: Exercise proves effective in a systematic review of work-related complaints of the arm, neck, or shoulder.
abstract: OBJECTIVE
  Interventions such as physiotherapy and ergonomic adjustments play a major role in the treatment of most work-related complaints of the arm, neck, and/or shoulder (CANS). We evaluated whether conservative interventions have a significant impact on outcomes for work-related CANS.
  
  
  METHODS
  A systematic review was conducted. Only (randomized) trials studying interventions for patients suffering from work-related CANS were included. Interventions may include exercises, relaxation, physical applications, and workplace adjustments. Two authors independently selected the trials, assessed methodological quality, and extracted data.
  
  
  RESULTS
  We included 26 studies (in total 2,376 patients); 23 studies included patients with chronic nonspecific complaints. Over 30 interventions were evaluated and 7 main subgroups of interventions could be determined, of which the subgroup "exercises" was the largest one. Overall, the quality of the studies appeared to be poor.
  
  
  CONCLUSIONS
  There is limited evidence for the effectiveness of exercises when compared to massage, adding breaks during computer work, massage as add-on treatment to manual therapy, manual therapy as add-on treatment to exercises, and some keyboards in people with carpal tunnel syndrome when compared to other keyboards or placebo. For other interventions no clear effectiveness could be demonstrated.
authors.affiliation: Department of General Practice, Erasmus Medical Centre, Rotterdam, The Netherlands. a.verhagen@erasmusmc.nl
authors.forename: Arianne P
authors.initials: AP
authors.lastname: Verhagen
authors.forename: Celinde
authors.initials: C
authors.lastname: Karels
authors.forename: Sita M A
authors.initials: SM
authors.lastname: Bierma-Zeinstra
authors.forename: Anita
authors.initials: A
authors.lastname: Feleus
authors.forename: Saeede
authors.initials: S
authors.lastname: Dahaghin
authors.forename: Alex
authors.initials: A
authors.lastname: Burdorf
authors.forename: Bart W
authors.initials: BW
authors.lastname: Koes
mesh_terms: D001132:Arm; D006804:Ergonomics; D005081:Exercise Therapy; D006801:Humans; D009333:Neck; D009468:Neuromuscular Diseases / Q000628:therapy*; D009784:Occupational Diseases / Q000628:therapy*; D026741:Physical Therapy Modalities; D016032:Randomized Controlled Trials as Topic; D012782:Shoulder; D016896:Treatment Outcome