title: Are work disability prevention interventions effective for the management of neck pain or upper extremity disorders? A systematic review by the Ontario Protocol for Traffic Injury Management (OPTIMa) collaboration.
abstract: OBJECTIVE
  We conducted a systematic review to critically appraise and synthesize literature on the effectiveness of work disability prevention (WDP) interventions in workers with neck pain, whiplash-associated disorders (WAD), or upper extremity disorders.
  
  
  METHODS
  We searched electronic databases from 1990 to 2012. Random pairs of independent reviewers critically appraised eligible studies using the Scottish Intercollegiate Guidelines Network criteria. Scientifically admissible studies were summarized and synthesized following best-evidence synthesis methodology.
  
  
  RESULTS
  Of the 6,359 articles retrieved, 16 randomized controlled trials were eligible for critical appraisal and five were admissible. We found that a return-to-work coordination program (including workplace-based work hardening) was superior to clinic-based work hardening for persistent rotator cuff tendinitis. Workplace high-intensity strength training and workplace advice had similar outcomes for neck and shoulder pain. Mensendieck/Cesar postural exercises and strength and fitness exercises had similar outcomes for non-specific work-related upper limb complaints. Adding a brief job stress education program to a workplace ergonomic intervention was not beneficial for persistent upper extremity symptoms. Adding computer-prompted work breaks to ergonomic adjustments and workplace education benefited workers' recovery from recent work-related neck and upper extremity complaints.
  
  
  CONCLUSIONS
  At present, no firm conclusions can be drawn regarding the effectiveness of WDP interventions for managing neck pain, WAD, and upper extremity disorders. Our review suggests a return-to-work coordination program is more effective than clinic-based work hardening. Also, adding computer-prompted breaks to ergonomic and workplace interventions benefits workers' recovery. The current quality of evidence does not allow for a definitive evaluation of the effectiveness of ergonomic interventions.
authors: UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT), 6100 Leslie Street, Toronto, ON, M2H 3J1, Canada, sharanya.varatharajan@uoit.ca.
authors: Sharanya
authors: S
authors: Varatharajan
authors: Pierre
authors: P
authors: Côté
authors: Heather M
authors: HM
authors: Shearer
authors: Patrick
authors: P
authors: Loisel
authors: Jessica J
authors: JJ
authors: Wong
authors: Danielle
authors: D
authors: Southerst
authors: Hainan
authors: H
authors: Yu
authors: Kristi
authors: K
authors: Randhawa
authors: Deborah
authors: D
authors: Sutton
authors: Gabrielle
authors: G
authors: van der Velde
authors: Silvano
authors: S
authors: Mior
authors: Linda J
authors: LJ
authors: Carroll
authors: Craig
authors: C
authors: Jacobs
authors: Anne
authors: A
authors: Taylor-Vaisey
mesh_terms: D006801:Humans; D019547:Neck Pain / Q000517:prevention & control / Q000534:rehabilitation*; D009784:Occupational Diseases / Q000517:prevention & control / Q000534:rehabilitation*; D016272:Occupational Health; D016032:Randomized Controlled Trials as Topic; D055070:Resistance Training; D062707:Return to Work; D020069:Shoulder Pain / Q000517:prevention & control / Q000534:rehabilitation*; D000078202:Systematic Reviews as Topic; D034941:Upper Extremity; D014911:Whiplash Injuries / Q000150:complications / Q000534:rehabilitation*