Skip to main content
SpringerLink
Log in

Workplace-Based Rehabilitation of Upper Limb Conditions: A Systematic Review

  • Published:
Journal of Occupational Rehabilitation Aims and scope Submit manuscript

Abstract

Purpose The objective of this systematic review was to identify, collate and analyse the current available evidence on the effectiveness of workplace-based rehabilitative interventions in workers with upper limb conditions on work performance, pain, absenteeism, productivity and other outcomes. Methods We searched Medline, Cochrane Library, Scopus, Web of Science, Academic Search Premier, Africa-Wide Information, CINAHL, OTSeeker and PEDro with search terms in four broad areas: upper limb, intervention, workplace and clinical trial (no date limits). Studies including neck pain only or musculoskeletal pain in other areas were not included. Results Initial search located 1071 articles, of which 80 were full text reviewed. Twenty-eight articles were included, reporting on various outcomes relating to a total of seventeen studies. Nine studies were of high methodological quality, seven of medium quality, and one of low quality. Studies were sorted into intervention categories: Ergonomic controls (n = 3), ergonomic training and workstation adjustments (n = 4), exercise and resistance training (n = 6), clinic-based versus workplace-based work hardening (n = 1), nurse case manager training (n = 1), physiotherapy versus Feldenkrais (n = 1), and ambulant myofeedback training (n = 1). The largest body of evidence supported workplace exercise programs, with positive effects for ergonomic training and workstation adjustments, and mixed effects for ergonomic controls. Ambulant myofeedback training had no effect. The remaining three categories had positive effects in the single study on each intervention. Conclusion While there is substantial evidence for workplace exercise programs, other workplace-based interventions require further high quality research. Systematic review registration PROSPERO CRD42017059708.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Schultz G, Mostert K, Rothmann I. Repetitive strain injury among South African employees: the relationship with burnout and work engagement. Int J Ind Ergon. 2012;42(5):449–456.

    Article  Google Scholar 

  2. Van Eerd D, Munhall C, Irvin E, Rempel D, Brewer S, Van Der Beek AJ, Dennerlein JT, Tullar J, Skivington K, Pinion C, Amick B. Effectiveness of workplace interventions in the prevention of upper extremity musculoskeletal disorders and symptoms: an update of the evidence. Occup Environ Med. 2016;73(1):62–70.

    Article  PubMed  Google Scholar 

  3. Kielkowski D, Rees D, Bradshaw D. Burden of occupational morbidity in South Africa: two large field surveys of self-reported work-related and work-aggravated disease. S Afr J Sci. 2004;100(7–8):399–402.

    Google Scholar 

  4. Williams RM, Westmorland MG, Schmuck G, MacDermid JC. Effectiveness of workplace rehabilitation interventions in the treatment of work-related upper extremity disorders: a systematic review. J Hand Ther. 2004;17(2):267–273.

    Article  PubMed  Google Scholar 

  5. Edries N, Jelsma J, Maart S. The impact of an employee wellness programme in clothing/textile manufacturing companies: a randomised controlled trial. BMC Public Health. 2013;13(1):1–9.

    Article  Google Scholar 

  6. Franche RL, Cullen K, Clarke J, Irvin E, Sinclair S, Frank J, Institute for Work & Health (IWH) Workplace-Based RTW Intervention Literature Review Research Team. Workplace-based return-to-work interventions: a systematic review of the quantitative literature. J Occup Rehabil. 2005;15(4):607–631.

    Article  PubMed  Google Scholar 

  7. Schiller J. Bringing in treatment: establishing a workplace rehabilitation program. Risk Manag. 1996;43(5):49–51.

    Google Scholar 

  8. Cancelliere C, Donovan J, Stochkendahl MJ, Biscardi M, Ammendolia C, Myburgh C, Cassidy JD. Factors affecting return to work after injury or illness: best evidence synthesis of systematic reviews. Chiropractic Manual Ther. 2016;24(1):1–23.

    Article  Google Scholar 

  9. Burns PB, Rohrich RJ, Chung KC. The levels of evidence and their role in evidence-based medicine. Plast Reconstr Surg. 2011;128(1):305–310.

    Article  CAS  Google Scholar 

  10. MacDermid JC. An introduction to evidence-based practice for hand therapists. J Hand Ther. 2004;17(2):105–117.

    Article  PubMed  Google Scholar 

  11. Kennedy CA, Amick BC III, Dennerlein JT, Brewer S, Catli S, Williams R, Serra C, Gerr F, Irvin E, Mahood Q, Franzblau A. Systematic review of the role of occupational health and safety interventions in the prevention of upper extremity musculoskeletal symptoms, signs, disorders, injuries, claims and lost time. J Occup Rehabil. 2010;20(2):127–162.

    Article  PubMed  Google Scholar 

  12. Moher D, Shamseer L, Clarke M, Ghersi D, Liberati A, Petticrew M, Shekelle P, Stewart LA. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Syst Rev. 2015;4(1):1–9.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Shamseer L, Moher D, Clarke M, Ghersi D, Liberati A, Petticrew M, Shekelle P, Stewart LA. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015: elaboration and explanation. BMJ. 2015;349:1–25.

    Article  Google Scholar 

  14. Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JP, Clarke M, Devereaux PJ, Kleijnen J, Moher D. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. PLoS Med. 2009;6(7):1–28.

    Article  Google Scholar 

  15. American Occupational Therapy Association. Guidelines for systematic reviews. 2014. https://ajot.submit2aota.org/journals/ajot/forms/systematic_reviews.pdf.

  16. Andersen LL, Saervoll CA, Mortensen OS, Poulsen OM, Hannerz H, Zebis MK. Effectiveness of small daily amounts of progressive resistance training for frequent neck/shoulder pain: randomised controlled trial. PAIN® 2011;152(2):440–446.

    Article  Google Scholar 

  17. Andersen LL, Zebis MK. Process evaluation of workplace interventions with physical exercise to reduce musculoskeletal disorders. Int J Rheumatol. 2014;2014:761363. https://doi.org/10.1155/2014/761363.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Lidegaard M, Jensen RB, Andersen CH, Zebis MK, Colado JC, Wang Y, Heilskov-Hansen T, Andersen LL. Effect of brief daily resistance training on occupational neck/shoulder muscle activity in office workers with chronic pain: randomized controlled trial. Biomed Res Int. 2013;2013:262386. https://doi.org/10.1155/2013/262386.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Andersen CH, Sjøgaard G, Andersen LL, Zebis MK, Mortensen OS. Protocol for shoulder function training reducing musculoskeletal pain in shoulder and neck: a randomized controlled trial. BMC Musculoskelet Disord. 2011;12(1):1–5.

    Article  Google Scholar 

  20. Andersen CH, Andersen LL, Zebis MK, Sjøgaard G. Effect of scapular function training on chronic pain in the neck/shoulder region: a randomized controlled trial. J Occup Rehabil. 2014;24(2):316–324.

    Article  PubMed  Google Scholar 

  21. Andersen LL, Persson R, Jakobsen MD, Sundstrup E. Psychosocial effects of workplace physical exercise among workers with chronic pain: randomized controlled trial. Medicine. 2017;96(1):e5709.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Sundstrup E, Jakobsen MD, Andersen CH, Jay K, Persson R, Aagaard P, Andersen LL. Participatory ergonomic intervention versus strength training on chronic pain and work disability in slaughterhouse workers: study protocol for a single-blind, randomized controlled trial. BMC Musculoskelet Disord. 2013;14(1):1–9.

    Article  Google Scholar 

  23. Sundstrup E, Jakobsen MD, Brandt M, Jay K, Persson R, Aagaard P, Andersen LL. Workplace strength training prevents deterioration of work ability among workers with chronic pain and work disability: a randomized controlled trial. Scand J Work Environ Health. 2014;40(3):244–251.

    Article  PubMed  Google Scholar 

  24. Sundstrup E, Jakobsen MD, Andersen CH, Jay K, Persson R, Aagaard P, Andersen LL. Effect of two contrasting interventions on upper limb chronic pain and disability: a randomized controlled trial. Pain Physician. 2014;17(2):145–154.

    PubMed  Google Scholar 

  25. Sundstrup E, Jakobsen MD, Brandt M, Jay K, Aagaard P, Andersen LL. Strength training improves fatigue resistance and self-rated health in workers with chronic pain: a randomized controlled trial. Biomed Res Int. 2016;2016:1–11.

    Article  Google Scholar 

  26. Voerman GE, Sandsjö L, Vollenbroek-Hutten MM, Larsman P, Kadefors R, Hermens HJ. Effects of ambulant myofeedback training and ergonomic counselling in female computer workers with work-related neck-shoulder complaints: a randomized controlled trial. J Occup Rehabil. 2007;17(1):137–152.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Bernaards CM, Ariëns GA, Hildebrandt VH. The (cost-) effectiveness of a lifestyle physical activity intervention in addition to a work style intervention on the recovery from neck and upper limb symptoms in computer workers. BMC Musculoskelet Disord. 2006;7(1):1–11.

    Article  Google Scholar 

  28. Bernaards CM, Ariëns GA, Simons M, Knol DL, Hildebrandt VH. Improving work style behavior in computer workers with neck and upper limb symptoms. J Occup Rehabil. 2008;18(1):87–101.

    Article  PubMed  Google Scholar 

  29. Dropkin J, Kim H, Punnett L, Wegman DH, Warren N, Buchholz B. Effect of an office ergonomic randomised controlled trial among workers with neck and upper extremity pain. Occup Environ Med. 2015;72(1):6–14.

    Article  Google Scholar 

  30. Feuerstein M, Nicholas RA, Huang GD, Dimberg L, Ali D, Rogers H. Job stress management and ergonomic intervention for work-related upper extremity symptoms. Appl Ergon. 2004;35(6):565–574.

    Article  PubMed  Google Scholar 

  31. Jay K, Brandt M, Andersen LL. Effect of video-based versus personalized instruction on errors during elastic tubing exercises for musculoskeletal pain: a randomized controlled trial. Biomed Res Int. 2014;2014:1–7.

    Google Scholar 

  32. Lundblad I, Elert J, Gerdle B. Randomized controlled trial of physiotherapy and Feldenkrais interventions in female workers with neck-shoulder complaints. J Occup Rehabil. 1999;9(3):179–194.

    Article  Google Scholar 

  33. Aaras A, Ro O, Thoresen M. Can a more neutral position of the forearm when operating a computer mouse reduce the pain level for visual display unit operators? A prospective epidemiological intervention study. Int J Hum Comput Interact. 1999;11(2):79–94.

    Article  Google Scholar 

  34. Aarås A, Dainoff M, Ro O, Thoresen M. Can a more neutral position of the forearm when operating a computer mouse reduce the pain level for visual display unit operators? A prospective epidemiological intervention study: part II. Int J Hum Comput Interact. 2001;13(1):13–40.

    Article  Google Scholar 

  35. Aarås A, Dainoff M, Ro O, Thoresen M. Can a more neutral position of the forearm when operating a computer mouse reduce the pain level for VDU operators? Int J Ind Ergon. 2002;30(4):307–324.

    Article  Google Scholar 

  36. Cheng AS, Hung LK. Randomized controlled trial of workplace-based rehabilitation for work-related rotator cuff disorder. J Occup Rehabil. 2007;17(3):487–503.

    Article  PubMed  Google Scholar 

  37. Esmaeilzadeh S, Ozcan E, Capan N. Effects of ergonomic intervention on work-related upper extremity musculoskeletal disorders among computer workers: a randomized controlled trial. Int Arch Occup Environ Health. 2014;87(1):73–83.

    Article  PubMed  Google Scholar 

  38. Hagberg M, Harms-Ringdahl K, Nisell R, Hjelm EW. Rehabilitation of neck-shoulder pain in women industrial workers: a randomized trial comparing isometric shoulder endurance training with isometric shoulder strength training. Arch Phys Med Rehabil. 2000;81(8):1051–1058.

    Article  PubMed  CAS  Google Scholar 

  39. Martimo KP, Shiri R, Miranda H, Ketola R, Varonen H, Viikari-Juntura E. Effectiveness of an ergonomic intervention on the productivity of workers with upper-extremity disorders-a randomized controlled trial. Scand J Work Environ Health. 2010;36(1):25–33.

    Article  PubMed  Google Scholar 

  40. Ripat J, Scatliff T, Giesbrecht E, Quanbury A, Friesen M, Kelso S. The effect of alternate style keyboards on severity of symptoms and functional status of individuals with work related upper extremity disorders. J Occup Rehabil. 2006;16(4):707–718.

    Article  PubMed  Google Scholar 

  41. Shiri R, Martimo KP, Miranda H, Ketola R, Kaila-Kangas L, Liira H, Karppinen J, Viikari-Juntura E. The effect of workplace intervention on pain and sickness absence caused by upper-extremity musculoskeletal disorders. Scand J Work Environ Health. 2011;37(2):120–128.

    Article  PubMed  Google Scholar 

  42. Lincoln AE, Feuerstein M, Shaw WS, Miller VI. Impact of case manager training on worksite accommodations in workers’ compensation claimants with upper extremity disorders. J Occup Environ Med. 2002;44(3):237–245.

    Article  PubMed  Google Scholar 

  43. Camargo PR, Haik MN, Ludewig PM, Filho RB, Mattiello-Rosa SM, Salvini TF. Effects of strengthening and stretching exercises applied during working hours on pain and physical impairment in workers with subacromial impingement syndrome. Physiother Theory Pract. 2009;25(7):463–475.

    Article  PubMed  Google Scholar 

  44. United States Department of Labor. Dictionary of occupational titles. (Revised 4th ed.). Washington, DC: United States Department of Labor; 1991.

    Google Scholar 

  45. Cullen KL, Irvin E, Collie A, Clay F, Gensby U, Jennings PA, Hogg-Johnson S, Kristman V, Laberge M, McKenzie D, Newnam S. Effectiveness of workplace interventions in return-to-work for musculoskeletal, pain-related and mental health conditions: an update of the evidence and messages for practitioners. J Occup Rehabil. 2017;28(1):1–15.

    Article  PubMed Central  Google Scholar 

  46. Burger M, Kriel R, Damon A, Abel A, Bansda A, Wakens M, Ernstzen D. The effectiveness of low-level laser therapy on pain, self-reported hand function, and grip strength compared to placebo or “sham” treatment for adults with carpal tunnel syndrome: a systematic review. Physiother Theory Pract. 2017;33(3):184–197.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division Occupational Therapy, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa

    Munira Hoosain & Susan de Klerk

  2. Division Physiotherapy, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa

    Marlette Burger

Authors
  1. Munira Hoosain
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Susan de Klerk
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Marlette Burger
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Munira Hoosain.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Research Involving Human and Animal Participants

This article does not contain any studies with human participants or animals performed by any of the authors.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (DOCX 18 KB)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Hoosain, M., de Klerk, S. & Burger, M. Workplace-Based Rehabilitation of Upper Limb Conditions: A Systematic Review. J Occup Rehabil 29, 175–193 (2019). https://doi.org/10.1007/s10926-018-9777-7

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10926-018-9777-7

Keywords

Search

Navigation