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Journal of Occupational Rehabilitation

, Volume 24, Issue 4, pp 692–708 | Cite as

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

  • Sharanya VaratharajanEmail author
  • Pierre Côté
  • Heather M. Shearer
  • Patrick Loisel
  • Jessica J. Wong
  • Danielle Southerst
  • Hainan Yu
  • Kristi Randhawa
  • Deborah Sutton
  • Gabrielle van der Velde
  • Silvano Mior
  • Linda J. Carroll
  • Craig Jacobs
  • Anne Taylor-Vaisey
Review

Abstract

Purpose 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.

Keywords

Neck pain and associated disorders Whiplash-associated disorders Upper extremity disorders Work disability prevention interventions Treatment Systematic review 

Notes

Acknowledgments

We would like to acknowledge and thank all of the individuals who have made important contributions to this review: Arthur Ameis, Carlo Ammendolia, Poonam Cardoso, Douglas Gross, Gail Lindsay, Margareta Nordin, Mike Paulden, Roger Salhany, John Stapleton, Maja Stupar, and Angela Verven. We would also like to thank Trish Johns-Wilson at the University of Ontario Institute of Technology for her review of the search strategy. Ontario Ministry of Finance; the study sponsor had no involvement in the study design, collection, analysis, interpretation of data, writing of the manuscript or decision to submit the manuscript for publication.

Conflict of interest

No conflicts of interest to disclose for all authors.

Supplementary material

10926_2014_9501_MOESM1_ESM.pdf (98 kb)
Supplementary material 1 (PDF 98 kb)

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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Sharanya Varatharajan
    • 1
    • 2
    • 3
    Email author
  • Pierre Côté
    • 1
    • 2
    • 4
    • 5
  • Heather M. Shearer
    • 1
    • 2
    • 3
  • Patrick Loisel
    • 3
    • 6
  • Jessica J. Wong
    • 1
    • 2
    • 7
  • Danielle Southerst
    • 1
    • 2
    • 7
  • Hainan Yu
    • 1
    • 2
    • 3
  • Kristi Randhawa
    • 1
    • 2
    • 3
  • Deborah Sutton
    • 1
    • 2
    • 3
  • Gabrielle van der Velde
    • 8
    • 9
    • 10
  • Silvano Mior
    • 3
    • 5
  • Linda J. Carroll
    • 11
  • Craig Jacobs
    • 1
    • 2
    • 12
  • Anne Taylor-Vaisey
    • 1
    • 2
  1. 1.UOIT-CMCC Centre for the Study of Disability Prevention and RehabilitationUniversity of Ontario Institute of Technology (UOIT)TorontoCanada
  2. 2.UOIT-CMCC Centre for the Study of Disability Prevention and RehabilitationCanadian Memorial Chiropractic College (CMCC)TorontoCanada
  3. 3.Division of Graduate Education and ResearchCanadian Memorial Chiropractic College (CMCC)TorontoCanada
  4. 4.Canada Research Chair in Disability Prevention and RehabilitationUniversity of Ontario Institute of Technology (UOIT)OshawaCanada
  5. 5.Faculty of Health SciencesUniversity of Ontario Institute of Technology (UOIT)OshawaCanada
  6. 6.Division of Occupational and Environmental Health, Dalla Lana School of Public HealthUniversity of TorontoTorontoCanada
  7. 7.Division of Undergraduate EducationCanadian Memorial Chiropractic College (CMCC)TorontoCanada
  8. 8.Toronto Health Economics and Technology Assessment (THETA) CollaborativeTorontoCanada
  9. 9.Faculty of PharmacyUniversity of TorontoTorontoCanada
  10. 10.Institute for Work and HealthTorontoCanada
  11. 11.Department of Public Health Sciences and Alberta Centre for Injury Prevention and Research, School of Public HealthUniversity of AlbertaEdmontonCanada
  12. 12.Division of Clinical EducationCanadian Memorial Chiropractic College (CMCC)TorontoCanada

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