Work-Related Musculoskeletal Disorders Report, Workshop Summary, and Workshop Papers (1999) / Chapter Skim
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A Review of Research on Interventions to Control Musculoskeletal Disorders
A Review of Research on Interventions to Control Musculoskeletal Disorders
Pages 200-230
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From page 200... ...
The research evidence relating to the efficacy of laboratory interventions, field interventions with healthy subjects, and field interventions with injured subjects is then presented, followed by concluding remarks about the state of the scientific knowledge on interventions to control musculoskeletal disorders. We propose a model to examine interventions to control musculoskeletal disorders based on the balance theory of Smith & Carayon-Sainfort (19S9, 1995~.
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These include engineering redesigns, changes in work methods, administrative controls, training, organized exercise, work hardening, personal protective equipment, and medical management to reduce exposures. Some of these have been evaluated in research studies using both laboratory ant!
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~ nils approach Is often accompanied by employee training to provide a basis for the behavior change. The main direction of work methods improvement is to modify the task design to recluce or eliminate risk factors.
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field studies, which were further broken clown by intervention type: engineering, administrative, work method, training/exercise, ant! personal protective equipment.
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sample sizes. These problems are most frequent in field intervention studies, but are also observed in the laboratory studies.
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Given the tradeoffs between laboratory and field studies, it is clear that both are necessary to gain a complete picture of the effectiveness of interventions to control musculoskeletal disorders. Considering the inherent limitations discussed above, the results of any single study in isolation must be interpreted carefully.
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(3) The range and time of exposures in the laboratory studies were very limited when compared to the field studies, and most were "constrained" by the apparatus or procedures such that the subjects' responses were constrained or limited to a small range.
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There were no differences found between wearing and not wearing a belt for maximum acceptable weight limits, joint angles, peak lifting force, total muscle work, or average muscle power (Lavender ant} Kenyeri, 1995; Mariey and Duggasani, 1996; Woo(lhouse, Heinen, Shall ant! Bragg, 1990~.
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(5) There is some evidence that the use of weight handling devices such as hoists can recluce the risk factors for upper extremity musculoskeletal disorders.
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Eight of the studies measured disorder endstates (such as diagnosed injury, sick days due to injury)
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symptoms, earlier return to work, and for reduced use of sick leave. Five studies found positive results, nine found mixed results, and only one found no results.
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(9) Many studies had measures of the symptoms of musculoskeletal disorder and/or disorder endstates (such as diagnosed injury, sick days due to injury.
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B General Conclusions about the Findings from the Field Intervention Research Studies using Healthy Subjects: Six of the studies fount!
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: The studies were not consistent in the random assignment of subjects to treatments. Eleven laboratory studies either randomly assignee!
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The laboratory studies ant! injured-subject held intervention research generally had sound designs (i.e.
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215 (c) Limitations for drawing conclusions: There are not enough laboratory studies of interventions that examine critical risk factors for back or upper extremity clisorders.
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Specifically, the important issues for musculoskeletal disorder intervention research include: l. Random assignment to groups Using control groups 3.
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(19914. Effect of an exercise program on sick leave due to back pain.
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An ergonomic intervention study. Journal of Occupational Medicine, 34~)
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(1998~. Effects of a split keyboard design and wrist rest on performance, posture, and comfort.
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