None of the ergonomic interventions was more beneficial for any outcome measures when compared with another treatment or with no treatment or with placebo .
Behavioural interventions had inconsistent effects on pain and disability , with some subgroups showing benefit and others showing no significant improvement when compared with no treatment , minor intervention controls or other behavioural interventions .In the eight studies that evaluated various other interventions , there was no evidence of a clear beneficial effect of any of the interventions provided .
We found very low- quality evidence indicating that pain , recovery , disability and sick leave are similar after exercises when compared with no treatment , with minor intervention controls or with exercises provided as additional treatment to people with work-related complaints of the arm , neck or shoulder .
Low- quality evidence also showed that ergonomic interventions did not decrease pain at short-term follow-up but did decrease pain at long-term follow-up .
There was no evidence of an effect on other outcomes .
For behavioural and other interventions , there was no evidence of a consistent effect on any of the outcomes .
BACKGROUND Work-related upper limb disorder ( WRULD ) , repetitive strain injury ( RSI ) , occupational overuse syndrome ( OOS ) and work-related complaints of the arm , neck or shoulder ( CANS ) are the most frequently used umbrella terms for disorders that develop as a result of repetitive movements , awkward postures and impact of external forces such as those associated with operating vibrating tools .
Work-related CANS , which is the term we use in this review , severely hampers the working population .
OBJECTIVES To assess the effects of conservative interventions for work-related complaints of the arm , neck or shoulder ( CANS ) in adults on pain , function and work-related outcomes .
Cost-effectiveness of postural exercise therapy versus physiotherapy in computer screen-workers with early non-specific work-related upper limb disorders (WRULD); a randomized controlled trial
Background Exercise therapies generate substantial costs in computer workers with non-specific work-related upper limb disorders ( WRULD ) . Aims To study if postural exercise therapy is cost-effective compared to regular physiotherapy in screen-workers with early complaints , both from health care and societal perspective . Methods Prospect i ve r and omized trial including cost-effectiveness analysis ; one year follow-up . Participants : Eighty-eight screen-workers with early non-specific WRULD ; six drop-outs . Interventions : A ten week postural exercise program versus regular physiotherapy .  Outcome measures : Effectiveness measures : Pain : visual analogous scale ( VAS ) , self-perceived WRULD ( yes/no ) . Functional outcome : Disabilities of Arm , Shoulder and H and - Dutch Language Version ( DASH-DLV ) . Quality of life outcome : EQ-5D.Economic measures : health care costs including patient and family costs and productivity costs result ing in societal costs . Cost-effectiveness measures : health care costs and societal costs related to the effectiveness measures . Outcome measures were assessed at baseline ; three , six and twelve months after baseline . Results At baseline both groups were comparable for baseline characteristics except scores on the Pain Catastrophizing Scale and comparable for costs . No significant differences between the groups concerning effectiveness at one year follow-up were found . Effectiveness scores slightly improved over time . After one year 55 % of participants were free of complaints . After one year the postural exercise group had higher mean total health care costs , but lower productivity costs compared to the physiotherapy group . Mean societal costs after one year ( therefore ) were in favor of postural exercise therapy [ - € 622 ; 95 % CI -2087 ; + 590 ) ] . After one year , only self- perceived WRULD seemed to result in acceptable cost-effectiveness of the postural exercise strategy over physiotherapy ; however the probability of acceptable cost-effectiveness did not exceed 60%.Considering societal costs related to QALYs  , postural exercise therapy had a probability of over 80 % to be cost-effective over a wide range of cost-effectiveness ceiling ratios ; however based on a marginal QALY-difference of 0.1 over a 12 month time frame . Conclusion Although our trial failed to find significant differences in VAS , QALYs and ICERs based on VAS and QALYs at one-year follow-up , CEACs suggest that postural exercise therapy according to Mensendieck/Cesar has a higher probability of being cost-effective compared to regular physiotherapy ; however further research is required . Trial registration IS RCT N
None of the ergonomic interventions was more beneficial for any outcome measures when compared with another treatment or with no treatment or with placebo .
Behavioural interventions had inconsistent effects on pain and disability , with some subgroups showing benefit and others showing no significant improvement when compared with no treatment , minor intervention controls or other behavioural interventions .In the eight studies that evaluated various other interventions , there was no evidence of a clear beneficial effect of any of the interventions provided .
We found very low- quality evidence indicating that pain , recovery , disability and sick leave are similar after exercises when compared with no treatment , with minor intervention controls or with exercises provided as additional treatment to people with work-related complaints of the arm , neck or shoulder .
Low- quality evidence also showed that ergonomic interventions did not decrease pain at short-term follow-up but did decrease pain at long-term follow-up .
There was no evidence of an effect on other outcomes .
For behavioural and other interventions , there was no evidence of a consistent effect on any of the outcomes .
BACKGROUND Work-related upper limb disorder ( WRULD ) , repetitive strain injury ( RSI ) , occupational overuse syndrome ( OOS ) and work-related complaints of the arm , neck or shoulder ( CANS ) are the most frequently used umbrella terms for disorders that develop as a result of repetitive movements , awkward postures and impact of external forces such as those associated with operating vibrating tools .
Work-related CANS , which is the term we use in this review , severely hampers the working population .
OBJECTIVES To assess the effects of conservative interventions for work-related complaints of the arm , neck or shoulder ( CANS ) in adults on pain , function and work-related outcomes .