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 .
Changes in Cognitive-Behavioral Factors and Muscle Activation Patterns after Interventions for Work-Related Neck-Shoulder Complaints: Relations with Discomfort and Disability
Objectives Knowledge regarding the working mechanism of an intervention is essential for obtaining a better underst and ing of the intervention and contributes to optimize its outcome . This study aim ed at investigating whether changes in cognitive-behavioral factors and muscle activation patterns after myofeedback training and ergonomic counseling were associated with outcome , in subjects with work-related musculoskeletal neck-shoulder complaints . Methods Seventy-nine symptomatic subjects received either myofeedback with ergonomic counseling ( Mfb/EC ) or ergonomic counseling alone ( EC ) . Outcome measures discomfort and disability , and process factors catastrophizing , pain control , fear-avoidance beliefs , and muscle activation patterns were assessed at baseline , after the interventions ( T0 ) , and at 3 months follow-up ( T3 ) . Mixed modeling techniques were used for analysis . Results Outcome in terms of discomfort and disability was generally comparable between both interventions . Catastrophizing was significantly reduced and fear-avoidance beliefs about work slightly increased after the interventions , but no consistent changes in muscle activation patterns were observed . Changes in discomfort were especially associated with changes in catastrophizing at T0 and T3 , but R2 was low ( < 0.14 ) . Reduced catastrophizing at T0 and T3 , and also reduced fear-avoidance beliefs about work at T3 , were related to reduced disability ( R2 between 0.30 and 0.40 ) . No differences between the two intervention groups were observed . Conclusions Intervention effects were generally non-specific and findings suggested that cognitive-behavioral factors underlie the outcome of these interventions rather than changes in muscle activation patterns . Emphasizing these factors during therapy may increase the beneficial outcome of occupational interventions
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 .