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Interventions for the prevention and management of neck/upper extremity musculoskeletal conditions: A systematic review

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Journal: Occupational Environmental Medicine. 2006 September 14 [E-publication ahead of print] Authors and Affiliation: Boocock MG, McNair PJ, Larmer PJ, Armstrong B, Collier J, Simmonds M, Garrett N. Auckland University of Technology, New Zealand. PMID: 16973739 Whether considered from medical, social or economic perspectives, the cost of musculoskeletal injuries suffered in the workplace is substantial and there is a need to identify the most efficacious interventions for their effective prevention, management and rehabilitation. Previous reviews have highlighted the limited number of studies that focus on upper extremity intervention programs. The aim of the current study was to evaluate the findings of primary, secondary and/or tertiary intervention studies for neck/upper extremity conditions undertaken between 1999 and 2004 and compare these results with those of previous reviews. Relevant studies were retrieved through the use of a systematic approach to literature searching and evaluated using a standardized tool. Evidence was then classified according to a 'pattern of evidence' approach. Studies were categorized into subgroups depending on the type of INTERVENTION: mechanical exposure interventions; production systems/organizational culture interventions; and modifier interventions. Thirty-one intervention studies met the inclusion criteria. The findings provided evidence to support the use of some mechanical and modifier interventions as approaches for preventing and managing neck/upper extremity musculoskeletal conditions and Fibromyalgia. Evidence to support the benefits of production systems/organizational culture interventions was found to be lacking. This review identified no one single or multidimensional strategy for intervention that was considered effective across occupational settings. There is limited information to support the establishment of evidence-based guidelines applicable to a number of industrial sectors.

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