The effect of workplace intervention on pain and sickness absence caused by upper-extremity musculoskeletal disorders. Prevalence and impact of musculoskeletal disorders of the upper limb in the general population. Workplace upper limb disorders: a prospective study with intervention. Effect of two contrasting interventions on upper limb chronic pain and disability: a randomized controlled trial. A Tailored Workplace Exercise Program for Women at Risk for Neck and Upper Limb Musculoskeletal Disorders: A Randomized Controlled Trial A prospective cohort study on severe pain as a risk factor for long-term sickness absence in blue- and white-collar workers Proximal myofascial dysfunction in complex regional pain syndrome: a retrospective prevalence study. Pressure pain thresholds of upper limb peripheral nerve trunks in asymptomatic subjects. Incidence of musculoskeletal disorders among newly employed manufacturing workers. Epidemiologic surveillance of upper-extremity musculoskeletal disorders in the working population. Reduction of Pain-Related Disability in Working Populations: A Randomized Intervention Study of the Effects of an Educational Booklet Addressing Psychosocial Risk Factors and Screening Workplaces for Physical Health Hazards Influence of upper- and lower-limb exercise training on cardiovascular function and walking distances in patients with intermittent claudication. The (cost-)effectiveness of a lifestyle physical activity intervention in addition to a work style intervention on the recovery from neck and upper limb symptoms in computer workers Sickness absence in patients with arm, neck and shoulder complaints presenting in physical therapy practice: 6 months follow-up. Variation in phantom limb pain: results of a diary study. Exploring Factors Influencing Low Back Pain in People With Nondysvascular Lower Limb Amputation: A National Survey. The effect of upper-extremity aerobic exercise on complex regional pain syndrome type I: a randomized controlled study on subacute stroke
OBJECTIVES The aim of this study was to assess the effect of an ergonomic intervention on pain and sickness absence caused by upper-extremity musculoskeletal disorders . METHODS In this r and omized controlled study , subjects aged 18 - 60 years ( N=177 ) seeking medical advice due to upper-extremity symptoms were included if their symptoms , or the exacerbation of symptoms , had started < 30 days prior to the medical consultation and immediate sick leave was not required .  Workplace ergonomic improvements were made in the intervention group . Data on symptoms and sickness absences were gathered during one-year follow-up . RESULTS Pain intensity , pain interference with work , leisure time , or sleep did not differ between the intervention and control group during the one-year follow-up . During the first three months of follow-up , the percentage of employees with sickness absence due to upper-extremity or other musculoskeletal disorders did not differ between the intervention ( N=89 ) and control ( N=84 ) group , but the total number of sickness absence days in the intervention group was about half of that in the control group ( mean 6.2 versus 9.8 days for upper-extremity disorder and 6.0 versus 11.5 days for upper-extremity and other musculoskeletal disorders combined ) . During 4 - 12 months of follow-up , the percentage of employees with sickness absence due to upper-extremity disorder ( 10.1 % versus 16.7 % , P=0.20 ) or upper-extremity and other musculoskeletal disorders combined ( 20.2 % versus 32.1 % , P=0.07 ) was lower in the intervention than the control group . CONCLUSIONS Our findings suggest that an early ergonomic intervention reduces sickness absence due to upper-extremity or other musculoskeletal disorders OBJECTIVE To determine the prevalence , interrelation , and impact of musculoskeletal disorders of the upper limb in the general population . METHODS A total of 9,696 r and omly selected adults of working age were surveyed in a 2-stage cross-sectional study involving a screening question naire and a st and ardized physical examination in symptomatic subjects . Age- and sex-specific prevalence rates were estimated for several musculoskeletal disorders and for nonspecific pain in the upper limbs . The overlap and impact on daily activities and healthcare utilization were explored . RESULTS Among 6,038 first-stage responders , 3,152 reported upper limb symptoms and 1,960 were subsequently examined . Of subjects with pain , 44.8 % had 1 or more specific soft-tissue disorders . Site-specific prevalence rates were as follows : shoulder tendinitis 4.5 % among men and 6.1 % among women ; adhesive capsulitis 8.2 % among men and 10.1 % among women ; lateral epicondylitis 1.3 % among men and 1.1 % among women ; de Quervain 's disease 0.5 % among men and 1.3 % among women ; other tenosynovitis of the h and or wrist , 1.1 % among men and 2.2 % among women . Specific disorders tended to cluster ( P < 0.001 ) in individuals , with particular overlap at the shoulder . Compared with subjects with nonspecific pain , those with specific disorders more often reported inability to perform everyday tasks ( P < 0.05 ) , consultation with a doctor ( P < 0.05 ) , and use of prescribed medication ( P < 0.05 ) . CONCLUSION Upper limb pain is common in the general population and is often associated with physical signs suggestive of specific upper-limb disorders . These disorders have a substantial impact on physical function and use of health care A prospect i ve longitudinal study was carried out to investigate the occurrence of upper limb disorders in an electromechanical plant between 1980 and 1988 . It included clinical and epidemiological studies , measurement of  vibration produced by the power tools used , ergonomic assessment of the works and time and motion studies . Simultaneously during the same period remedial actions were taken through multidisciplinary interventions when the specific causal factors were known . The study shows the clinical entities of the disorder , identifies the risk factors and evaluates the results of the interventions . It assists in establishing a cause and effect relationship for the condition and demonstrates the way a preventive strategy could be developed BACKGROUND Chronic pain and disability of the arm , shoulder , and h and severely affect labor market participation . Ergonomic training and education is the default strategy to reduce physical exposure and thereby prevent aggravation of pain . An alternative strategy could be to increase physical capacity of the worker by physical conditioning . OBJECTIVES To investigate the effect of 2 contrasting interventions , conventional ergonomic training ( usual care ) versus resistance training , on pain and disability in individuals with upper limb chronic pain exposed to highly repetitive and forceful manual work . STUDY DESIGN Examiner-blinded , parallel-group r and omized controlled trial with allocation concealment . SETTING Slaughterhouses located in Denmark , Europe . METHODS Sixty-six adults with chronic pain in the shoulder , elbow/forearm , or h and /wrist and work disability were r and omly allocated to 10 weeks of specific resistance training for the shoulder , arm , and h and muscles for 3 x 10 minutes per week , or ergonomic training and education ( usual care control group ) .  Pain intensity ( average of shoulder , arm , and h and , scale 0 - 10 ) was the primary outcome , and disability ( Work module of DASH question naire ) as well as isometric shoulder and wrist muscle strength were secondary outcomes . RESULTS Pain intensity , disability , and muscle strength improved more following resistance training than usual care ( P < 0.001 , P = 0.05 , P < 0.0001 , respectively [ corrected ] ) . Pain intensity decreased by 1.5 points ( 95 % confidence interval -2.0 to -0.9 ) following resistance training compared with usual care , corresponding to an effect size of 0.91 ( Cohen 's d ) . LIMITATIONS Blinding of participants is not possible in behavioral interventions . However , at baseline outcome expectations of the 2 interventions were similar . CONCLUSION Resistance training at the workplace results in clinical relevant improvements in pain , disability , and muscle strength in adults with upper limb chronic pain exposed to highly repetitive and forceful manual work . TRIAL REGISTRATION NCT01671267 Objective : The aim of this study was to evaluate a tailored physical activity protocol performed in a work environment with a group of female workers employed in manual precision tasks to reduce upper limb pain . Methods : Sixty female subjects were r and omly assigned to an intervention group or a control group . The IG was administered of a 6-month , twice-a-week , tailored exercise program , whereas the CG received no intervention . Results : The IG showed a reduction on shoulder pain accompanied by increases on the range of motion measures . In addition , reductions in upper limb pain and neck disability were detected with concomitant increases in grip strength . Conclusions : This study indicated positive effects of a tailored workplace exercise protocol in female workers exposed to moderate risk for work-related musculoskeletal disorders , showing clinical ly meaningful reductions of pain symptoms and disability on upper limb and neck regions Objective To estimate the impact of pain in different body regions on future long-term sickness absence ( LTSA ) among blue- and white-collar workers . Method Prospect i ve cohort study in a representative sample of 5603 employees ( the Danish Work Environment Cohort Study ) interviewed in 2000 , and followed in 2001–2002 in a national sickness absence register . Cox regression analysis was performed to assess the risk estimates of mutually adjusted severe pain in the neck/shoulder , low back , h and /wrist and knees for onset of LTSA , defined as receiving sickness absence compensation for at least 3 consecutive weeks . Age , gender , body mass index , smoking and diagnosed disease were controlled for . Results In 2000 the prevalence among blue- and white-collar workers , respectively , of severe pain was 33 % and 29 % ( neck/shoulder ) , 33 % and 25 % ( low back ) , 16 % and 11 % ( h and /wrists ) , and 16 % and 12 % ( knees ) . During 2001–2002 , the prevalence of LTSA among blue- and white-collar workers was 18 % and 12 % , respectively . H and /wrist pain ( HR 1.49 , 95 % CI 1.23 to 1.81 ) and low back pain ( HR 1.30 , 95 % CI 1.11 to 1.53 ) were significant risk factors among the total cohort . Neck/shoulder pain was a significant risk factor among white-collar workers only ( HR 1.35 , 95 % CI 1.21 to 1.85 ) . Knee pain was not a significant risk factor . Conclusion While h and /wrist pain and low back pain are general risk factors for LTSA , neck/shoulder pain is a specific risk factor among white-collar workers . This study suggests the potential for preventing future LTSA through interventions to manage or reduce musculoskeletal pain OBJECTIVE To assess the prevalence of clinical ly evident myofascial dysfunction ( MD ) and its relationship to motor neglect ( MN ) in Complex Regional Pain Syndrome ( CRPS ) . DESIGN Retrospective chart review . PATIENTS Forty-one consecutively evaluated CRPS patients . OUTCOME MEASURES ( a ) Prevalence of trigger points in the proximal musculature of the CRPS limb . ( b ) Prevalence of MN in a subset ( n = 34 ) . RESULTS MD was detected in 61 % of CRPS patients . It was more prevalent in the upper limb ( 70 % ) than in the lower limb ( 47 % ) . MN was more common in those who also had MD . CONCLUSION MD is common in CRPS patients , especially in the upper limb and in those patients with MN . Prospect i ve trials are needed to confirm these intriguing findings , which may have important implication s regarding CRPS pathophysiology and treatment BACKGROUND AND PURPOSE Palpation of peripheral nerve trunks has been advocated as a method of assessing the presence of hyperalgesic nerve tissue as a contributing factor to pain syndromes in musculoskeletal disorders of the upper quadrant . This study investigated , in the first instance , the pressure pain thresholds of the median , radial and ulnar nerve trunks of the upper limb in healthy , asymptomatic subjects . METHOD Forty-five male and 50 female healthy volunteer subjects participated in this study which involved measurement of  pressure pain thresholds  by use of pressure algometry bilaterally over the three peripheral nerve trunks in the upper limbs . RESULTS Pressure pain thresholds were shown to be lowest in the median nerve ( p = 0.001 ) and lower in female subjects ( p = 0.001 ) . Laterality ( p = 0.077 ) or the age of the subject ( p = 0.254 ) did not significantly influence results . CONCLUSIONS The study demonstrated differences in pressure pain thresholds in the three nerve trunks of the upper limb . These findings should be taken into account when interpreting the findings of nerve palpation in musculoskeletal upper quadrant disorders OBJECTIVES The incidence of upper-limb , neck-shoulder , and low-back disorders and their induction times were investigated among new workers in tasks with various physical workloads . METHODS New trailer assemblers ( N=364 ) were followed prospect ively for 45 months -- the workers ' health status via medical records and exposure to physical workload factors via job titles , walk-throughs , task descriptions , and some direct measurements . The incidence rate of first sick leave due to such disorders was calculated for different workload groups . The proportion of workers surviving without musculoskeletal disorders was estimated by the Kaplan-Maier product-limit estimator , and the effect of the exposure on the risk of incident disorders was estimated with the Cox proportional hazards model . RESULTS The highest annual incidences were observed for strenuous tasks , the incidence rate for men being 16.8 per 100 person-years [ 95 % confidence interval ( 95 % CI ) 8.0 - 30.9 ] for upper-limb disorders in strenuous tasks and 6.1 ( 95 % CI 2.0 - 14.1 ) in nonstrenuous tasks and that for women being 32.0 ( 95 % CI 11.7 - 69.7 ) and 9.9 ( 95 % CI 0.2 - 54.9 ) , respectively . The men 's risk of contracting an upper-limb or neck-shoulder disorder in strenuous tasks was about threefold [ hazard ratio ( HR ) 3.2 ( 95 % CI 1.1 - 9.4 ) for upper-limb disorders and 2.7 ( 95 % CI 0.9 - 8.1 ) for neck-shoulder disorders ] that of nonstrenuous tasks , whereas workload seemed not to affect low-back disorders . The workers first sought medical advice for their disorders typically some months after employment began . CONCLUSIONS Newly employed workers in h and -intensive tasks have a high risk of upper-limb and neck-shoulder disorders . An etiologic role for activities involving high force dem and s in upper-limb and neck-shoulder disorders is possible OBJECTIVE Since 2002 , an epidemiologic surveillance system of work-related , upper-limb musculoskeletal disorders ( MSDs ) has been implemented in France 's Pays de la Loire region to assess the prevalence of MSDs and their risk factors in the working population . METHODS The surveillance was based on a network of occupational physicians ( OPs ) and used the recommendations of a group of European experts ( criteria document consensus ) . In 2002 - 2003 , 80 of 400 OPs volunteered to participate . All underwent a training program to st and ardize the physical examination .  Health status was assessed by self-administered question naire and physical examination . Occupational risk factors were assessed by self-administered question naire .  Exposure scores were computed for each anatomic zone by summing the risk factors taken into account by the criteria document . RESULTS More than 50 % of the 2,685 men and women r and omly included in 2002 - 2003 experienced nonspecific musculoskeletal symptoms during the preceeding 12 months and approximately 30 % experienced them in the preceeding week . The prevalence of clinical ly diagnosed MSDs was high : approximately 13 % of workers experienced at least 1 of the MSDs . The most frequent disorder was rotator cuff syndrome followed by carpal tunnel syndrome and lateral epicondylitis . The prevalence of MSDs increased with age and varied widely across economic sectors and occupations . More than half of the workers were exposed to at least 2 risk factors of MSDs . Exposure varied according to industrial activity and occupation . According to the criteria document , a high percentage of MSD cases could be classified as probably work related ( 95 % in men and 89 % in women age < 50 , and 87 % in men and 69 % in women age > 50 ) . CONCLUSION Nonspecific upper-limb symptoms and specific upper-limb MSDs are common in the working population . These results show the need to implement prevention programs in most sectors to reduce the prevalence of MSDs Study Design . Cluster r and omized controlled trial with 6 and 8 quarters of follow-up . Objective . To test the effects of giving evidence -based information addressing psychosocial risk factors for pain-related disability and of screening workplaces for physical health hazards at work on reducing new episodes and duration of pain-related and general absence taking . Summary of Background Data . The “ flag strategy ” for h and ling low back pain problems is recommended in many Western countries but , so far , r and omized intervention studies addressing psychosocial risk factors for disability related to low back pain show mixed results . Methods . We followed employees from 39 different work sites in western Denmark , who had received interventions consisting of either a carefully prepared booklet providing evidence -based information on common musculoskeletal pain problems alone or in combination with systematic workplace screening for physical work hazards .  Absence due to pain for at least 7 days and the cumulative numbers of absence days were the main outcome measures . General absence taking was analyzed , too . Company registration s of sickness absence in combination with self-report on the cause of a given absence spell was used to inform absence spells . Results . A total of 3808 of 4006 eligible employees provided information . Among 1063 participants in the control arm , 1458 in the information arm , and 1287 in the  information and workplace screening  arm , 4.6 % , 6.9 % , and 4.6 % , respectively , experienced pain-related absence , and 27.8 % , 27.2 % , and 24.0 % , respectively , experienced general absence taking during follow-up . No positive effect on the risk of the 2 measures of absence or on the cumulative duration of absence among cases was seen . Conclusion . Results did not support population -based interventions addressing psychosocial risk factors for pain-related disability alone or in combination with workplace screening as effective in reducing the risk of pain-related absence taking or the duration of absence PURPOSE The effects of upper-limb ( arm cranking ) and lower-limb ( leg cranking ) exercise training on walking distances in patients with intermittent claudication was assessed . METHODS Sixty-seven patients ( 33 to 82 years old ) with moderate to severe intermittent claudication were recruited , and the maximum power generated during incremental upper- and lower-limb ergometry tests was determined , as were pain-free and maximum walking distances ( by using a shuttle walk test ) . Patients were r and omly assigned to an upper-limb training group ( n = 26 ) or a lower-limb training group ( n = 26 ) . An additional  untrained group ( n = 15 ) was recruited on an ad hoc basis in parallel with the main trial by using identical inclusion criteria . This group was subsequently shown to possess a similar demographic distribution to the two exercise groups . Supervised training sessions were held twice weekly for 6 weeks . RESULTS Both training programs significantly improved the maximum power generated during the incremental upper- and lower-limb ergometry tests ( P < . 001 ) , which may reflect an increase in central cardiovascular function that was independent of the training mode . More importantly , pain-free and maximum walking distances also improved in both training groups ( P < .001 ) . The improvements in the training groups were similar ; there were no changes in the untrained control group . These findings suggest that the symptomatic improvement after upper-limb exercise training may result , in part , from systemic cardiovascular effects rather than localized metabolic or hemodynamic changes . CONCLUSION Carefully prescribed upper-limb exercise training can evoke a rapid symptomatic improvement in patients with claudication , while avoiding the physical discomfort experienced when performing lower-limb weight-bearing exercise Background Neck and upper limb symptoms are frequently reported by computer workers .  Work style interventions are most commonly used to reduce work-related neck and upper limb symptoms but lifestyle physical activity interventions are becoming more popular to enhance workers health and reduce work-related symptoms . A combined approach targeting work style and lifestyle physical activity seems promising , but little is known on the effectiveness of such combined interventions . Methods / design The RSI@Work study is a r and omised controlled trial that aims to assess the added value of a lifestyle physical activity intervention in addition to a work style intervention to reduce neck and upper limb symptoms in computer workers . Computer workers from seven Dutch companies with frequent or long-term neck and upper limb symptoms in the preceding six months and /or the last two weeks are r and omised into three groups : ( 1 ) work style group , ( 2 ) work style and physical activity group , or ( 3 ) control group . The work style intervention consists of six group meetings in a six month period that take place at the workplace , during work time , and under the supervision of a specially trained counsellor . The goal of this intervention is to stimulate workplace adjustment and to improve body posture , the number and quality of breaks and coping behaviour with regard to high work dem and s. In the combined ( work style and physical activity ) intervention the additional goal is to increase moderate to heavy physical activity . The control group receives usual care . Primary outcome measures are degree of recovery , pain intensity , disability , number of days with neck and upper limb symptoms , and number of months without neck and upper limb symptoms . Outcome measures will be assessed at baseline and six and 12 months after r and omisation . Cost-effectiveness of the group meetings will be assessed using an employer 's perspective . Discussion This study will be one of the first to assess the added value of a lifestyle physical activity intervention in addition to a work style intervention in reducing neck and upper limb symptoms of computer workers . The results of the study are expected in 2007 OBJECTIVE To describe  sickness absence in patients with arm , neck and /or shoulder complaints and to evaluate determinants of sickness absence during 6 months follow-up . METHODS A prospect i ve cohort study in physical therapy practice with follow-up measurements at 3 and 6 months . The main outcome measure was the occurrence of sickness absence due to arm , neck and shoulder complaints during 6 months follow-up . Determinants were tested in univariate and multivariate GEE ( Generalized Estimating Equations ) analysis . RESULTS At baseline 161 patients ( 33 % ) reported absence from work . The multivariate analysis showed that self-reported work-relatedness of complaints , previous musculoskeletal trauma , higher severity of complaints at baseline , more somatization and low decision authority at work were associated with sickness absence during the follow-up period . CONCLUSION In physical therapy practice , social and psychological factors ( at work ) influence the occurrence of sickness absence in patients with arm , neck and /or shoulder complaints . These factors can be taken into account when developing and evaluating interventions to reduce sickness absence among these patients Amputees experience multiple , complex problems in addition to phantom limb pain . Although studies have yielded useful data on the relationship between phantom limb pain and other variables , this research generally has evaluated only one aspect of phantom limb pain and measured it at only one time point . The present study examined ongoing phantom limb pain and associated factors prospect ively through the use of hourly pain diaries that are completed over a 7-day period . The sample comprised a subset of 89 lower limb amputees taking part in a longitudinal research study . Subjects had a mean age of 46.1 years . Forty-seven per cent were female , 53 % male . Subjects completed a  Pain/Coping Diary  that measured phantom limb pain intensity , activity levels , medication use , and alcohol use on an hourly basis over a 7-day period . It also asked subjects to list the coping strategies used on the same hourly basis over a 7-day period . The diaries highlighted the following : Phantom limb pain appears to be episodic in nature and there is great variation in its intensity . Amputees use a limited repertoire of coping strategies to deal with episodes of phantom limb pain , and of those strategies that are used , few reduce the level of pain . This variability in phantom limb pain has important implication s for those involved in the care of amputees as a report of phantom limb pain at a given point in time may not reflect the amputee 's overall pain experience BACKGROUND Chronic low back pain ( LBP ) is a common musculoskeletal impairment in people with lower limb amputation . Given the multifactorial nature of LBP , exploring the factors influencing the presence and intensity of LBP is warranted . OBJECTIVE To investigate which physical , personal , and amputee-specific factors predicted the presence and intensity of LBP in persons with nondysvascular transfemoral amputation ( TFA ) and transtibial amputation ( TTA ) . DESIGN A retrospective cross-sectional survey . SETTING A national r and om sample of people with nondysvascular TFA and TTA . PARTICIPANTS Participants ( N = 526 ) with unilateral TFA and TTA due to nondysvascular etiology ( ie , trauma , tumors , and congenital causes ) and a minimum prosthesis use of 1 year since amputation were invited to participate in the survey . The data from 208 participants ( 43.4 % response rate ) were used for multivariate regression analysis . METHODS ( INDEPENDENT VARIABLES ) Personal ( ie , age , body mass , gender , work status , and presence of comorbid conditions ) , amputee-specific ( ie , level of amputation , years of prosthesis use , presence of phantom-limb pain , residual-limb problems , and nonamputated limb pain ) , and physical factors ( ie , pain-provoking postures including st and ing , bending , lifting , walking , sitting , sit-to-st and , and climbing stairs ) . MAIN OUTCOME MEASURES ( DEPENDENT VARIABLES ) LBP presence and intensity . RESULTS A multivariate logistic regression model showed that the presence of 2 or more comorbid conditions ( prevalence odds ratio [ POR ] = 4.34 , P = .01 ) , residual-limb problems ( POR = 3.76 , P < .01 ) , and phantom-limb pain ( POR = 2.46 , P = .01 ) influenced the presence of LBP . Given the high LBP prevalence ( 63 % ) in the study , there is a tendency for overestimation of POR , and the results must be interpreted with caution . In those with LBP , the presence of residual-limb problems ( β = 0.21 , P = .01 ) and experiencing LBP symptoms during sit-to-st and task ( β = 0.22 , P = .03 ) were positively associated with LBP intensity , whereas being employed demonstrated a negative association ( β = -0.18 , P = .03 ) in the multivariate linear regression model . CONCLUSIONS Rehabilitation professionals should be cognizant of the influence that comorbid conditions , residual-limb problems , and phantom pain have on the presence of LBP in people with nondysvascular lower limb amputation .  Further prospect i ve studies could investigate the underlying causal mechanisms of LBP . LEVEL OF EVIDENCE II Abstract Background and purpose : Complex regional pain syndrome type I ( CPRS I ) , is a complex of symptoms characterized by diffuse pain usually with associated swelling , vasomotor instability , and severe functional impairment of the affected extremity in stroke patients . Pain is a prominent feature and is often refractory to variety of treatment . Methods : To investigate the clinical , functional , and psychosocial effects of upper extremity aerobic exercise ( UEAE ) and compare the effect of aerobic exercise with that of conventional physiotherapy in patients with CPRS type I following stroke as a r and omized controlled assesor blinded 4 week- study . A total of 52 in patients with stroke [ mean age : 65.95 ± 8.7 ( min . = 53 , max . = 80 ) years , and the mean age of the control group was 67.50 ± 11.2 years ] , all within 6 months post-stroke and diagnosed with CPRS I.  The UEAE program consisted of an arm crank ergometer ( 10 W/min ) , in addition to a conventional physiotherapy ( whirlpool , TENS , retrograd massage ) . Primary outcome measures were CPRS clinical determinants ( pain , hyperalgesia , allodynia , and autonomic abnormalities ) secondary outcome measures were functional independence measure ( FIM ) , Nottingham Health Profile ( NHP ) , and Beck Depression Scale scores that were performed at 0 month ( baseline ) and 4 weeks ( post-treatment ) . Results : In UEAE group , patients reported significant pain relief ( 89.9 % ) and significant decline in CRPS signs and symptoms . The mean change in pain at shoulder , pain at the h and as well as and NHP and BDS scores between groups were statistically significant ( P < 0.05 ) . Conclusions : UEAE made an excellent improvement in the symptoms and signs of CRPS I. Combined treatment of conventional physiotherapy and aerobic exercises may be an excellent synthesis for this syndrome in these patients
There was limited evidence that computer keyboards with altered force displacement characteristics or altered geometry were effective in reducing carpal tunnel syndrome symptoms .
There was limited , but high quality , evidence that multi-disciplinary rehabilitation for non-specific musculoskeletal arm pain was beneficial for those workers absent from work for at least four weeks .
In adults with tenosynovitis there was limited evidence that modified computer keyboards were effective in reducing symptoms .
There was a lack of high quality evidence to inform workplace management of lateral epicondylitis .
BACKGROUND Upper limb pain is common among working-aged adults and a frequent cause of absenteeism .
AIMS To systematic ally review the evidence for workplace interventions in four common upper limb disorders .