TY - JOUR
T1 - Interventions for the primary prevention of work-related carpal tunnel syndrome
AU - Lincoln, Andrew E.
AU - Vernick, Jon S.
AU - Ogaitis, Susanne
AU - Smith, Gordon S.
AU - Mitchell, Clifford S.
AU - Agnew, Jacqueline
N1 - Funding Information:
This work was supported by grant R49CCR302486 from the Centers for Disease Control and Prevention to the Johns Hopkins Center for Injury Research and Policy and grant DA MD17–95–1–5066 from the Defense Women’s Health Program, U.S. Army Medical Research and Materiel Command, Fort Detrick, Maryland. Our thanks go to Diane Thompson and Frederick Rivara for their guidance, Chris Beahler and Jennifer Sundheim for their assistance in obtaining relevant literature, Ellen MacKenzie for her helpful comments, and Marc Starnes for his statistical assistance.
PY - 2000/5
Y1 - 2000/5
N2 - Objective: To evaluate interventions for the primary prevention of work- related carpal tunnel syndrome (CTS). Selection Criteria: Studies had to include an engineering, administrative, personal, or multiple component intervention applied to a working or working-age population. All study designs that included comparison data were considered. Outcome measures included the incidence, symptoms, or risk factors for CTS, or a work-related musculoskeletal disorder of the upper extremity that included CTS in the definition. Results: Twenty-four studies met our inclusion criteria. Engineering interventions included alternative keyboards, computer mouse designs and wrist supports, keyboard support systems, and tool redesign. Personal interventions included ergonomics training, splint wearing, electromyographic biofeedback, and on-the-job exercise programs. Multiple component interventions (e.g., ergonomic programs) included workstation redesign, establishment of an ergonomics task force, job rotation, ergonomics training, and restricted duty provisions. Multiple component programs were associated with reduced incidence rates of CTS, but the results are inconclusive because they did not adequately control for potential confounders. Several engineering interventions positively influenced risk factors associated with CTS, but the evaluations did not measure disease incidence. None of the personal interventions alone was associated with significant changes in symptoms or risk factors. All of the studies had important methodologic limitations that may affect the validity of the results. Conclusions: While results from several studies suggest that multiple component ergonomics programs, alternative keyboard supports, and mouse and tool redesign may be beneficial, none of the studies conclusively demonstrates that the interventions would result in the primary prevention of carpal tunnel syndrome in a working population. Given the societal impact of CTS, the growing number of commercial remedies, and their lack of demonstrated effectiveness, the need for more rigorous and long-term evaluation of interventions is clear. Funding for intervention research should prioritize randomized controlled trials that include: (1) adequate sample size, (2) adjustment for relevant confounding variables, (3) isolation of specific program elements, and (4) measurement of long-term primary outcomes such as the incidence of CTS, and secondary outcomes such as employment status and cost. (C) 2000 American Journal of Preventive Medicine.
AB - Objective: To evaluate interventions for the primary prevention of work- related carpal tunnel syndrome (CTS). Selection Criteria: Studies had to include an engineering, administrative, personal, or multiple component intervention applied to a working or working-age population. All study designs that included comparison data were considered. Outcome measures included the incidence, symptoms, or risk factors for CTS, or a work-related musculoskeletal disorder of the upper extremity that included CTS in the definition. Results: Twenty-four studies met our inclusion criteria. Engineering interventions included alternative keyboards, computer mouse designs and wrist supports, keyboard support systems, and tool redesign. Personal interventions included ergonomics training, splint wearing, electromyographic biofeedback, and on-the-job exercise programs. Multiple component interventions (e.g., ergonomic programs) included workstation redesign, establishment of an ergonomics task force, job rotation, ergonomics training, and restricted duty provisions. Multiple component programs were associated with reduced incidence rates of CTS, but the results are inconclusive because they did not adequately control for potential confounders. Several engineering interventions positively influenced risk factors associated with CTS, but the evaluations did not measure disease incidence. None of the personal interventions alone was associated with significant changes in symptoms or risk factors. All of the studies had important methodologic limitations that may affect the validity of the results. Conclusions: While results from several studies suggest that multiple component ergonomics programs, alternative keyboard supports, and mouse and tool redesign may be beneficial, none of the studies conclusively demonstrates that the interventions would result in the primary prevention of carpal tunnel syndrome in a working population. Given the societal impact of CTS, the growing number of commercial remedies, and their lack of demonstrated effectiveness, the need for more rigorous and long-term evaluation of interventions is clear. Funding for intervention research should prioritize randomized controlled trials that include: (1) adequate sample size, (2) adjustment for relevant confounding variables, (3) isolation of specific program elements, and (4) measurement of long-term primary outcomes such as the incidence of CTS, and secondary outcomes such as employment status and cost. (C) 2000 American Journal of Preventive Medicine.
KW - Carpal tunnel syndrome
KW - Intervention studies
KW - Occupational health
KW - Review literature
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U2 - 10.1016/S0749-3797(00)00140-9
DO - 10.1016/S0749-3797(00)00140-9
M3 - Article
C2 - 10793280
AN - SCOPUS:0033998840
SN - 0749-3797
VL - 18
SP - 37
EP - 50
JO - American journal of preventive medicine
JF - American journal of preventive medicine
IS - 4 SUPPL. 1
ER -