Occupational Therapy

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Browsing Occupational Therapy by Subject "Backache -- Medical rehabilitation"

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    Workplace-based rehabilitation of upper limb conditions : a systematic review
    (Stellenbosch : Stellenbosch University, 2018-03) Hoosain, Munira Begum; De Klerk, Susan; Burger, Marlette; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Health & Rehabilitation Sciences. Occupational Therapy.
    ENGLISH SUMMARY : Background: Upper limb conditions are a common and growing cause of work related ill health and disability. International and South African legislation support work rehabilitation and specifically workplace-based rehabilitation, but the availability of workplace-based rehabilitation services appears to be limited in South Africa, with more focus on once-off work evaluations. Evidence is needed on the effectiveness of workplace-based rehabilitation services, in order to inform future service delivery. Objective: The objective of this systematic review was to identify, collate and analyse the current available evidence on the effectiveness of workplace-based rehabilitative interventions in workers with upper limb conditions on work performance, pain, absenteeism, productivity and other outcomes such as ergonomic risk and mental health. Methods: This systematic review was designed in accordance with PRISMA guidelines and registered with PROSPERO as number: PROSPERO CRD42017059708. We searched Medline (PubMed), Cochrane Library, Scopus, Web of Science, EBSCOhost (Academic Search Premier, Africa-Wide, CINAHL), OTSeeker and PEDro with search terms in four broad areas: upper limb, intervention, workplace and clinical trial (no date limits). Studies including neck pain only or musculoskeletal pain in other areas were not included. Risk of bias in included studies was assessed using a question and rating system developed by the Institute for Work and Health (IWH). As meta-analysis was not possible, study results were analysed through a narrative synthesis. Results: The initial literature search located 1071 articles, of which 80 were full text reviewed. Seventeen studies were included, across 28 articles, reporting on various outcomes. Nine studies were of high methodological quality, seven of medium quality, and one of low quality. Studies were sorted into intervention categories: Ergonomic controls (n=3), ergonomic training and workstation adjustments (n=4), exercise and resistance training (n=6), clinic-based versus workplace-based work hardening (n=1), nurse case manager training (n=1), physiotherapy versus Feldenkrais (n=1), and ambulant myofeedback training (n=1). The largest body of evidence supported workplace exercise programs, with positive effects for ergonomic training and workstation adjustments, and mixed effects for ergonomic controls. Ambulant myofeedback training had no effect. The remaining three categories had positive effects in the single study on each intervention. Conclusion and Recommendations: There is substantial evidence supporting workplace exercise programs. Further research needs to be conducted on the remaining intervention categories. Researchers are encouraged to collaborate with clinicians to enable more high quality research in “real-life” rehabilitation contexts, including individualised work rehabilitation. Clinicians should build partnerships with the Department of Labour and stakeholders at workplaces, in order to develop rehabilitation resources in work environments.