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A preventive program for work-related musculoskeletal disorders among surgeons: outcomes of a randomized controlled clinical trial
Giagio S, Volpe G, Pillastrini P, Gasparre G, Frizziero A, Squizzato F
Annals of Surgery 2019 Jan 18:Epub ahead of print
clinical trial
6/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

This multicenter randomized study evaluates the effectiveness of a program based on ergonomics application and specific physical exercises to reduce work-related musculoskeletal disorders among surgeons. The intervention group showed a significant improvement in quality of life, low back pain, and analgesic consumption after 6 months. OBJECTIVE: To evaluate the effectiveness of a program to reduce work-related musculoskeletal disorders (WRMSD) among surgeons. BACKGROUND: Surgeons are at high risk of WRMSD due to many physical and psychosocial factors. METHODS: This study is a multicenter randomized clinical trial (UMIN000028557) conducted from January to August 2015. Following cluster randomization by surgical division, surgeons were allocated to 2 groups. The NPP group (No Preventive Program) underwent no intervention, while the PP group (Preventive Program) followed ergonomic principles in the operating room and specific physical exercises supervised by a physical therapist. A multiple logistic regression was performed to identify baseline WRMSD risk factors. WRMSD assessment was based on 1 ad hoc and 3 validated questionnaires: Nordic Musculoskeletal Questionnaire (NMQ), Numerical Rating Scale (NRS), and Short Form 36 Health Survey (SF-36). Follow-up was planned after 3 and 6 months. RESULTS: One hundred forty-one surgeons matched the inclusion criteria and were randomized in the PP (n = 65) and NPP (n = 76) groups. At the initial analysis, physical activity was the only modifiable independent risk factor for WRMSD (OR 2.44; p = 0.05). The PP group showed a significant improvement in the item "General Health" (GH) regarding quality of life at 3 (NPP 70.5 +/- 15.2 versus PP 75.9 +/- 14.1; p = 0.04) and 6 months (70.6 +/- 13.4 versus 75.3 +/- 13.0; p = 0.04). The PP group had a significant reduction of low back pain (66.2% versus 50.0%; p = 0.04) and analgesic consumption (30.9% versus 15.5%; p = 0.03) after 6 months. CONCLUSIONS: This study demonstrated the effectiveness of a global program based on the application of ergonomics in the operating room and specific physical exercises.
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