Level of evidence for UEMSD interventions and accompanying messages
| Level of evidence (direction of effect)* | Intervention (number of studies)† | Message |
|---|---|---|
| Strong (positive) | ▸ Resistance training (7) | Implementing a workplace-based resistance training exercise programme, policy or practice can help manage and prevent UEMSD symptoms and disabilities |
| Moderate (positive) | ▸ Stretching exercise programmes (includes UE component) (6) ▸ Vibration feedback on static mouse use (3) ▸ Forearm supports (workstation) (3) | Consider implementing in practices if applicable to the work context |
| Moderate (no effect) | ▸ Job stress management training (UE outcomes) (2) ▸ Biofeedback (EMG) training (5) ▸ Workstation adjustment alone (minimal worker engagement) (5) | Seek alternative interventions based on OHS experience/knowledge |
| Limited (positive) | ▸ Aerobic exercise programmes (3) ▸ Alternative keyboard (force profile) (1) ▸ Trackball pointing device (+/− arm supports) (1) ▸ Rest breaks (5) ▸ Postural exercise programme (1) ▸ Specialised exercise program (Feldenkrais) (1) ▸ Curved seat pan chair (non-office) (1) ▸ Lighter/wider dental tools (1) ▸ Neuromuscular exercise (non-office) (1) | Not enough evidence from the scientific literature to guide current policies/practices |
| Limited (no effect) | ▸ Work redesign to minimise shoulder load (non-office) (4) ▸ Joystick pointing device (+/− arm supports) (1) ▸ Neck school programme (1) individualised exercise programme (+/− stress management) (1) | Not enough evidence from the scientific literature to guide current policies/practices |
| Mixed | ▸ Ergonomics training+workstation adjustment (8) ▸ Low-intensity participatory ergonomics (PE) programmes (4) ▸ Cognitive behavioural training programme (2) ▸ Ergonomics training (2) | Not enough evidence from the scientific literature to guide current policies/practices |
| Insufficient | ▸ Rest breaks plus exercise (1) ▸ Reduced hours (1) ▸ Alternative keyboard (split) (1) ▸ Individual interventions (office) (1) ▸ Patient handling programme (1) ▸ OHS training (2–3 h) and/or ergonomic advice/change and/pr exercise and/or medical examination (1) | Not enough evidence from the scientific literature to guide current policies/practices |
*No studies reported a negative effect.
†Studies may appear in multiple intervention categories if they have different intervention arms.
OHS, Occupational Health and Safety; UEMSD, upper extremity musculoskeletal disorders.