Documents de Vet, Henrica C.W. 5 results

"STUDY DESIGN:
A 3-year prospective cohort study among workers of 34 companies in the Netherlands.
OBJECTIVES:
To investigate the relation between flexion and rotation of the trunk and lifting at work and the occurrence of low back pain.
SUMMARY OF BACKGROUND DATA:
Previous studies on work-related physical risk factors for low back pain either lacked quantification of the physical load or did not take confounding by individual and psychosocial factors into account.
METHODS:
The study population consisted of 861 workers with no low back pain at baseline and complete data on the occurrence of low back pain during the 3-year follow-up period. Physical load at work was assessed by means of analyses of video-recordings. Information on other risk factors and the occurrence of low back pain was obtained by means of self-administered questionnaires. RESULTS: An increased risk of low back pain was observed for workers who worked with the trunk in a minimum of 60 degrees of flexion for more than 5% of the working time (RR 1.5, 95% CI 1.0-2.1), for workers who worked with the trunk in a minimum of 30 degrees of rotation for more than 10% of the working time (RR 1.3, 95% CI 0.9-1. 9), and for workers who lifted a load of at least 25 kg more than 15 times per working day (RR 1.6, 95% CI 1.1-2.3).
CONCLUSIONS:
Flexion and rotation of the trunk and lifting at work are moderate risk factors for low back pain, especially at greater levels of exposure."

"the objective was to determine whether physical and psychosocial load at work influence sickness absence due to low back pain. After adjustment of the work related physical and psychosocial factors for each other and for other potential determinants, significant rate ratios ranging from 2.0 to 3.2 were found for trunk flexion, trunk rotation, lifting, and low job satisfaction. A dose-response relation was found for trunk flexion, but not for trunk rotation or lifting. Non-significant rate ratios of about 1.4 were found for low supervisor support and low coworker support. Quantitative job demands, conflicting demands, decision authority, and skill discretion showed no relation with sickness absence due to low back pain. Flexion and rotation of the trunk, lifting, and low job satisfaction are risk factors for sickness absence due to low back pain. Some indications of a relation between low social support, either from supervisors or coworkers, and sickness absence due to low back pain are also present. "

Various conservative treatment options for repetitive strain injury are widely used, despite questionable evidence of their effectiveness. This systematic review evaluates the effectiveness of these treatment options for relieving symptoms of repetitive strain injury and improving activities of daily living. Searches in Medline and Embase, with additional reference checking resulted in 15 eligible trials for this review. Methodological quality was assessed, and data-extraction was performed. With the use of a "best-evidence synthesis", no strong evidence was found for the effectiveness of any of the treatment options. There is limited evidence that multidisciplinary rehabilitation, ergonomic intervention measures, exercises, and spinal manipulation combined with soft tissue therapy are effective in providing symptom relief or improving activities of daily living. There is conflicting evidence for the effectiveness of behavioral therapy. In conclusion, little is known about the effectiveness of conservative treatment options for repetitive strain injury. To establish strong evidence, more high-quality trials are needed.

Objectives This study investigated the relationship between psychosocial work characteristics and low-back pain and the potential intermediate role of psychological strain variables in this relationship. Methods The research was part of a prospective cohort study of risk factors for musculoskeletal symptoms. The study population consisted of 861 workers from 34 companies in The Netherlands who had no low-back pain at baseline and for whom data on the occurrence of low-back pain were obtained with annual questionnaires during a 3-year follow-up period. Information on psychosocial work characteristics and psychological strain variables was collected using a questionnaire at baseline. Cases of low-back pain were defined as workers who reported, in at least one of the annual follow-up questionnaires, that they had had regular or prolonged low-back pain in the previous 12 months.Results After adjustment for individual factors and quantified physical load at work, nonsignificant relative risks ranging from 1.3 to 1.6 were observed for high quantitative job demands, high conflicting demands, low supervisory support, and low co-worker support. Decision authority and skill discretion showed no relationship with low-back pain. In general, the estimated relative risks for the psychosocial work characteristics were scarcely influenced by additional adjustment for job satisfaction, emotional exhaustion, and sleeping difficulties. Conclusions It can be concluded that low social support, from either supervisors or co-workers, appears to be a risk factor for low-back pain. Some indications of a relationship between high quantitative job demands and high conflicting demands and low-back pain were also found. Little evidence was found for an intermediate role for the psychological strain variables under study.

"In opdracht van de ministeries van Sociale Zaken en Werkgelegenheid en Volksgezondheid, Welzijn en Sport is door TNO Arbeid, in samenwerking met het Nederlands Kenniscentrum Arbeid en Klachten Bewegingsapparaat, de Faculteit der Bewegingswetenschappen van de Vrije Universiteit en het EMGO-instituut van het VU Medische Centrum, onderzoek verricht naar preventie, behandeling en reïntegratie bij Repetitive Strain Injuries (RSI). Het belangrijkste doel van deze studie was prioriteiten te stellen in toekomstig onderzoek naar de effectiviteit van preventieve, curatieve en reïntegratiemaatregelen voor RSI, zodat de onderzoeksmiddelen zo efficiënt mogelijk kunnen worden ingezet. Voordat de projectgroep deze prioriteiten kon stellen, was het van belang te weten van welke preventieve maatregelen, behandelingen en reïntegratiemethoden al wel bewezen was dat deze effectief zijn. In aanvulling daarop is de stand van zaken over ontstaansmechanismen weergegeven en wordt beknopt de stand van zaken voor risicofactoren voor RSI samengevat. "