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A Preventive Program for Work-related Musculoskeletal Disorders Among Surgeons

Outcomes of a Randomized Controlled Clinical Trial

Giagio, Silvia PT*; Volpe, Giovanni PT*; Pillastrini, Paolo PT, MSc; Gasparre, Giuseppe MD*; Frizziero, Antonio MD*; Squizzato, Francesco MD

doi: 10.1097/SLA.0000000000003199
RANDOMIZED CONTROLLED TRIALS
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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 vs PP: 75.9 ± 14.1; P = 0.04) and 6 months (70.6 ± 13.4 vs 75.3 ± 13.0; P = 0.04). The PP group had a significant reduction of low back pain (66.2% vs 50.0%; P = 0.04) and analgesic consumption (30.9% vs 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.

*Department of Physical and Rehabilitation Medicine, University of Padova, Padova, Italy

Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Bologna, Italy

Vascular and Endovascular Surgery Division, University of Padova, Padova, Italy.

Reprints: Francesco Squizzato, MD, Vascular and Endovascular Surgery Division, School of Medicine, University of Padova, via Giustiniani 2, 35128, Padova, Italy. E-Mail. Francesco_squizzato@icloud.com.

The authors report no conflicts of interest.

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