Intervenções no trabalho para prevenção de distúrbios musculoesqueléticos: uma revisão sistemática

Abstract

Musculoskeletal Disorders (MSD) cause physical and psychological suffering in workers due to a set of symptoms that can affect one or more body segments, so interventions can be a strategy to avoid these effects. Interventions to prevent workrelated MSDs can be carried out in the work environment in different ways: on the physical work environment with adjustments or adaptations to the physical structure of work; on the individual through bodily activities such as physical exercises or interventions focusing on behavioral aspects based on the worker's needs; on the organizational aspects of work that include the pace of work and the organization of tasks, for example. It is, therefore, a systematic review (SR) of the literature that aimed to analyze the effects of intervention studies in the work environment for the prevention of MSD; the specific objectives were: to describe the main preventive DME interventions applied to occupational categories; identify and describe the results of interventions and the populations addressed; classify studies according to methodological quality criteria. The following databases were consulted: Pubmed, Lilacs, PEDro and Web of Science, from 2015 to 2020 (publications until October 31, 2020). Articles whose study designs were randomized trials and community trials published in English, Portuguese and Spanish that aimed to prevent MSDs through interventions at work, provided they were not from the perspective of clinical care, were eligible. The search strategy was designed taking into account the specifics of each database and the search resulted in 1,354 recovered files. The files were stored in the Mendeley Desktop software, in which duplicates and files with invalid metadata were removed. According to the eligibility criteria, the selection resulted in 58 published studies that were organized in spreadsheets and whose data were extracted for analysis and synthesis of evidence. Of these studies, 38 were randomized controlled trials and 20 were community trials; 31 addressed interventions on the individual, 04 on the physical work environment, 03 studies carried out interventions on aspects of work organization; 20 studies investigated multidimensional interventions, that is, approaches in more than one sphere in the same intervention program. Most of the studies (28 studies) were published in European countries, in particular, in the Nordic and Scandinavian countries in diverse populations. The methodological quality of the studies was evaluated according to the Critical Appraisal Skills Program (CASP) tool and only 15 studies satisfactorily met its requirements and, therefore, their results were explored and used for discussion. The studies showed heterogeneity in terms of characteristics and analysis methods, which made the construction of a meta-analysis unfeasible. The studies showed positive results with improvement of musculoskeletal pain, reduction of absenteeism related to MSD, however, it cannot be said based on strong evidence about the most effective modality to prevent MSD in workers.