Background

Musculoskeletal injuries are common after road traffic crash (RTC) and can lead to poor work-related outcomes. This review evaluated the impact of interventions on work-related (e.g. sick leave), health, and functional outcomes in individuals with a RTC-related musculoskeletal injury, and explored what factors were associated with work-related outcomes.

Methods

Searches of seven databases were conducted up until 9/03/2023. Eligible interventions included adults with RTC-related musculoskeletal injuries, a comparison group, and a work-related outcome, and were in English. Meta-analyses were conducted using RevMan and meta-regressions in Stata.

Results

Studies (n = 27) were predominantly conducted in countries with third-party liability schemes (n = 26), by physiotherapists (n = 17), and in participants with whiplash injuries (94%). Pooled effects in favour of the intervention group were seen overall (SMD = − 0.14, 95% CI: − 0.29, 0.00), for time to return to work (− 17.84 days, 95% CI: − 24.94, − 10.74), likelihood of returning to full duties vs. partial duties (RR = 1.17, 95% CI: 1.01, 1.36), decreased pain intensity (− 6.17 units, 95% CI: − 11.96, − 0.39, 100-point scale), and neck disability (− 1.77 units, 95% CI: − 3.24, − 0.30, 50-point scale).

Discussion

Interventions after RTC can reduce time to return to work and increase the likelihood of returning to normal duties, but the results for these outcomes were based on a small number of studies with low-quality evidence. Further research is needed to evaluate a broader range of interventions, musculoskeletal injury types, and to include better quality work-related outcomes.

中文翻译：

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道路交通事故相关肌肉骨骼损伤后干预措施对工作成果的有效性：系统评价和荟萃分析

背景

道路交通事故 (RTC) 后肌肉骨骼损伤很常见，并可能导致工作相关结果不佳。本综述评估了干预措施对 RTC 相关肌肉骨骼损伤个体的工作相关（例如病假）、健康和功能结果的影响，并探讨了哪些因素与工作相关结果相关。

方法

截至 2023 年 9 月 3 日，对七个数据库进行了检索。符合条件的干预措施包括患有 RTC 相关肌肉骨骼损伤的成年人、对照组和与工作相关的结果，并且采用英语。使用 RevMan 和 Stata 中的元回归进行荟萃分析。

结果

研究 ( n  = 27) 主要在具有第三方责任计划的国家 ( n  = 26) 进行，由物理治疗师 ( n  = 17) 以及颈部扭伤的参与者 (94%) 进行。总体而言，对于返回工作时间（− 17.84 天，95% CI：− 24.94，− 10.74）、可能性（SMD = − 0.14，95% CI：− 0.29，0.00），有利于干预组的汇总效应恢复全部职责与部分职责的差异（RR = 1.17，95% CI：1.01，1.36），疼痛强度降低（− 6.17 单位，95% CI：− 11.96，− 0.39，100 分制）以及颈部残疾（− 1.77 单位，95% CI：− 3.24，− 0.30，50 分制）。

讨论

RTC 后的干预措施可以减少返回工作的时间并增加返回正常职责的可能性，但这些结果是基于少量低质量证据的研究。需要进一步的研究来评估更广泛的干预措施、肌肉骨骼损伤类型，并包括更好质量的工作相关结果。