A Cochrane review [Abstract] 1 included 10 studies with a total of 2745 subjects. Two studies were assessed with low risk of bias. The interventions included body function, activity performance, participation, environmental interventions and personal factors as a single strategy, or a combination of strategies. Most trials (N = 8) examined office workers. Few workers were sick-listed. Thus, workplace interventions (WIs) were seldom designed to improve return-to-work.
There was low quality evidence that showed no significant differences between specific single WIs and no intervention for pain prevalence or severity. If present, significant results in favour of WIs were not sustained across follow-up times. There was moderate quality evidence (1 study, 415 workers) that a four-component WI was significantly more effective in reducing sick leave in the intermediate-term (OR 0.56, 95% CI 0.33 to 0.95), but not in the short- (OR 0.83, 95% CI 0.52 to 1.34) or long-term (OR 1.28, 95% CI 0.73 to 2.26). These findings might be because only a small proportion of the workers were sick-listed.
Comment:The quality of evidence is downgraded by imprecise results (few patients and wide confidence intervals) and inconsistency (heterogeneity in interventions and outcomes).
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