A personalized self-management and intensive spa therapy intervention for musculoskeletal disorders of the upper extremities contributes to reduce disability: A randomized controlled trial

Abstract

Musculoskeletal disorders (MSDs) constitute a major occupational health problem in the working population. MSDs manifest as localized pain or functional difficulty in one or more anatomical areas, such as the cervical spine, shoulder, elbow, hand, and wrist. Although physical exercise is widely recommended, few studies with a good level of evidence have enabled us to base a complete, well-constructed intervention on exercise that can be offered as secondary prevention in these disorders. A prospective, multicenter, comparative, randomized study using Zelen's design. This study falls under active prevention of MSDs of the upper extremities. Participants are workers aged between 18 and 65 years, with any type of job or workstation, with or without a history of sick leave. The primary aim is to show the superiority at 3 months of a combination of spa therapy, exercise, and self-management workshops for 6 days over self-management workshops in terms of employee functional capacity in personal and professional daily life (QUICK DASH scale). We included 148 patients, 73 assigned to the intervention group and 75 to the control group. At 3 months, the total score of functional disability assessed by QUICK DASH decreased in both groups. This reduction was higher in the intervention group (−10.04 ± 15.83) versus control group (−5.57 ± 13.45). We noticed a non-significant decrease for QUICK DASH total score ( P = 0.10). However, the field specifically assessing disabilities in physical activities; QUICK DASH sport; had significantly decreased in the intervention group (−14.58 ± 21.49) versus control group (−6.72 ± 19.04) ( P = 0.02). The originality of this intervention lies, in its short, intensive format, which is compatible with remaining in work; and in its multidisciplinary approach. This trial demonstrates the benefits of a short course of spa therapy combined with a personalized self-management program on the functional capacity in their daily life.