CUMULATIVE TRAUMA DISORDER CLINICAL INTERVENTION STUDY

累积创伤障碍临床干预试验旨在前瞻性比较两种临床方案治疗与办公室工作和键盘输入相关的上肢问题。 这两个方案是1）初级医疗管理和2）物理医学与二级医疗管理。 此外，将通过将每个治疗组细分为再培训组和非再培训组，并在完成两种治疗方案后进行强化个体再培训，评估键盘技术再培训对长期结局的有效性。 技术再培训的长期评价是对“内在人体工程学”方法有效性的评估，该方法强调工作模式和风格对上肢损伤的贡献作用。 将对所有参与者进行现场补救，与该患者队列的当前医疗和人体工程学实践一致。将以两种主要方式评估治疗疗效，即通过症状和功能的回忆性评估以及通过临床评估，其中包括肌力、活动范围和灵活性以及疼痛激发的评估。 将通过直接临床评价、疼痛和功能的主观报告以及慢性或复发的证据来评估再培训的有效性。 将在主要治疗干预结束时（8-10周）和治疗结束后6个月评价治疗疗效。

The cumulative trauma disorder clinical intervention trial is designed to prospectively compare two clinical regimens for the treatment of upper extremity problems associated with office work and keyboarding. The two regimens are 1) primary medical management and 2) physical medicine with secondary medical management. In addition, the effectiveness of keyboard technique retraining on longer term outcome will be assessed by sub-dividing each treatment arm into a retrained and non-retrained group, with intensive individual retraining following completion of the two therapeutic regimens. The long-term evaluation of technique retraining represents an assessment of the effectiveness of the "intrinsic ergonomics" approach which emphasizes the contributory role of work patterns and styles to upper extremity injury. Worksite remediation will be conducted on all participants, consistent with current medical and ergonomic practice for this patient cohort. Efficacy of treatment will be assessed in two principal ways, by anamnestic assessment of symptoms and function and by clinical assessment, which will include evaluations of muscle strength, range of motion and flexibility, and provocation of pain. Efficacy of retraining will be assessed by direct clinical evaluation, subjective report of pain and function, and evidence of chronicity or recurrence. Efficacy of treatment will be evaluated at the conclusion of the principal therapeutic intervention (8-10 weeks) and at six months after the conclusion of treatment.