Lateral Epicondylitis and Physical Exposure at Work? A Review of Prospective Studies and Meta-Analysis
Lateral Epicondylitis and Physical Exposure at Work? A Review of Prospective Studies and Meta-Analysis
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DOI：
10.1002/acr.22874
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发表时间：
2016-11-01
影响因子：
4.7
通讯作者：
Aublet-Cuvelier, Agnes
中科院分区：
文献类型：
--
作者：
Descatha, Alexis;Albo, Francesco;Aublet-Cuvelier, Agnes
鉴于最近发表的研究，对前瞻性研究进行荟萃分析，以评估外上髁炎与工作中的身体暴露之间的任何关联。（队列或纵向，或发生率）不受语言或发表年份的限制，从4个数据库中选择原始前瞻性研究（PubMed、Scopus、Web of Science和Base de Donnees de Sante Publique）。从文献中提取了工作中的身体暴露与事件外上髁炎之间的相关性，并使用通用方差法（元优势比[meta-OR]）计算了元风险。在纳入的6，922例受试者（和3，449例随访受试者）中，256例事件外上髁炎在基线后2.5-6年诊断。所有已发表的研究均发现，腕关节和/或肘关节的联合生物力学暴露与外上髁炎发生率之间正相关的相对风险有显著估计。总体Meta OR为2.6（95%可信区间1.9-3.5），异质性较低（Q=1.4，P>0.05）。漏斗图和Egger的测试并没有表明主要的出版bias.ConclusionThe结果的荟萃分析强烈支持的假设之间的关联的生物力学暴露，涉及手腕和/或肘部在工作和发病率的外上髁炎。
ObjectiveIn view of recent published studies, a meta-analysis was undertaken on prospective studies in order to assess any association between lateral epicondylitis and physical exposure at work.MethodsUsing the key words lateral epicondylitis AND occupational AND (cohort OR longitudinal, OR incidence) without limitations on the language or year of publication, original prospective studies were selected from 4 databases (PubMed, Scopus, Web of Science, and Base de Donnees de Sante Publique) after 2 rounds (valid design, valid association reported, and valid work exposure). Relevant associations between physical exposure at work and incident lateral epicondylitis were extracted from the articles, and a meta-risk was calculated using the generic variance approach (meta-odds ratios [meta-ORs]).ResultsFrom 2001 to 2014, 5 prospective studies were included. Among 6,922 included subjects (and 3,449 who were followed), 256 cases of incident lateral epicondylitis were diagnosed 2.5-6 years after baseline. All the published studies found a significant estimation of relative risk for a positive association between combined biomechanic exposure involving the wrist and/or elbow and incidence of lateral epicondylitis. The overall meta-OR was 2.6 (95% confidence interval 1.9-3.5), with a low heterogeneity (Q=1.4, P>0.05). Funnel plots and Egger's test did not suggest major publication bias.ConclusionThe results of this meta-analysis strongly support the hypothesis of an association between biomechanic exposure involving the wrist and/or elbow at work and incidence of lateral epicondylitis.