CUMULATIVE TRAUMA DISORDER CLINICAL INTERVENTION STUDY

累积创伤障碍临床干预试验旨在前瞻性地比较两种治疗办公室工作和键盘相关上肢问题的临床方案。这两种方案是1)初级医疗管理和2)物理医疗加二级医疗管理。此外，键盘技术再培训的长期效果将通过将每支治疗臂细分为再培训组和非再培训组进行评估，在完成两种治疗方案后，进行密集的个人再培训。技术再培训的长期评估是对“内在人体工程学”方法的有效性的评估，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保持一致。治疗效果将通过两种主要方法进行评估，一种是对症状和功能的记忆评估，另一种是临床评估，其中包括对肌肉力量、活动范围和灵活性以及疼痛刺激的评估。再培训的效果将通过直接的临床评估、对疼痛和功能的主观报告以及慢性或复发的证据来评估。治疗效果将在主要治疗干预结束时(8-10周)和治疗结束后6个月进行评估。

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.