Combined Ergonomic and Physical Activity Interventions for Preventing Work-Related Musculoskeletal Disorders: An Integrated Review

Background: Work-related musculoskeletal disorders (WMSDs) account for 30% of workplace injuries, creating significant occupational health and economic burdens. The purpose of this review was to synthesize existing evidence on the effectiveness of combined ergonomic and physical activity interventions compared to single-approach methods in preventing WMSDs among workers engaged in manual handling and repetitive motion. Methods: A systematic search across Web of Science Core Collection, CINAHL, Embase, and PubMed was conducted for English-language studies (2019–2024) following PRISMA guidelines. Studies examining ergonomic interventions, manual handling training, or workplace physical activity programs for adult workers were included. The Johns Hopkins Nursing Evidence-Based Practice Model guided quality assessment. Seven studies from six countries met the inclusion criteria: one Level I randomized controlled trial (A quality), four Level II quasi-experimental studies (B quality), and two Level III observational studies (B quality). Results: Combined interventions of ergonomic and physical activity showed potential benefits of pain reductions (neck: 38%, hand/wrist: 37%) and flexibility improvements, though effect sizes varied considerably. Single interventions showed fewer benefits: ergonomic education reduced high-risk MSDs from 35.1% to 0%, while whole-body stretching achieved greater pain intensity reduction (mean difference 3.6) compared to education alone (mean difference 2.5). Intervention durations ranged from 6 weeks to 22 months across healthcare, manufacturing, and industrial workers. Conclusions/Application to Practice: Combined ergonomic and physical activity interventions appeared more effective than single approaches for WMSD prevention, demonstrating clinically meaningful improvements with high completion rates. However, study design variability necessitates cautious interpretation. Future research requires standardized trials with long-term and cost-effectiveness analyses.