Does Integration of Physiotherapy and Ergonomics Improve Worker’s Health and Work Efficiency? A Narrative Review

Abstract

Background: Work-related musculoskeletal disorders (WMSDs) are a leading cause of occupational morbidity, absenteeism, and reduced productivity, particularly in sedentary and desk-based occupations. While ergonomic modifications and physiotherapy interventions independently demonstrate benefit, the added value of integrated approaches remains uncertain. Objective: To systematically synthesize recent evidence on whether combined physiotherapy and ergonomic interventions improve musculoskeletal health and work-related outcomes. Methods: A systematic review without meta-analysis was conducted. PubMed/MEDLINE, ScienceDirect, Pedro, and Google Scholar were searched for English-language studies published between January 2020 and December 2025. Eligible studies included randomized controlled trials, cluster RCTs, quasi-experimental, and controlled interventional studies evaluating integrated physiotherapy and ergonomic programs in working populations. Dual screening, standardized data extraction, and risk-of-bias assessment were performed. Results: Twenty studies met inclusion criteria, including 12 controlled trials. Across controlled studies, 83% reported statistically significant reductions in musculoskeletal pain, with moderate effect sizes (SMD −0.65 to −0.72; mean differences approximately −1.8 to −2.1 on 10-point scales). Productivity or work-ability outcomes improved in 80% of reporting studies, though effects were smaller (e.g., SMD +0.48, 95% CI 0.12–0.84) and more heterogeneous. Risk of bias was low in 58% of controlled trials; overall certainty was moderate for pain outcomes and low-to-moderate for productivity outcomes. Conclusion: Integrated physiotherapy and ergonomic interventions are consistently associated with meaningful pain reduction and functional improvement, with emerging but less certain evidence for productivity benefits. Standardized productivity measures and longer-term trials are needed.