Physical activity interventions and musculoskeletal health in surgeons: a systematic review and meta-analysis

Surgeons face a significant risk of work-related musculoskeletal disorders due to the demands of their profession. However, the effects of physical activity interventions (eg, exercises or active and passive microbreaks) remain unclear. This study aimed to evaluate the effects of physical activity interventions on musculoskeletal health in the surgical population.A systematic literature search was conducted between 15 April 2024 and 30 May 2024, using six databases. We only included experimental studies, and meta-analyses were conducted for active microbreaks, while we narratively synthesised the results for other physical activity interventions due to small number of studies. The level of evidence was evaluated using Grading of Recommendations Assessment, Development and Evaluation.Among 5576 identified articles, a total of 9 articles were included. For active microbreaks, the meta-analyses showed pooled estimates between -0.24 (95% CI -0.36 to -0.11) and -0.62 (95% CI -0.87 to -0.37) for pain in body regions related to the spine, upper extremity and lower extremity. For passive microbreaks, significantly lower levels of musculoskeletal pain and strain were found in the spine, neck, arms and knees at the end of the procedure compared with no intervention. For exercise with and without ergonomic counselling, a significant decrease in pain was found from baseline to 3, 6 and 12 months in most body parts. For all intervention types, the level of evidence ranged from very low to low.We found that physical activity interventions have positive effects on the musculoskeletal health of surgeons. However, the low level of evidence highlights the need for high-quality research.