This story may leave the reader with the impression that the evidence in support of exercise as a treatment for repetitive motion injuries is more consistently positive than it really is. The lead author of the literature review is quoted as saying that it’s not possible to draw firm conclusions, yet the story depicts exercise as ‘the best medicine’ for these (sometimes) work-related complaints.
The evidence for the value of exercise was actually found to be similar to that for the value of ergonomic approaches such as specially designed keyboards. In both cases the authors found conflicting evidence that these strategies help. While the difference in wording (conflicting versus limited evidence) may seem like splitting hairs, limited evidence means that positive outcomes were found in one well-designed trial, or consistently positive findings across multiple trials. On the other hand, conflicting evidence means that outcomes across trials were inconsistent–sometimes positive, sometimes showing no effect at all or perhaps even a negative effect.
The story might have done better to highlight how little is actually known about what works for these disorders–particularly in light of how much money is spent to address them. Most of the reviewed studies were poor quality and too small to draw any valid conclusions. While quoting experts who assert that various approaches can help makes for an interesting story, it doesn’t reflect what the available research shows–and so may not be as helpful as the writer may have intended.
The story quotes an expert who states that exercise is ‘cheap’, which is generally true, but can vary depending on the type of exercise. The exercises included in most of the studies examined were taught and supervised by trained individuals, which can increase the cost.
The story does not provide any data (either relative or absolute) about the benefits of exercise and other approaches to managing these injuries. This was probably appropriate, because outcomes are defined in different ways depending on the study, but the story author might have explained it. We’ll give the story the benefit of the doubt and grade it satisfactory.
The potential harms of exercise in the context of repetitive strain injuries, such as making the injury worse, are not mentioned.
The story accurately describes the original article as a review of studies, but it misstates the authors’ conclusions and makes it appear that exercise was far more effective than ergonomic approaches. In the original review, 8 of 14 studies looked at the effects of exercise compared with no treatment, and the authors state that here they found conflicting evidence of the effectiveness of exercise. The story inaccurately states that ‘the majority found positive results.’ Although the authors reported that the evidence for ergonomic adjustments such as special keyboards was also conflicting, the story says that evidence of their efficacy was limited.
It should also have stated that most of the 22 studies reviewed were rated as poor quality by the reviewers, and that 103 of the 126 references reviewed were rejected for various reasons.
The story states that the direct and indirect costs associated with repetitive strain disorders are as much as $100 billion dollars annually in the U.S. The original article actually estimated these costs at about 1/50 that much, or $2 billion. This exaggeration of impact is a form of disease-mongering.
Story quotes the lead author of the review as well as other experts, whose affiliations are provided.
The article correctly states that many types of exercise have been studied for repetitive strain injuries. However, rather than “hiking, cycling, walking, swimming and yoga,” as stated in the article, the studies examined generally were investigating the effects of prescribed exercises in a supervised context.
The story mentions that exercise in various forms has been studied as a potential therapy for repetitive strain injuries for many years and is not new.
The story does not appear to have relied solely or largely on a news release.
Systematic, Criteria-Driven
Monday at #ADA2021, an infectious disease epidemiologist, a journalist, and a researcher shared perspectives on communication of risk in the era of COVID-19: http://ow.ly/ROfR30rMeE7 @AstleyCM @garyschwitzer @berthahidalgo @ADA_DiabetesPro
Shoutouts to @susan_bewley @drkevinknopf @MichaelBaum11 in this call for more than fawning coverage from press releases for these kinds of stories.
Also, linked history inside goes back 5 years just on Grail apparently trying to become Holy Grail. https://twitter.com/garyschwitzer/status/1408849696416841731
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