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[Return to work after musculoskeletal disorders: a systematic review of good practices guidelines].

OBJECTIVE
To identify existing return-to-work (RTW) guidelines following a sickness absence (SA) due to musculoskeletal disorders (MSD) and evaluate their methodological quality.


METHODS
We performed a systematic search for RTW guideliness written in English, Spanish and Catalan, that included total or partial information on MSD. The identified guidelines were evaluated qualitatively and quantitatively by seven experts using the validated AGREE method. Standardized scores for each domain were calculated for each of the guidelines, as well as the median of the experts scores for each of the items. In addition, each expert made a subjective judgment on the quality of the selected guidelines.


RESULTS
Thirty-two guidelines were identified. From these, 6 (3 of which were MSD-specific) were selected for an evaluation of their methodological quality. Only two, the Official Disability Guidelines (ODG) and the Work-related Musculoskeletal Disorders Guide & Tools (WRGT) were felt to be suitable for use without further methodological modifications. In general, all of the guidelines properly define their objectives and target audience, and the RTW options are presented in a clear and precise way. However, all guides but one (ODG) have limitations in the criteria for selection of scientific evidence, and the potential conflicts of interest are not stated.


CONCLUSIONS
Only two guides of high methodological quality were identified. However, an evidence-based evaluation of the quality of their recommendations is recommended prior to their use in professional practice.