Abstract
van Eijsden-Besseling MD, van den Bergh KA, Staal JB, de Bie RA, van den Heuvel WJ.
The course of nonspecific work-related upper limb disorders and the influence of demographic
factors, psychologic factors, and physical fitness on clinical status and disability.
Objective
To assess the course of nonspecific work-related upper limb disorders (WRULD) and
the influence of sociodemographic factors, psychologic factors, and physical fitness
on clinical status and functional disability.
Design
Retrospective cohort study with cross-sectional analysis among computer workers with
several stages of nonspecific WRULD; average follow-up 4 years. Sociodemographic and
medical characteristics were assessed based on medical records at onset and diagnosis.
After informed consent at follow-up, participants received a questionnaire assessing
psychologic and physical fitness characteristics.
Setting
Outpatient department of rehabilitation medicine, University Hospital Maastricht;
tertiary referral center for nonspecific WRULD.
Participants
Computer workers (N=182) with nonspecific WRULD, 18 to 50 years, first consultation
1998 to 2001; those with specific WRULD and incomplete medical records and treatment
charts were excluded.
Interventions
Not applicable.
Main Outcome Measures
Stage of nonspecific WRULD (clinical status) and Disabilities of Arm, Shoulder and
Hand questionnaire [DASH] (functional disability).
Results
A total of 104 patients (57%) returned the completed questionnaire at follow-up (November
2003). Fourteen percent developed chronic benign pain syndrome, 9% recovered. The
remaining (77%) worsened slightly. A higher DASH score was associated with being elderly
(unstandardized regression coefficient [B=.64]), being a woman (B=10.42), having a
lower educational achievement (B=9.72), and poorer self-reported physical fitness
level (B=1.68); lower educational achievement and poorer self-reported physical fitness
were associated with a more severe clinical status. Psychologic factors did not influence
disability or clinical status.
Conclusions
The prognosis of computer workers with nonspecific WRULD is not favorable. Those with
a lower educational achievement and poorer self-reported physical fitness are at risk
for a more severe clinical status and functional disability. Being elderly and a woman
are also risk factors for further disability. A prospective cohort study is needed
to unravel these relationships. Nevertheless, computer workers with nonspecific WRULD
should be encouraged to enter fitness programs.
Key Word
List of Abbreviations:
DASH (Disabilities of Arm, Shoulder and Hand questionnaire), DASH-DLV (Disabilities of Arm, Shoulder and Hand questionnaire, Dutch Language Version), WRULD (work-related upper limb disorders)To read this article in full you will need to make a payment
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Article info
Footnotes
Supported by Maastricht University, Maastricht, The Netherlands.
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.
Identification
Copyright
© 2010 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
