Advertisement

Upper Limb Absence: Predictors of Work Participation and Work Productivity

Published:January 11, 2016DOI:https://doi.org/10.1016/j.apmr.2015.12.022

      Abstract

      Objectives

      To analyze work participation, work productivity, contributing factors, and physical work demands of individuals with upper limb absence (ULA).

      Design

      Cross-sectional study: postal survey (response rate, 45%).

      Setting

      Twelve rehabilitation centers and orthopedic workshops.

      Participants

      Individuals (n=207) with unilateral transverse upper limb reduction deficiency (RD) or acquired amputation (AA), at or proximal to the carpal level, between the ages of 18 and 65 years, and a convenience sample of control subjects (n=90) matched on age and sex.

      Interventions

      Not applicable.

      Main Outcome Measures

      Employment status, self-reported work productivity measured with the Quality-Quantity method, and self-reported upper extremity work demands measured with the Upper Extremity Work Demands scale.

      Results

      Seventy-four percent of the individuals with RD and 57% of the individuals with AA were employed (vs 82% of the control group and 66% of the general population). Male sex, younger age, a medium or higher level of education, prosthesis use, and good general health were predictors of work participation. Work productivity was similar to that of the control group. Higher work productivity was inversely related to musculoskeletal complaint–related pain. When having predominantly mentally demanding work, individuals with ULA perceived higher upper extremity work demands compared with controls.

      Conclusions

      Work participation of individuals with RD was slightly higher compared with that of the general population, whereas employment rates of individuals with AA were slightly lower. Furthermore, work productivity did not differ between individuals with RD, AA, and controls.

      Keywords

      List of abbreviations:

      AA (acquired amputation), CI (confidence interval), MSC (musculoskeletal complaint), RD (reduction deficiency), UEWD (Upper Extremity Work Demands), ULA (upper limb absence)
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Archives of Physical Medicine and Rehabilitation
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Kejlaa G.H.
        The social and economic outcome after upper limb amputation.
        Prosthet Orthot Int. 1992; 16: 25-31
        • Datta D.
        • Selvarajah K.
        • Davey N.
        Functional outcome of patients with proximal upper limb deficiency—acquired and congenital.
        Clin Rehabil. 2004; 18: 172-177
        • Ostlie K.
        • Magnus P.
        • Skjeldal O.H.
        • Garfelt B.
        • Tambs K.
        Mental health and satisfaction with life among upper limb amputees: a Norwegian population-based survey comparing adult acquired major upper limb amputees with a control group.
        Disabil Rehabil. 2011; 33: 1594-1607
        • World Health Organization
        International Classification of Functioning, Disability and Health.
        World Health Organization, Geneva2001
        • Waddell G.
        • Burton K.
        Is work good for health and well-being?.
        TSO, London2006
        • Ross C.E.
        • Mirowsky J.
        Does employment affect health?.
        J Health Soc Behav. 1995; 36: 230-243
        • Van der Sluis C.K.
        • Hartman P.P.
        • Schoppen T.
        • Dijkstra P.U.
        Job adjustments, job satisfaction and health experience in upper and lower limb amputees.
        Prosthet Orthot Int. 2009; 33: 41-51
        • Fernandez A.
        • Isusi I.
        • Gomez M.
        Factors conditioning the return to work of upper limb amputees in Asturias, Spain.
        Prosthet Orthot Int. 2000; 24: 143-147
        • Wright T.W.
        • Hagen A.D.
        • Wood M.B.
        Prosthetic usage in major upper extremity amputations.
        J Hand Surg [Am]. 1995; 20: 619-622
        • Sjöberg L.
        • Nilsagard Y.
        • Fredriksson C.
        Life situation of adults with congenital limb reduction deficiency in Sweden.
        Disabil Rehabil. 2014; 36: 1562-1571
        • McDonald M.
        • DiBonaventura M.
        • Ullman S.
        Musculoskeletal pain in the workforce: the effects of back, arthritis, and fibromyalgia pain on quality of life and work productivity.
        J Occup Environ Med. 2011; 53: 765-770
        • Jones L.E.
        • Davidson J.H.
        Save that arm: a study of problems in the remaining arm of unilateral upper limb amputees.
        Prosthet Orthot Int. 1999; 23: 55-58
        • Hanley M.A.
        • Ehde D.M.
        • Jensen M.
        • Czerniecki J.
        • Smith D.G.
        • Robinson L.R.
        Chronic pain associated with upper-limb loss.
        Am J Phys Med Rehabil. 2009; 88: 742-751
        • Ephraim P.L.
        • Wegener S.T.
        • MacKenzie E.J.
        • Dillingham T.R.
        • Pezzin L.E.
        Phantom pain, residual limb pain, and back pain in amputees: results of a national survey.
        Arch Phys Med Rehabil. 2005; 86: 1910-1919
        • Blyth F.M.
        • March L.M.
        • Nicholas M.K.
        • Cousins M.J.
        Chronic pain, work performance and litigation.
        Pain. 2003; 103: 41-47
        • Tuomi K.
        • Ilmarinen J.
        • Jahkola A.
        • Katajarinne L.
        • Tulkki A.
        Work ability index.
        2nd ed. Finnish Institute of Occupational Health, Helsinki1997
        • Brouwer W.B.
        • Koopmanschap M.A.
        • Rutten F.F.
        Productivity losses without absence: measurement validation and empirical evidence.
        Health Policy. 1999; 48: 13-27
        • Tang K.
        Estimating productivity costs in health economic evaluations: a review of instruments and psychometric evidence.
        Pharmacoeconomics. 2015; 33: 31-48
        • Opsteegh L.
        • Soer R.
        • Reinders-Messelink H.A.
        • Reneman M.F.
        • van der Sluis C.K.
        Validity of the dictionary of occupational titles for assessing upper extremity work demands.
        PLoS One. 2010; 5: e15158
        • Hildebrandt V.H.
        • Bongers P.M.
        • van Dijk F.J.
        • Kemper H.C.
        • Dul J.
        The Dutch Musculoskeletal Questionnaire for the measurement of musculoskeletal workload in worker groups: description and basic qualities.
        Vrije Universiteit van Amsterdam, Amsterdam2001
        • Van der Zee K.I.
        • Sanderman R.
        Het meten van de algemene gezondheidsdtoestand met de RAND-36: een handleiding.
        ([Measuring general health with the RAND-36: a manual.]) Noordelijk Centrum voor Gezondheidsvraagstukken, Groningen1993
        • Schreurs P.J.
        • van de Willige G.
        • Tellegen B.
        • Brosschot J.F.
        [Revised manual of the Utrecht Coping List (UCL)] [Dutch].
        Swets & Zeitlinger, Lisse1993
        • Tait R.C.
        • Chibnall J.T.
        • Krause S.
        The Pain Disability Index: psychometric properties.
        Pain. 1990; 40: 171-182
        • Tait R.C.
        • Pollard C.A.
        • Margolis R.B.
        • Duckro P.N.
        • Krause S.J.
        The Pain Disability Index: psychometric and validity data.
        Arch Phys Med Rehabil. 1987; 68: 438-441
        • Soer R.
        • Koke A.J.
        • Vroomen P.C.
        • et al.
        Extensive validation of the Pain Disability Index in three groups of patients with musculoskeletal pain.
        Spine. 2013; 38: e562-e568
        • Statistics Netherlands
        [Labor force: binding labor market 2000-2014].
        ([Dutch]. Beroepsbevolking; binding arbeidsmarkt 2000-2014)February 13, 2015 (Available at:) (Accessed June 6, 2015)
        • Sadosky A.B.
        • DiBonaventura M.
        • Cappelleri J.C.
        • Ebata N.
        • Fujii K.
        The association between lower back pain and health status, work productivity, and health care resource use in Japan.
        J Pain Res. 2015; 8: 119-130
        • Sadosky A.B.
        • Bushmakin A.G.
        • Cappelleri J.C.
        • Lionberger D.R.
        Relationship between patient-reported disease severity in osteoarthritis and self-reported pain, function and work productivity.
        Arthritis Res Ther. 2010; 12: R162
        • Scotland T.R.
        • Galway H.R.
        A long-term review of children with congenital and acquired upper limb deficiency.
        J Bone Joint Surg Br. 1983; 65: 346-349
        • Biddiss E.
        • Chau T.
        Upper-limb prosthetics: critical factors in device abandonment.
        Am J Phys Med Rehabil. 2007; 86: 977-987
        • Johansen H.
        • Ostlie K.
        • Andersen L.O.
        • Rand-Hendriksen S.
        Adults with congenital limb deficiency in Norway: demographic and clinical features, pain and the use of health care and welfare services. A cross-sectional study.
        Disabil Rehabil. 2015; 37: 2076-2082