Highlights
- •Musculoskeletal complaints occur frequently in individuals with upper limb absence with considerable consequences.
- •Individuals with reduction deficiency or acquired amputation need clinical attention because both groups are prone to musculoskeletal complaints.
- •Musculoskeletal complaint prevention programs are warranted and should include assessment of mental health.
- •Individuals with high perceived physical work demands experience musculoskeletal complaints more often.
- •Older individuals should be monitored specifically for musculoskeletal complaints and related disability.
Abstract
Objective
(1) To determine the prevalence of musculoskeletal complaints (MSCs) in individuals
with upper limb absence in The Netherlands, (2) to assess the health status of individuals
with upper limb absence in general and in relation to the presence of MSCs, and (3)
to explore the predictors of development of MSCs and MSC-related disability in this
population.
Design
Cross-sectional study: national survey.
Setting
Twelve rehabilitation centers and orthopedic workshops.
Participants
Individuals (n=263; mean age, 50.7±16.7y; 60% men) ≥18 years old, with transverse
upper limb reduction deficiency (42%) or amputation (58%) at or proximal to the carpal
level (response, 45%) and 108 individuals without upper limb reduction deficiency
or amputation (n=108; mean age, 50.6±15.7y; 65% men) (N=371).
Interventions
Not applicable.
Main Outcome Measures
Point and year prevalence of MSCs, MSC-related disability (Pain Disability Index),
and general health perception and mental health (RAND-36 subscales).
Results
Point and year prevalence of MSCs were almost twice as high in individuals with upper
limb absence (57% and 65%, respectively) compared with individuals without upper limb
absence (27% and 34%, respectively) and were most often located in the nonaffected
limb and upper back/neck. MSCs were associated with decreased general health perception
and mental health and higher perceived upper extremity work demands. Prosthesis use
was not related to presence of MSCs. Clinically relevant predictors of MSCs were middle
age, being divorced/widowed, and lower mental health. Individuals with upper limb
absence experienced more MSC-related disability than individuals without upper limb
absence. Higher age, more pain, lower general and mental health, and not using a prosthesis
were related to higher disability.
Conclusions
Presence of MSCs is a frequent problem in individuals with upper limb absence and
is associated with decreased general and mental health. Mental health and physical
work demands should be taken into account when assessing such a patient. Clinicians
should note that MSC-related disability increases with age.
Keywords
List of abbreviations:
CI (confidence interval), MSC (musculoskeletal complaint)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: February 21, 2016
Footnotes
Supported by Stichting Beatrixoord Noord Nederland (project no. 210.134).
The sponsor had no role in study design, data collection and analysis, interpretation of data, and writing of the report.
Disclosures: none.
Identification
Copyright
© 2016 by the American Congress of Rehabilitation Medicine
